Intensive Therapies for the Treatment of Pediatric Obesity

  • Joan C. Han
  • Jack A. Yanovski
Part of the Issues in Clinical Child Psychology book series (ICCP)

For children and adolescents with abnormally high body adiposity, therapies for minimizing future weight gain and inducing weight loss may play important roles in the prevention and treatment of the comorbid conditions associated with obesity. While the initial approach to the management of obesity in children and adolescents should be moderate caloric restriction in combination with behavior modification, increased physical activity, and decreased time spent in sedentary behaviors (Barlow & Dietz, 1998; Speiser et al., 2005), these conservative measures are not always successful in producing long-term weight control (Epstein, Valoski, Wing, & McCurley, 1990, 1994). Therefore, more aggressive approaches—such as restriction of energy intake below 1000 kcal/d, pharmacotherapy, and bariatric surgery—have been suggested as treatment options for severe pediatric obesity. In this chapter, we will review the limited available data for the safety and efficacy of these intensive therapies in children and adolescents.


Bariatric Surgery Gastric Bypass Obesity Surgery Laparoscopic Adjustable Gastric Banding Excess Weight Loss 
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  1. Abu-Abeid, S., Gavert, N., Klausner, J. M., & Szold, A. (2003). Bariatric surgery in adolescence. Journal of Pediatric Surgery, 38, 1379–1382PubMedCrossRefGoogle Scholar
  2. Andelman, M. B., Jones, C., & Nathan, S. (1967). Treatment of obesity in underprivileged adolescents. Comparison of diethylpropion hydrochloride with placebo in a double-blind study. Clinical Pediatrics, 6, 327–330PubMedCrossRefGoogle Scholar
  3. Anderson, A. E., Soper, R. T., & Scott, D. H. (1980). Gastric bypass for morbid obesity in children and adolescents. Journal of Pediatric Surgery, 15, 876–881PubMedCrossRefGoogle Scholar
  4. Angrisani, L., Favretti, F., Furbetta, F., Paganelli, M., Basso, N., Doldi, S. B., et al. (2005). Obese teenagers treated by Lap-Band System: The Italian experience. Surgery, 138, 877–881PubMedCrossRefGoogle Scholar
  5. Anon. (1979). Liquid Protein Diets. Center for Disease Control, EPI 78-11-2 Google Scholar
  6. Anon. (1991). NIH conference: Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Annals of Internal Medicine, 115, 956–961Google Scholar
  7. Anon. (1996). Long-term pharmacotherapy in the management of obesity: National Task Force on the Prevention and Treatment of Obesity. Journal of the American Medical Association, 276, 1907–1915CrossRefGoogle Scholar
  8. Anon. (1997). Cardiac valvulopathy associated with exposure to fenfluramine or dexfen-fluramine: U.S. Department of Health and Human Services interim public health recommendations, November 1997. Morbity and Mortality Weekly Report, 46, 1061– 1066Google Scholar
  9. Anon. (2005). Effects of metformin on Energy Intake, Energy Expenditure, and Body Weight in Overweight Children with Insulin Resistance: Accessed November 7, 2005, at
  10. C. M., Baker, C., Ludwig, D. S., Hoppin, A. G., Hsu, G., Lenders, C., et al. (2005). Best practice guidelines in pediatric/adolescent weight loss surgery. Obesity Research, 13, 274–282PubMedCrossRefGoogle Scholar
  11. Bacon, G. E., & Lowrey, G. H. (1967). A clinical trial of fenfluramine in obese children. Current Therapeutic Research: Clinical and Experimental, 9, 626–630Google Scholar
  12. Barlow, S. E., & Dietz, W. H. (1998). Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics, 102, 29CrossRefGoogle Scholar
  13. Berkowitz, R., Fujioke, K., Daniels, S. R., Hoppin, A. G., Owen, S., Perry, A. C., et al. (2006) Effects of sibutramine treatment in obese adolescents: A randomized trial. Annals of Internal Medicine, 145, 81–90PubMedGoogle Scholar
  14. Berkowitz, R. I., Wadden, T. A., Tershakovec, A. M., & Cronquist, J. L. (2003). Behavior therapy and sibutramine for the treatment of adolescent obesity: A randomized controlled trial. Journal of the American Medical Association, 289, 1805–1812PubMedCrossRefGoogle Scholar
  15. Brolin, R. L., Robertson, L. B., Kenler, H. A., & Cody, R. P. (1994). Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Annals of Surgery, 220, 782–790PubMedCrossRefGoogle Scholar
  16. Brown, M. R., Klish, W. J., Hollander, J., Campbell, M. A., & Forbes, G. B. (1983). A high protein, low calorie liquid diet in the treatment of very obese adolescents: Long-term effect on lean body mass. American Journal of Clinical Nutrition, 38, 20–31PubMedGoogle Scholar
  17. Buchwald, H., Avidor, Y., Braunwald, E., Jensen, M. D., Pories, W., Fahrbach, K., et al. (2004). Bariatric surgery: A systematic review and meta-analysis. Journal of the American Medical Association, 292, 1724–1737PubMedCrossRefGoogle Scholar
