Sample Solution

Other drugs used only in certain special situations are:
• Growth hormone: Prader Willi syndrome
• Octreotide: Hypothalamic obesity
• Leptin: Leptin deficiency
The FDA approved a number of weight-loss medications for adults and these medications are appropriate for those ≥16 years of age with BMI ≥30kg/m2 or who have BMI ≥27 kg/m2 and at least one weight related comorbidity (e.g., hypertension or T2DM).
Medication should be discontinued and the child should be re-evaluated if he/she does not have a 0.4% BMI/BMI z-score reduction after taking full dose of anti-obesity medication for 12 weeks.
BARIATRIC SURGERY
Pre-requisites (Endocrine Society recommendations):
1) Adolescent Tanner 4-5, and final/near final adult height.
2) BMI 40kg/m2 or BMI >35kg/m2 and significant extreme comorbidities.
3) Extreme obesity and co-morbidities persist despite lifestyle modification, with or without trial of pharmacotherapy.
4) Psychological evaluation confirms stability & competence of the family
5) Patient demonstrates ability to adhere to the principles of healthy dietary and activity habits.
6) Access to experienced surgeon in medical center.

Contraindications of bariatric surgery: preadolescents, pregnant/ breastfeeding, unresolved eating disorder, untreated psychiatric disorder, or Prader-Willi syndrome.

PREVENTION