Emerging treatments for severe obesity in children and adolescents

Your clinical review article in BMJ was timely and brings out the need to understand the multi-dimensional problem associated with childhood obesity compared to adult obesity.

The body metabolism in a child is tuned to developmental process which is in a more synthetic phase than, say, a catabolic one.

It would be appropriate to find out the basal insulin levels in normal and obese children. We could also compare the insulin levels between, for example:

1. child with adult

2. an ageing person

in normal and obese subjects.

Rather the anabolic to catabolic hormones between these two groups.

Childhood obesity is a global problem but with possible ethnic variability flattened by a change in lifestyle aping western food habits.

Fast food, physical inactivity coupled with, say, internet games or television shows make the problem more complicated.

The easiest solution is to fall a prey to finding an anti-obesity drug influenced by corporate pharmaceutical companies and ignoring finding a long time solution to bring about behavioral change related to physical and psycho-social elements.

We need to teach children that they need to eat a diet that is culturally compatible to their genetic phenotype, with adults as examples following the advice with respect to their life style and diet.

Such an approach will help children have normal functional homeostasis contrary to say the dysfunctional metabolic homeostasis in obese children.