Comorbidity and therapy of obesity in children and adolescents from the medical point of view

In all industrial nations obesity in children and adolescents is increasing. Obesity is accompanied by increasing cardiovascular risk factors and diabetes mellitus in these age groups. About 1 % of obese children suffer from type 2 diabetes, about one third from mild arterial hypertension and a quarter from dislipidemia. In obese children, early atherosclerotic changes are detected by measurement of the thickness of the intima media of the A. carotis by ultrasound. Weight reduction is the therapy of choice to reduce co-morbidity; in growing children constant weight for one year is sufficient to improve the cardiovascular risk profile. AGA guidelines for weight reduction recommends for children and their parents a long-term therapy based on nutritional, behavioural and physical therapy. In "Obeldicks", a training programme following the AGA guidelines, 79 % of the participants reduced their weight and also showed a significant weight reduction 4 years after termination of the treatment.