Adipositas im Kindes- und Jugendalter

Zusammenfassung

Adipositas ist bereits im Kindes- und Jugendalter mit einer Vielzahl von kardiovaskulären Risikofaktoren assoziiert. Während diese meist asymptomatisch sind, leiden die adipösen Kinder v. a. unter den psychosozialen Folgen. Die Ursache der Adipositas im Kindesalter ist meist multifaktoriell und reicht von genetischen Faktoren über Umweltfaktoren bis hin zur familiären Situation. Bisherige Präventionskonzepte sind noch nicht nachhaltig überzeugend. Die Therapie der Wahl besteht aus einer Lebensstilintervention basierend auf Schulungsprogrammen. Misserfolge sind nicht nur auf fehlende Motivation, sondern auch auf die Gegenregulation des Körpers bei Gewichtsabnahme zurückzuführen. Die Therapie der extremen Adipositas im Jugendalter ist ein ungelöstes Problem, da Schulungsprogramme in der Regel nicht erfolgreich sind. Bariatrische Verfahren können zwar effektiv das Ausmaß des Übergewichts reduzieren, haben jedoch vielfältige Nebenwirkungen und benötigen eine lebenslange Betreuung, welche vor Beginn der Operation gewährleistet sein muss.

Abstract

Obesity in childhood and adolescence is associated with multiple cardiovascular risk factors. Most of them are asymptomatic and the obese children suffer from psychosocial consequences. The causes of obesity in childhood are mainly multi-factorial including beside others genetic factor, family stetting and environmental factors. Preventions concepts have failed so far to reduce effectively the prevalence of obesity. The treatment of choice is lifestyle intervention. Failures are not only caused by lack of motivation but also by counter regulation of body weight in weight loss. Therapy of extreme obese adolescents has not been solved. Bariatric surgery is able to reduce weight in these adolescents however, the complications and side effects have to be kept in mind. Furthermore, there is a need for a life-long medical care, which has to be guaranteed before surgery.

Schlüsselwörter

Adipositas bei Kindern - Lebensstilintervention - Prävention - metabolisches Syndrom - bariatrische Chirurgie

Keywords

obesity in childhood - lifestyle intervention - prevention - metabolic syndrome - bariatric surgery

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