[Paediatric teams in front of childhood obesity: a qualitative study within the STOP project]

Misalignment among adolescents living with obesity, caregivers, and healthcare professionals: ACTION Teens global survey study

BACKGROUND

There is limited evidence regarding the experiences, challenges, and needs of adolescents living with obesity (ALwO), their caregivers, and healthcare professionals (HCPs).

OBJECTIVES

The cross-sectional, survey-based global ACTION Teens study aimed to identify perceptions, attitudes, behaviours, and barriers to effective obesity care among ALwO, caregivers of ALwO, and HCPs.

METHODS

ALwO (aged 12 to <18 years; N = 5275), caregivers (N = 5389), and HCPs treating ALwO (N = 2323) from 10 countries completed an online survey (August-December 2021).

RESULTS

Most ALwO perceived their weight as above normal (76% vs. 66% of caregivers), were worried about its impact on their health (85% vs. 80% of caregivers), and recently made a weight loss attempt (58%). While 45% of caregivers believed ALwO would slim down with age, only 24% of HCPs agreed. Most commonly reported weight loss motivators for ALwO were wanting to be more fit/in better shape according to ALwO (40%) and caregivers (32%), and improved confidence/social life according to HCPs (69%). ALwO weight loss barriers included lack of hunger control (most commonly reported by ALwO/caregivers), lack of motivation, unhealthy eating habits (most commonly agreed by HCPs), and lack of exercise.

CONCLUSIONS

Misalignment between ALwO, caregivers, and HCPs-including caregivers' underestimation of the impact of obesity on ALwO and HCPs' misperception of key motivators/barriers for weight loss-suggests a need for improved communication and education.

Guide and advances on childhood obesity determinants: Setting the research agenda

Childhood obesity demands global solutions. Low birth weight and small for gestational age were associated with childhood obesity. Available data do not support prenatal exposure to antibiotics as risk factor for childhood obesity, and posology must be assessed. Prenatal exposure to persistent organic pollutants shows associations with childhood obesity. Gut microbiota composition influences obesity onset in childhood. Despite the unquestionable role of Mediterranean diet on healthy weight, there are only incomplete indications of metabolic benefits in childhood weight after following Mediterranean diet. Negative association between total dairy consumption and childhood obesity has been found, but inverse causality could not be discarded. Ultra-processed food intake is an adverse determinant of childhood obesity. Physical inactivity and sedentarism are critical risk factors of children adiposity; hence, built environment and environmental features will be determinants of childhood obesity. A consistent metabolic pattern of childhood obesity was observed; metabolomics research is needed to assess the role of specific molecules concerning childhood obesity. Epigenetic experiences support association with childhood obesity for DNA methylation of specific genes and miRNAs. Therefore, recent childhood obesity rates cannot only be explained by genetic predisposition and changes in lifestyle habits. It implies gene-environment interactions. It will be the next research.