Update on diagnosis and management of childhood obesities

The high prevalence of overweight and obesity in the infant and adolescent population has resulted in the latter being one of the most frequent reasons for consultation in our country in Pediatric Offices, both in primary care and in hospital care, as well as for referral for specialized evaluation in pediatric endocrinology consultations. In addition, the increasingly frequent development of very severe (even extreme) forms of obesity before reaching adulthood, in many cases with early onset including even from the first months of life, has led to increased research efforts aimed not only to the diagnosis of specific etiological entities underlying the excessive accumulation of adipose tissue, but also to the development of pharmacological treatments applicable to the different etiologies of the disease during the pediatric age. These pharmacological treatments necessarily need to be accompanied by correction of the imbalance between energy intake and expenditure present in almost all children and adolescents suffering from obesity by modifications in diet and exercise. This article will update the diagnostic strategies available to establish the etiological differential etiological diagnosis of the different childhood and adolescent obesities, whether they are caused by genetic (syndromic or not), endocrinological, or secondary to other underlying conditions. We will also review the current status of the therapeutic options available in the pediatric age group for the treatment of obesity with particular emphasis on the pharmacological treatments available, either specifically in the presence of well-defined diagnostic entities or non-specifically, in the absence of a confirmatory etiological diagnosis.