List of contributors | p. xi |
Foreword | p. xv |
William H. DietzPreface | p. xix |
Part I Causes | p. 1 |
1 Measurement and definition | p. 3 |
Tim J. Cole and Marie Francoise Rolland-Cachera1.1 Introduction | p. 3 |
1.2 Natural history of adiposity | p. 4 |
1.3 Measurement of body fat | p. 4 |
1.4 Adiposity as proxy for later adiposity, morbidity and mortality | p. 14 |
1.5 Definition of childhood obesity | p. 15 |
1.6 Conclusions | p. 22 |
1.7 References | p. 22 |
2 Epidemiology | p. 28 |
Michele Guillaume and Inge Lissau2.1 Introduction | p. 28 |
2.2 Epidemiology and methods | p. 28 |
2.3 The scale of the problem | p. 34 |
2.4 Conclusions | p. 44 |
2.5 References | p. 45 |
3 Molecular and biological factors with emphasis on adipose tissue development | p. 50 |
Martin Wabitsch3.1 Introduction | p. 50 |
3.2 Regulation of body weight | p. 51 |
3.3 Single gene defects | p. 52 |
3.4 Regulation of body energy stores at adipose tissue level | p. 55 |
3.5 Changes of body fat stores during development | p. 55 |
3.6 Changes at cellular level related to changes in body fat | p. 57 |
3.7 Lipid storage in adipose tissue (lipogenesis) | p. 58 |
3.8 Lipid mobilization (lipolysis) | p. 59 |
3.9 Preadipocytes in human adipose tissue | p. 60 |
3.10 Proliferation and differentiation of preadipocytes | p. 60 |
3.11 Adipogenic activity of human serum | p. 60 |
3.12 Hormonal and nutritional factors regulating adipose differentiation | p. 62 |
3.13 Human adipocytes are secretory cells | p. 65 |
3.14 Conclusions | p. 66 |
3.15 References | p. 66 |
4 Nutrition | p. 69 |
Marie Francoise Rolland-Cachera and France Bellisle4.1 Introduction | p. 69 |
4.2 Secular trends of nutrition and obesity | p. 69 |
4.3 Relationship between nutrition and adiposity | p. 74 |
4.4 Qualitative assessment of intake behaviour | p. 79 |
4.5 Lifestyle | p. 83 |
4.6 Conclusions | p. 85 |
4.7 References | p. 86 |
5 Physical Activity | p. 93 |
Yves Schutz and Claudio Maffeis5.1 Introduction | p. 93 |
5.2 Energy expenditure assessment | p. 93 |
5.3 Energy intake vs. energy expenditure | p. 94 |
5.4 Components of total energy expenditure | p. 95 |
5.5 Excess energy intake vs. low energy expenditure | p. 98 |
5.6 Aerobic capacity (VO [subscript 2 max]) in obesity | p. 101 |
5.7 Substrate oxidation and substrate balance | p. 102 |
5.8 Conclusions | p. 104 |
5.9 References | p. 105 |
6 Psychosocial factors | p. 109 |
Andrew J. Hill and Inge Lissau6.1 Children's social background | p. 109 |
6.2 Attitudes to obesity | p. 111 |
6.3 Children's self-worth | p. 115 |
6.4 Parents and peers | p. 118 |
6.5 Conclusions | p. 122 |
6.6 References | p. 123 |
Part II Consequences | p. 129 |
7 Clinical features, adverse effects and outcome | p. 131 |
Karl F.M. Zwiauer and Margherita Caroli and Ewa Malecka-Tendera and Elizabeth M.E. Poskitt7.1 Clinical findings and immediate adverse effects | p. 131 |
7.2 Intermediate medical consequences | p. 142 |
7.3 Long-term consequences | p. 145 |
7.4 References | p. 147 |
8 The obese adolescent | p. 154 |
Marie-Laure Frelut and Carl-Erik Flodmark8.1 Biophysical factors | p. 154 |
8.2 Psychological aspects | p. 160 |
8.3 References | p. 166 |
9 Prader-Willi and other syndromes | p. 171 |
Giuseppe Chiumello and Elizabeth M.E. Poskitt9.1 Introduction | p. 171 |
9.2 Endocrine problems | p. 171 |
9.3 Prader-Willi syndrome (PWS) | p. 174 |
9.4 Other obesity syndromes | p. 180 |
9.5 References | p. 184 |
10 Hormonal and metabolic changes | p. 189 |
Ewa Malecka-Tendera and Denes Molnar10.1 Pituitary-adrenal axis | p. 190 |
10.2 Pituitary-gonadal axis | p. 192 |
10.3 Pituitary-thyroid axis | p. 194 |
10.4 Growth hormone and insulin-like growth factors | p. 195 |
10.5 Hyperinsulinaemia and insulin resistance | p. 198 |
10.6 Leptin | p. 203 |
10.7 References | p. 209 |
