J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Review

Volume 2, Number 3, June 2010, pages 105-111

Pharmacological Approaches for Management of Child and Adolescent Obesity

**Table 1.** Pharmacological Approaches and Other Related Studies for the Management of Child and Adolescent Obesity-2007-2010
Authors/Year	Type of study	Methods	Results	Conclusion
1) Rogovik study/2010 [27]	Review	Review of current literature related to role of pharmacotherapy and weight loss supplements in childhood obesity management	Orlistat is the only FDA approved drug among the group of weight loss medications for the treatment of overweight and obese adolescents.	Researchers conclude that no single approach will successfully treat obesity, and lifestyle modification presently remains the main pillar of any intervention aiming at decreasing bodyweight.
2) Whitlock study/2010 [26]	Systematic review	Researchers reviewed database of abstracts	Two medications showed significant weight loss	Short-term benefits of comprehensive medium- to high-intensity behavioral interventions in obese children and adolescents.
3) Coutinho study /2009 [10]	Review	Review of several studies using combination therapy of orlistat and sibutramine	It will be plausible to combine both drugs for beneficial effects.	Orlistat has proven its efficacy in the XENDOS study. Its role in the SCOUT study is yet awaited.
4) Czernichow study/2009 [17]	Meta-analysis of Randomized-controlled trials.	Total of eight trials with sample size of 1391 individuals was included in the present analysis	The mean decrease in weight between the intervention and the control group was 5.25 kg (95% CI 3.03-7.48) after a minimum follow-up of 6 months.	There was little evidence that treatment was associated with risk on cardiovascular risk factors.
5) Kanekar study/2009 [3]	Meta-analysis	Electronic databases were searched for school-based childhood obesity interventions and a total of five studies were analyzed.	The results of the pooled estimate of reviewed studies were not significant for the outcome measure body mass index at p < 0.05 level.	Current school-based childhood obesity interventions do not seem to modify body mass index
6) Tziomalos study/2009 [11]	Review	The most important articles on sibutramine up to January 2009 were located by a PubMed and Medline search	Sibutramine reduces food intake and body weight more than placebo	Sibutramine, in conjunction with lifestyle measures, is a useful drug for reducing body weight
7) Godoy-Matos study/2009 [6]	Review	Review of non-pharmacological, pharmacological and surgical treatment for obesity.	Pharmacological and surgical management is effective in weight reduction.	Sibutramine and orlistat may be good pharmacological options when lifestyle modifications alone do not work.
8) Oude Luttikhuis study/2009 [19]	Review	Review of randomized controlled trials of lifestyle, drug and surgical interventions was done from 1985-2008	Reduction in overweight at 6 and 12 months follow up was seen with or without the addition of orlistat or sibutramine	Combined behavioral lifestyle interventions can produce a significant and clinically meaningful reduction in overweight
9) Rogovik study/2009 [21]	Review	Review of weight-loss supplements and role of pharmacotherapy	Pharmacotherapy should be considered for children older than 12 years old	Most weight-loss supplements cannot be recommended at this time for children
10) Woo study/2009 [23]	Review	Review of pharmacological treatments for obesity, surgical options and recommendations for pediatric primary care	Lifestyle modification is the mainstay of obesity treatment for all ages. Pharmacotherapy reserved for specific adolescents	Therapies that are available to treat severely obese adolescents are discussed
11) Viner study/2009 [24]	Review	Review of population-based prescribing data from UK between 1999-2006	The annual prevalence of anti obesity drug prescriptions rose significantly in 2006, a 15-fold increase	Further research into the effectiveness and safety of antiobesity drugs in clinical populations of children and adolescents is needed
12) Elfhag study/2008 [18]	Retrospective study	Data was collected on 478 obese patients on different types of previous weight loss treatments	Sibutramine and orlistat both produced weight loss	Sibutramine exhibits its greatest effects in whom eating is a natural response to hunger
13) Uli study/2008 [22]	Review	Guidelines recommended by an expert panel were used	Staged-approach for treatment of childhood obesity is suggested	Health policy interventions can prevent obesity
14) Whitlock study/2008 [25]	Review	Two systematic reviews used	Medications + behavior change	Policy development is the key
15) Moya study/2008 [20]	Review	The methodology involved identification of pediatric population at risk	Treatment guides were presented along with other individual prevention studies	Involving motivated pediatricians and better follow-up in the frame of general national preventive program can be a rational outcome
16) McGovern study/2008 [28]	Systematic review	Data sources used were nine electronic databases from inception until Feb 2006	Short-term medications were effective, including sibutramine	There is a limited evidence of short-term efficacy of medications and lifestyle interventions
17) Baumer study/2007 [5]	Review	Public health guidance clinical guidelines produced	Two quick reference guides summarize the public health and clinical recommendations for both adults and children	Need for future research related to obesity prevention
18) Danielsson study/2007 [12]	A double-blind placebo controlled cross-over study	BMI scores were analyzed using a repeated-measures design (ANOVA)	Sibutramine treated group showed a significant decrease in BMI scores compared to placebo group (p < 0.001)	Sibutramine lead to clinically and statistically significant weight reduction in short-term.
19) Singhal study/2007 [7]	Review	Evaluation of dietary, pharmacological and surgical management of obesity	Lifestyle interventions and behavioral modification are essential for obesity management	Further evaluation research is needed.
20) Spear study/2007 [8]	Review	Various behaviors reviewed	4-staged weight approach suggested	Office-based behaviors need to be modified

Table 1. Pharmacological Approaches and Other Related Studies for the Management of Child and Adolescent Obesity-2007-2010

Authors/Year

Type of study

Methods

Results

Conclusion

1) Rogovik study/2010 [27]

Review

Review of current literature related to role of pharmacotherapy and weight loss supplements in childhood obesity management

Orlistat is the only FDA approved drug among the group of weight loss medications for the treatment of overweight and obese adolescents.

