Morbid Obesity in Adolescents
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Kurt Widhalm Gerhard Prager Editors Morbid Obesity in Adolescents Conservative Treatment and Surgical Approaches
Editors Kurt Widhalm Department of Pediatrics Division Nutrition and Metabolism Medical University of Vienna Vienna Austria Gerhard Prager Department of Surgery Vienna Austria ISBN 978-3-7091-0967-0 ISBN 978-3-7091-0968-7 (ebook) DOI 10.1007/978-3-7091-0968-7 Springer Wien Heidelberg New York Dordrecht London Library of Congress Control Number: 2014953906 Springer-Verlag Wien 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Preface Overnutrition, Overweight, and Obesity are the main health problems in industrialized countries worldwide. One of the most striking phenomena is the prevalence in which many young individuals are affected with obesity and its health- and psychological consequences. These health hazards are much more influencing on the general well-being of children and adolescents and their families than most medical practitioners can imagine. Data has been showing that the quality of life in adolescents affected with the burden of obesity can be compared to subjects suffering from cancerous diseases. Moreover, the many morbidly obese young subjects are a group of patients who are affected with very severe problems in regard to metabolism, skeletal health, and skin. They often are unable to take part in sportive activities and tend to be socially isolated with a high probability of becoming depressive. Most of the available conservative treatment procedures are not adequately successful; therefore many centers around the world have commenced with surgical methods in the last decade. It is obvious that these procedures are very drastic and invasive and are accompanied by side effects like nutritional deficiencies, psychological disorders, and, in some cases, consequent surgical interventions. Based on these facts we tried to bring outstanding experts from various fields together and organized a 2-day meeting in Vienna. Our aim for this book was to present the lectures in a comprehensive form, dealing with different aspects of bariatric surgery in adolescent patients from epidemiology, effects on metabolism, accompanying diseases, options for conservative treatments, legal aspects, and the very experiences from international bariatric centers. We hope that physicians, pediatricians, surgeons, clinical nutritionists, psychologists, and social care workers will receive appropriate and evidence-based information in this rather new field of adolescent medicine. One final goal should be to focus on the importance of efforts to prevent morbid obesity from occurring. Vienna, Austria Vienna, Austria K. Widhalm G. Prager v
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Contents 1 Paediatric Body Composition Measurement Techniques in Morbidly Obese Patients... 1 Caterina Tosi and Angelo Pietrobelli 2 Insulin Resistance in the Morbidly Obese Adolescent... 7 Ram Weiss 3 Inflammation as a Trigger for Insulin Resistance and Cardiometabolic Disease... 15 Thomas M. Stulnig 4 Inpatient Lifestyle Interventions to Treat Childhood Obesity... 21 Wolfgang Siegfried and Thomas Reinehr 5 Conservative Treatment for Morbidly Obese Adolescents: The German Experience... 27 Andreas van Egmond-Fröhlich 6 Comorbidities: Non Alcoholic Fatty Liver in Childhood Obesity... 41 Birgit Jödicke and Susanna Wiegand 7 Measurement of Atherosclerosis in Morbidly Obese Adolescents... 55 Andrea Willfort-Ehringer and Michael E. Gschwandtner 8 Arthritis and Joint Problems in Morbidly Obese Adolescents... 67 Harald K. Widhalm 9 Bariatric Surgery in Adolescents: Practical Guidelines from a Pediatrician s Point of View... 75 Kurt Widhalm and Oliver Helk vii
viii Contents 10 Vitamin Deficiencies After Bariatric Surgery?... 83 Oliver Helk and Kurt Widhalm 11 Laparoscopic Gastric Banding... 93 Karl Miller 12 Metabolic Surgery in Adolescents... 101 Gerhard Prager, M. Poglitsch, and F. Langer 13 Situation in Sweden... 117 Carl-Erik Flodmark 14 Experiences from Adolescents at the Viennese Center for Bariatric Surgery... 139 Kurt Widhalm, Oliver Helk, and Gerhard Prager 15 Is There an Indication for BPD-DS/BPD? What the Potential Advantages/Disadvantages to RYNGB?... 145 Rudolf A. Weiner and Sylvia Weiner 16 Psychological, Nutritional and Sports-Scientific Aspects of Obesity in Adolescence... 159 Elisabeth Ardelt-Gattinger, Susanne Ring-Dimitriou, Sabine Dämon, Markus Meindl, Karl Miller, Mirjam Neubauer, Leonhard Thun-Hohenstein, and Daniel Weghuber 17 Current Guidelines of Bariatric Surgery in Adolescents... 173 Martin Fried, Karin Dolezalova, and Petra Sramkova 18 Cardiovascular Risk in Childhood Obesity... 183 Thomas Reinehr