Obesity in Childhood and Adolescence: Risk Factors, Prevention and Intervention

Longer lasting weight loss is only achieved in 10% of obese adults, who try to lose weight. Therefore, prevention programmes for children and adolescents should have highest priority. Proximal and distal risk factors for the development of obesity include high-energy intake, low physical activity, high genetic load, low socioeconomic status and migration background. Prevention and intervention programmes need to take psychosocial factors into account and offer a personalized therapy in the respective settings. Even though cognitive behaviour therapy is superior to lifestyle intervention alone, as weight loss during treatment is higher when cognitive behaviour therapy is offered, its long-term success is uncertain. The need to include the family environment into treatment programmes is illustrated by studies showing that treating parents alone has the same effect on children's weight loss as treating both parents and their children. Fast food, sugar sweetened drinks, hours of watching television and computer use are often discussed in terms of their causative role for obesity. The role of government policies to regulate the availability of fast food or sugar sweetened drinks as a prevention strategy is disputed, with little current empirical evidence as to the efficacy or effectiveness of such an approach. Nevertheless, public health regulations are unlikely to achieve the desired results at a population level, if not supported by families, schools and communities as well as the industry, currently investing more in economic success than responsibility for society.