Researchers conclude that no single approach will successfully treat obesity, and lifestyle modification presently remains the main pillar of any intervention aiming at decreasing bodyweight.

2) Whitlock study/2010 [26]

Systematic review

Researchers reviewed database of abstracts

Two medications showed significant weight loss

Short-term benefits of comprehensive medium- to high-intensity behavioral interventions in obese children and adolescents.

3) Coutinho study /2009 [10]

Review

Review of several studies using combination therapy of orlistat and sibutramine

It will be plausible to combine both drugs for beneficial effects.

Orlistat has proven its efficacy in the XENDOS study. Its role in the SCOUT study is yet awaited.

4) Czernichow study/2009 [17]

Meta-analysis of Randomized-controlled trials.

Total of eight trials with sample size of 1391 individuals was included in the present analysis

The mean decrease in weight between the intervention and the control group was 5.25 kg (95% CI 3.03-7.48) after a minimum follow-up of 6 months.

There was little evidence that treatment was associated with risk on cardiovascular risk factors.

5) Kanekar study/2009 [3]

Meta-analysis

Electronic databases were searched for school-based childhood obesity interventions and a total of five studies were analyzed.

The results of the pooled estimate of reviewed studies were not significant for the outcome measure body mass index at p < 0.05 level.

Current school-based childhood obesity interventions do not seem to modify body mass index

6) Tziomalos study/2009 [11]

Review

The most important articles on sibutramine up to January 2009 were located by a PubMed and Medline search

Sibutramine reduces food intake and body weight more than placebo

Sibutramine, in conjunction with lifestyle measures, is a useful drug for reducing body weight

7) Godoy-Matos study/2009 [6]

Review

Review of non-pharmacological, pharmacological and surgical treatment for obesity.

Pharmacological and surgical management is effective in weight reduction.

Sibutramine and orlistat may be good pharmacological options when lifestyle modifications alone do not work.

8) Oude Luttikhuis study/2009 [19]

Review

Review of randomized controlled trials of lifestyle, drug and surgical interventions was done from 1985-2008

Reduction in overweight at 6 and 12 months follow up was seen with or without the addition of orlistat or sibutramine

Combined behavioral lifestyle interventions can produce a significant and clinically meaningful reduction in overweight

9) Rogovik study/2009 [21]

Review

Review of weight-loss supplements and role of pharmacotherapy

Pharmacotherapy should be considered for children older than 12 years old

Most weight-loss supplements cannot be recommended at this time for children

10) Woo study/2009 [23]

Review

Review of pharmacological treatments for obesity, surgical options and recommendations for pediatric primary care

Lifestyle modification is the mainstay of obesity treatment for all ages. Pharmacotherapy reserved for specific adolescents

Therapies that are available to treat severely obese adolescents are discussed

11) Viner study/2009 [24]

Review

Review of population-based prescribing data from UK between 1999-2006

The annual prevalence of anti obesity drug prescriptions rose significantly in 2006, a 15-fold increase

Further research into the effectiveness and safety of antiobesity drugs in clinical populations of children and adolescents is needed

12) Elfhag study/2008 [18]

Retrospective study

Data was collected on 478 obese patients on different types of previous weight loss treatments

Sibutramine and orlistat both produced weight loss

Sibutramine exhibits its greatest effects in whom eating is a natural response to hunger

13) Uli study/2008 [22]

Review

Guidelines recommended by an expert panel were used

Staged-approach for treatment of childhood obesity is suggested

Health policy interventions can prevent obesity

14) Whitlock study/2008 [25]

Review

Two systematic reviews used

Medications + behavior change

Policy development is the key

15) Moya study/2008 [20]

Review

The methodology involved identification of pediatric population at risk

Treatment guides were presented along with other individual prevention studies

Involving motivated pediatricians and better follow-up in the frame of general national preventive program can be a rational outcome

16) McGovern study/2008 [28]

Systematic review

Data sources used were nine electronic databases from inception until Feb 2006

Short-term medications were effective, including sibutramine

There is a limited evidence of short-term efficacy of medications and lifestyle interventions

17) Baumer study/2007 [5]

Review

Public health guidance clinical guidelines produced

Two quick reference guides summarize the public health and clinical recommendations for both adults and children

Need for future research related to obesity prevention

18) Danielsson study/2007 [12]

A double-blind placebo controlled cross-over study

BMI scores were analyzed using a repeated-measures design (ANOVA)

Sibutramine treated group showed a significant decrease in BMI scores compared to placebo group (p < 0.001)

Sibutramine lead to clinically and statistically significant weight reduction in short-term.

19) Singhal study/2007 [7]

Review

Evaluation of dietary, pharmacological and surgical management of obesity

Lifestyle interventions and behavioral modification are essential for obesity management

Further evaluation research is needed.

20) Spear study/2007 [8]

Review

Various behaviors reviewed

4-staged weight approach suggested

Office-based behaviors need to be modified