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ObesityOct 22, 2022

Focus on family support, quality of life and play when treating obesity in children and adolescents

Dublin-based physiotherapist and academic Grace O’Malley led a team that created up-to-date guidelines for health professionals working with children and adolescents who are obese.

Dr O’Malley said: ‘For the first time in Ireland we are seeing direct investment in healthcare services for child and adolescent obesity through the HSE’s [Health Service Executive] Obesity National Clinical Programme.’

She was commenting on the publication of the guidelines in an article in Frontiers in Nutrition earlier this month (12 October) for the RSCI University of Medicine and Health Sciences’ website.

Dr O’Malley, who is the principal investigator of the RCSI Obesity Research and Care Group, said the guidelines could provide a springboard for further research.

 

Photo Credit: RCSI
Grace O'Malley, a physiotherapist by background, has an international reputation in the field

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Treatment should address a number of different factors in the child’s life to support high-quality nutrition, child development, play, sleep and family dynamics while being delivered by a range of health professionals with training in obesity care [Grace O'Malley]

Support for health professionals

Dr O'Malley noted: 'Our clinical guideline work will support health professionals and policy makers, ensuring the design and implementation of obesity services are guided by scientific evidence. Our work also identified clear gaps within existing clinical guidelines for childhood obesity and will help researchers to develop future studies with significant impact for children, families and the health system.’

Dr O’Malley’s team conducted a systematic review of the evidence and analysed nine high-quality guidelines, she said. ‘We found that family-orientated treatments are recommended as the first steps of treatment for childhood obesity and that different approaches are needed as the child develops into an adolescent.'

Dr O’Malley, who also holds a position at Children’s Health Ireland Child and Adolescent Obesity Service, noted: ‘Unfortunately, very little research to date has focused on the importance of adolescent health and the transition services required for adolescents moving from paediatric healthcare into adult healthcare.’

‘Treatment should address a number of different factors in the child’s life to support high-quality nutrition, child development, play, sleep and family dynamics while being delivered by a range of health professionals with training in obesity care.’

Poverty a priority

The guidelines tackle treatment approaches such as exercise therapy, sleep therapy, medications and surgery, and examine ways to address issues including family poverty, deprivation, access to healthy food and safe places to play.

The researchers focused on the main recommendations from nine international guidelines for treating obesity in children and adolescents. More information is needed on how health professionals are trained to assess and treat child and adolescent obesity, and how to address obesity-related stigma and bias, they suggest.

Systematic approach

‘Obesity is a chronic disease that is negatively affecting the physical and mental health of increasing numbers of children worldwide, and rates of obesity are increasing particularly quickly among young people from low-income households, said co-author Louise Tully, from the RCSI School of Physiotherapy.

Dr Tully added: ‘We need to prioritise access to quality care for children who have health complications related to obesity in order to improve their quality of life and slow down or reverse breathing difficulties, joint pain, non-alcoholic fatty liver disease and early type 2 diabetes.

‘Clinical guidelines exist to guide general practitioners and other health and social care professionals on how to help children and their families, but to date no-one had looked at these guidelines in a systematic way.’

RCSI University of Medicine and Health Sciences, Children’s Health Ireland, University College Dublin, St Vincent’s University Hospital, Dublin, St Columcille’s Hospital Weight Management Service, Loughlinstown, University of Limerick and University Hospital Limerick all collaborated on the study. The research was funded by the Department of Health – Sláintecare Integration Fund, the Health Research Board and the HSE Health and Wellbeing Division.

Key social factors needing attention include

food insecurity

limited cooking skills

inadequate housing

access to safe, fun and age-appropriate active play

To see the full version of the article, titled Guidelines for treating child and adolescent obesity: A systematic review, visit: https://www.frontiersin.org/articles/10.3389/fnut.2022.902865/full

Author: Ian A McMillan
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