Obesity  is defined as a body mass index (BMI) greater than  the 95th percentile for age  and gender.

• Although genetics  and some  disorders cause obesity, most  adolescent obesity results from a lack  of physical activity  and overeating. 
• The diagnosis  is based on a BMI over  the 95th percentile. 
• Eating a nutritious diet, moving more,  and going  to counseling help treat obesity. 

Obesity  is twice as common among adolescents as it  was 30 years ago. Although most of the complications  of obesity occur  in adulthood (see Obesity  and the Metabolic Syndrome: Obesity), obese adolescents are  more likely than their peers  to have high blood pressure  and type 2 diabetes. Although fewer than one third  of obese adults  were obese as adolescents, most obese adolescents remain obese in adulthood. 

The factors that influence obesity among adolescents are  the same as those among adults. Parents often are concerned  that obesity is the result of some type  of endocrine disease,  such as hypothyroidism  or hyperadrenocorticism, but  such disorders are rarely  the cause. Adolescents with  weight gain caused by endocrine disorders are usually  of small stature  and have other signs  of the underlying disorder. An adolescent who  is short  and has high blood pressure should be tested  for Cushing's syndrome (see Adrenal Gland Disorders: Cushing's Syndrome). Although genetic influences are common  and responsible genes  are now being identified, most obese adolescents simply consume more calories than they burn. Because  of society's stigma against obesity, many obese adolescents have a poor self-image  and become increasingly  sedentary and socially isolated. 

Intervention  for obese adolescents should be focused on developing healthy eating  and exercise habits rather than  on losing a specific amount  of weight. Caloric intake is reduced by 

• Establishing a well-balanced diet  of ordinary foods 
• Making permanent changes  in eating habits 

Calorie burning  is increased  by

• Increasing physical activity 

Summer camps  for obese adolescents usually help them lose  a significant amount  of weight,  but without continuing effort,  the weight usually is regained. Counseling  to help adolescents cope with their problems, including poor self-esteem, may be helpful. 

Drugs that help  reduce weight are generally not used during adolescence because  of concerns about safety and possible abuse. One exception is for obese adolescents with a strong family history  of type 2 diabetes. They  are at high  risk of developing diabetes. The drug metformin, which  is used to treat diabetes, may help them lose  weight and also lower their risk of developing diabetes. 

Notes: Dr. Nelson Crumfield

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EditText of this page (last edited June 17, 2010)