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New Strategy to Manage Childhood Obesity
New Strategy to Manage Childhood Obesity

Medscape

time21 hours ago

  • Health
  • Medscape

New Strategy to Manage Childhood Obesity

Obesity is increasingly considered unpreventable, making early and aggressive treatment a priority to minimize comorbidities. Although 30% of adult obesity begins in childhood, the most effective treatments for childhood obesity — medication and surgery — are often delayed in favor of diet and exercise, which are largely ineffective. In this ReCAP, Dr Janey Pratt, director of the Adolescent Bariatric Surgery Program at Lucille Packard Children's Hospital, Stanford, California, points to a recent Cochrane database systematic review which showed school-based diet and exercise interventions did not prevent or reduce childhood obesity. She goes on to explain the most recent American Academy of Pediatrics Clinical Practice Guidelines which, for the first time, recommend that treatment, rather than watchful waiting, is indicated for childhood obesity. Dr Pratt explains that FDA-approved obesity medications are an option for children as young as age 12, but surgery often has better long-term results. She outlines the medications available to treat childhood obesity, and then the 10-year outcomes of the Teen-LABS study, which show that half of adolescents who underwent bariatric surgery for obesity maintained significant weight loss. She concludes that a strategy of surgery first, followed by medication if needed, can optimize childhood obesity management and avoid lifelong medication for some patients.

Bariatric Surgery Linked With Psoriasis Improvement
Bariatric Surgery Linked With Psoriasis Improvement

Medscape

time29-05-2025

  • Health
  • Medscape

Bariatric Surgery Linked With Psoriasis Improvement

Most patients with psoriasis experienced clinical improvement or remission after metabolic and bariatric surgery (MBS) in a systematic review. METHODOLOGY: Researchers conducted a systematic review of 14 studies that included 169 patients (mean age, 46.8 years; 74% women) with psoriasis who underwent MBS. Participants underwent various surgical procedures; gastric bypass was the most common (75.1%), followed by sleeve gastrectomy (17.8%), gastric banding (5.3%), and jejunoileal bypass (0.6%). Psoriasis treatments prior to surgery included topical treatments (46.2%), non-biologic systemic treatments (35.5%), and biologics (16.6%). At baseline, psoriasis severity was predominantly moderate (76.3%); 8.2% were severe and 15.6% were mild cases, based on psoriasis area and severity index and percent body surface area scores. TAKEAWAY: Average body mass index (BMI) decreased from 43.7 at baseline to 32.9after surgery, with BMI reduction ranging from 8 to 25 during follow-up periods of 4 months to 9 years. Psoriasis was either mild or had completely resolved in 97.2% of patients after bariatric surgery, whereas 2.4% experienced worsening of psoriasis. A total of 78.1% of patients continued psoriasis treatment post-surgery, but medications were downgraded to a lower category (such as systemic to topical treatments, or no treatment) in many patients. IN PRACTICE: 'MBS may improve psoriasis outcomes following surgery,' the study authors wrote. 'While initial findings are promising, further controlled trials are necessary to validate the long-term effects of MBS on psoriasis and explore its potential role as an adjunctive therapy.' SOURCE: The study was led by Miranda K. Branyiczky, BSc, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada, and was published online on May 24 in the Journal of the American Academy of Dermatology . LIMITATIONS: Limitations were reporting bias, variability in outcome measures, and the inclusion of case reports or series. DISCLOSURES: This study did not receive any funding. One author reported receiving grants, research support, speaker fees, and honoraria from multiple pharmaceutical companies including AbbVie, Alumis, Amgen, Arcutis Biotherapeutics, Bristol Myers Squibb, Eli Lilly and Company, Janssen Pharmaceuticals, Novartis, and Pfizer.

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