Continuing Medical Education

A weighty matter: Identification and management of overweight and obesity in adolescents

Nasheeta Peer, Yasmeen N Ganie

Abstract


Overweight and obesity are common in South African boys (18.8%) and girls (26.3%). Considering the potential serious consequences of
these conditions, clinicians need to identify overweight and obese adolescents to enable early diagnosis and treatment. The key contributor in
adolescents is increased intake of unhealthy foods and lower levels of physical activity. The consequences of overweight and obesity in adolescence
are multisystemic and include cardiometabolic
(type 2 diabetes mellitus, high blood pressure, dyslipidaemia), respiratory (obstructive sleep
apnoea), gastrointestinal (non-alcoholic fatty liver disease), musculoskeletal, psychological (depression) and social (stigmatisation) effects.
Body mass index (BMI) is calculated to determine overweight and obesity in adolescents. Numerous expert committees, despite using different
methods, classify overweight and obesity in children by age- and gender-specific cut points for BMI. After a diagnosis of overweight and
obesity, secondary causes must be excluded, and a history of dietary intake, physical activity and sedentary behaviour obtained. This will
identify modifiable behaviours that promote energy imbalance. All obese adolescents should undergo cardiometabolic assessments comprising
fasting glucose, lipid and blood pressure measurements every 2 years. Interventions
should focus on creating healthier home environments that
provide easy access to healthy foods, encourage physical activity and discourage sedentary behaviour. Medication for weight loss or bariatric
surgery may be considered for severely obese adolescents who do not respond to other strategies.


Authors' affiliations

Nasheeta Peer, Non-communicable Diseases Research Unit, South African Medical Research Council, Durban; and Department of Medicine, Faculty of Health Sciences, University of Cape Town

Yasmeen N Ganie, Division of Paediatric Endocrinology and Metabolic Diseases, Inkosi Albert Luthuli Central Hospital, Durban; and Department of Paediatrics and Child Health, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban

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Keywords

Overweight; Obesity; Adolescence

Cite this article

South African Medical Journal 2016;106(7):662-665. DOI:10.7196/SAMJ.2016.v106i7.10946

Article History

Date submitted: 2016-04-20
Date published: 2016-06-17

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