What is the current incidence of childhood obesity?

Today, obesity or extreme overweight primarily affects adult populations in the most developed countries, reaching percentages of 20 to 30%.

Recently, the WHO highlighted an increase in adolescent obesity: in Europe, the prevalence is 10 times higher than in the 1970s.

Nowadays, obesity and overweight are responsible for:

• Type 2 diabetes in 80% of cases;
• 35% of cases of ischemic heart disease;
• Hypertension in adults with a percentage of 55%, the cause of approximately 1 million deaths each year and an increase in years lived with disability.

What are the causes of adolescent obesity?

The main causes of obesity in adolescents are behavioral factors, sedentary lifestyles, and the increased energy content of food.

The prevalence of overweight and obesity in children aged 6 to 11 is very high nationally: 23.6% of children are overweight; 12.3% are obese.

Today, 1 in 3 children is overweight. The most frequent causes of obesity are:

• Lack of physical activity (statistically, only one in ten children engages in proper sports) and poor eating habits;
• Parental negligence often ignoring the problem;
• Excessive video game and television use;

Preventing Obesity in Young People

The Importance of a “Good Example” Set by the Family

The example set by the family is the most significant: it is not possible to expect an adolescent to follow a healthy and balanced diet if all the members of their family ignore the importance of food education.

One of the main problems caused by adolescent obesity is that, in most cases, the consequences have repercussions in adulthood, leading to the onset of pathologies, even serious ones. These pathologies include:

• Cardiovascular diseases;
• Diabetes;
• Strokes;
• Certain types of neoplasia (breast, gallbladder, endometrial, colorectal, and renal);

The Importance of Prevention

Over the past 30 years, the number of cases of childhood obesity has increased significantly, and the figures are constantly rising.

This is why the World Health Organization has defined the prevention of this pathology as a primary public health objective, also in Italy.

Childhood overweight and obesity represent a real public health emergency in the Western world, both for the short, medium, and long-term risks they entail and for the social and healthcare costs they involve. This situation has prompted many clinicians to seek the most effective strategies to control and reduce the progressive increase in the number of obese children in Western countries.

Bariatric Surgery in Children and Adolescents

Bariatric surgery in young people helps prevent other diseases

A study published in the New England Journal of Medicine, which examined the case of 242 adolescents aged 13 to 19 who underwent bariatric surgery (gastric bypass and sleeve), showed that the operation had significant beneficial effects in 90% of the cases treated. While 98% of the subjects interviewed had a body weight of more than 140 kg and a body mass index (BMI) of more than 40, three years after the operation, most of them weighed at least 40 kg less.

According to specialists, the operation can also help adolescents avoid complications related to obesity, such as diabetes, obstructive sleep apnea, and hypertension. Another research conducted in Saudi Arabia also showed that obese children and adolescents aged 5 to 21 who underwent bariatric surgery had lost 62% of their excess weight within two years of the operation, thus avoiding the onset of other diseases.

Gastric bypass, gastric banding, and sleeve gastrectomy in children and adolescents

Several bariatric surgery techniques exist, gastric bypass, gastric banding, and sleeve gastrectomy, but it has not yet been determined which is best for children and adolescents. The most commonly performed surgical interventions have a dual restrictive and hormonal mechanism of action, whereby they reduce hunger and anticipate satiety.

In recent years, bariatric surgery has been widely tested in the context of adolescent populations (<18 years), although the long-term effects in this population are not yet known. Current guidelines are stricter in this delicate age group and concern not only weight limits but also the need to have reached skeletal maturity and growth and the ability to adhere to pre- and postoperative programs. Indeed, before the operation, it is mandatory to have undergone medical treatment for at least six months in a specialized center, while after the operation, it is important to have access to a specialized pediatric support structure. Obesity surgeries are very powerful, but they are not foolproof if not managed in the best possible way. Careful selection of candidates is fundamental to obtaining the best results. However, further long-term studies are needed. The limit of applying bariatric surgery only to adult subjects has been overcome, always with reasonable caution and with the prerogative that each individual case is unique and therefore requires a personalized approach.