11 Risk of cardiovascular complications | p. 221 |
David S. Freedman and Sathanur R. Srinivasan and Gerald S. Berenson11.1 Introduction | p. 221 |
11.2 Secular trends | p. 223 |
11.3 Associations with risk factors | p. 224 |
11.4 Body fat patterning | p. 230 |
11.5 Longitudinal analyses | p. 234 |
11.6 Conclusions | p. 235 |
11.7 References | p. 235 |
Part III Prevention and management | p. 241 |
12 Prevention | p. 243 |
Inge Lissau and Walter Burniat and Elizabeth M.E. Poskitt and Tim J. Cole12.1 Prevention before management | p. 243 |
12.2 Why prevention? | p. 243 |
12.3 Prevention strategy | p. 245 |
12.4 Responsibilities for prevention | p. 248 |
12.5 Reduce sedentary activity | p. 252 |
12.6 Reduce poor dietary habits | p. 257 |
12.7 Prevention programmes | p. 263 |
12.8 Monitoring and evaluation | p. 264 |
12.9 Conclusions | p. 264 |
12.10 References | p. 265 |
13 Home-based management | p. 270 |
Elizabeth M.E. Poskitt13.1 Introduction | p. 270 |
13.2 Principles of modifying lifestyles to encourage slimming in obese children | p. 273 |
13.3 What can be recommended? | p. 275 |
13.4 Eating and diet | p. 277 |
13.5 Conclusions | p. 280 |
13.6 References | p. 280 |
14 Dietary management | p. 282 |
Margherita Caroli and Walter Burniat14.1 Introduction | p. 282 |
14.2 History of dietary therapy | p. 282 |
14.3 Aims of dietary treatment | p. 283 |
14.4 Types of diet | p. 284 |
14.5 Consequences of dieting | p. 290 |
14.6 Guidelines for weight goals and dietetic treatments | p. 299 |
14.7 Conclusions | p. 301 |
14.8 References | p. 302 |
15 Management through activity | p. 307 |
Jana Parizkova and Claudio Maffeis and Elizabeth M.E. Poskitt15.1 Introduction | p. 307 |
15.2 Aims of the programmes | p. 308 |
15.3 Efficacy of exercise in lowering fat mass | p. 310 |
15.4 General principles | p. 313 |
15.5 Physical activity and exercise programmes | p. 314 |
15.6 How to improve compliance | p. 320 |
15.7 The role of the family | p. 321 |
15.8 Conclusions | p. 322 |
15.9 References | p. 323 |
16 Psychotherapy | p. 327 |
Carl-Erik Flodmark and Inge Lissau16.1 Obesity - a disease put into perspective | p. 327 |
16.2 The treatment of obesity | p. 328 |
16.3 Conclusions | p. 340 |
16.4 References | p. 341 |
17 Drug therapy | p. 345 |
Denes Molnar and Ewa Malecka-Tendera17.1 Appetite suppressants | p. 345 |
17.2 Thermogenic agents | p. 348 |
17.3 Digestive inhibitors | p. 349 |
17.4 Hormone analogues and antagonists | p. 350 |
17.5 References | p. 352 |
18 Surgical treatment | p. 355 |
Alessandro Salvatoni18.1 Introduction | p. 355 |
18.2 Surgical techniques and their complications | p. 355 |
18.3 Bariatric surgery in adolescence | p. 357 |
18.4 Conclusions | p. 358 |
18.5 References | p. 358 |
19 Interdisciplinary outpatient management | p. 361 |
Beatrice Bauer and Claudio Maffeis19.1 Goal and general philosophy | p. 361 |
19.2 Multifaceted treatment programmes | p. 364 |
19.3 Organizing team work | p. 370 |
19.4 Acknowledgements | p. 374 |
19.5 References | p. 374 |
20 Interdisciplinary residential management | p. 377 |
Marie-Laure Frelut20.1 Historical background and implementation | p. 377 |
20.2 A comprehensive approach | p. 378 |
20.3 Results and outcome | p. 385 |
20.4 Conclusions | p. 386 |
20.5 References | p. 386 |
21 The future | p. 389 |
W. Philip T. James21.1 Introduction | p. 389 |
21.2 Assessment of childhood obesity | p. 389 |
21.3 Ethnic differences in children's anthropometry | p. 391 |
21.4 The Thrifty Genotype | p. 393 |
21.5 The prevalence of childhood obesity | p. 394 |
21.6 Weaning practices and early eating habits | p. 395 |
21.7 The 'obesogenic' environment | p. 396 |
21.8 Can policy initiatives work? | p. 397 |
21.9 Devising and implementing new policies | p. 399 |
21.10 References | p. 401 |
Index | p. 403 |