  18. Canitano, R. (2005). Clinical experience with Topiramate to counteract neuroleptic induced weight gain in 10 individuals with autistic spectrum disorders. Brain Development, 27, 228–232PubMedCrossRefGoogle Scholar
  19. Chanoine, J. P., Hampl, S., Jensen, C., Boldrin, M., & Hauptman, J. (2005). Effect of orlistat on weight and body composition in obese adolescents: A randomized controlled trial. Journal of the American Medical Association, 293, 2873–2883PubMedCrossRefGoogle Scholar
  20. Connolly, H. M., Crary, J. L., McGoon, M. D., Hensrud, D. D., Edwards, B. S., Edwards, W. D., et al. (1997). Valvular heart disease associated with fenfluramine-phentermine. New England Journal of Medicine, 337, 581–588PubMedCrossRefGoogle Scholar
  21. Cummings, D. E., Weigle, D. S., Frayo, R. S., Breen, P. A., Ma, M. K., Dellinger, E. P., et al. (2002). Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. New England Journal of Medicine, 346, 1623–1630PubMedCrossRefGoogle Scholar
  22. DeFronzo, R. A., & Goodman, A. M. (1995). Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group. New England Journal of Medicine, 333, 541–549CrossRefGoogle Scholar
  23. Dolan, K., Creighton, L., Hopkins, G., & Fielding, G. (2003). Laparoscopic gastric banding in morbidly obese adolescents. Obesity Surgery, 13, 101–104PubMedCrossRefGoogle Scholar
  24. Epstein, L. H., Valoski, A., Wing, R. R., & McCurley, J. (1990). Ten-year follow-up of behavioral, family-based treatment for obese children. Journal of the American Medical Association, 264, 2519–2523PubMedCrossRefGoogle Scholar
  25. Epstein, L. H., Valoski, A., Wing, R. R., & McCurley, J. (1994). Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology, 13, 373–383PubMedCrossRefGoogle Scholar
  26. Farooqi, I. S., Jebb, S. A., Langmack, G., Lawrence, E., Cheetham, C. H., Prentice, A. M., et al. (1999). Effects of recombinant leptin therapy in a child with congenital leptin deficiency. New England Journal of Medicine, 341, 879–884PubMedCrossRefGoogle Scholar
  27. Farooqi, I. S., Matarese, G., Lord, G. M., Keogh, J. M., Lawrence, E., Agwu, C., et al. (2002). Beneficial effects of leptin on obesity, T cell hyporesponsiveness, and neuroendocrine/metabolic dysfunction of human congenital leptin deficiency. Journal of Clinical Investigation, 110, 1093–1103PubMedGoogle Scholar
  28. Figueroa-Colon, R., Franklin, F. A., Lee, J. Y., von Almen, T. K., & Suskind, R. M. (1996). Feasibility of a clinic-based hypocaloric dietary intervention implemented in a school setting for obese children. Obesity Research, 4, 419–429PubMedGoogle Scholar
  29. Figueroa-Colon, R., von Almen, T. K., Franklin, F. A., Schuftan, C., & Suskind, R. M. (1993). Comparison of two hypocaloric diets in obese children. American Journal of Diseases of Children, 147, 160–166PubMedGoogle Scholar
  30. Fobi, M. A. (1993). Vertical banded gastroplasty vs gastric bypass: 10 years follow-up. Obesity Surgery, 3, 161–164PubMedCrossRefGoogle Scholar
  31. Fogteloo, A. J., Pijl, H., Frolich, M., McCamish, M., & Meinders, A. E. (2003). Effects of recombinant human leptin treatment as an adjunct of moderate energy restriction on body weight, resting energy expenditure and energy intake in obese humans. Diabetes Nutrition and Metabolism, 16, 109–114Google Scholar
  32. Freemark, M., & Bursey, D. (2001). The effects of metformin on body mass index and glucose tolerance in obese adolescents with fasting hyperinsulinemia and a family history of type 2 diabetes. Pediatrics, 107, E55PubMedCrossRefGoogle Scholar
  33. Gibson, W. T., Farooqi, I. S., Moreau, M., DePaoli, A. M., Lawrence, E., O'Rahilly, S., et al. (2004). Congenital leptin deficiency due to homozygosity for the Delta133G mutation: report of another case and evaluation of response to four years of leptin therapy. Journal of Clinical Endocrinology and Metabolism, 89, 4821–4826PubMedCrossRefGoogle Scholar
  34. Godoy-Matos, A., Carraro, L., Vieira, A., Oliveira, J., Guedes, E. P., Mattos, L., et al. (2005). Treatment of obese adolescents with sibutramine: a randomized, double-blind, controlled study. Journal of Clinical Endocrinology and Metabolism, 90, 1460–1465PubMedCrossRefGoogle Scholar
  35. Golebiowska, M., Chlebna-Sokol, D., Kobierska, I., Konopinska, A., Malek, M., Mastalska, A., et al. (1981). [Clinical evaluation of Teronac (mazindol) in the treatment of obesity in children. Part II. Anorectic properties and side effects (author's transl)]. Przegl Lek, 38, 355–358PubMedGoogle Scholar
  36. Golebiowska, M., Chlebna-Sokol, D., Mastalska, A., & Zwaigzne-Raczynska, J. (1981). [The clinical evaluation of teronac (Mazindol) in the treatment of children with obesity. Part I. Effect of the drug on somatic patterns and exercise capacity (author's transl)]. Przegl Lek, 38, 311–314PubMedGoogle Scholar
  37. Gracious, B. L., Krysiak, T. E., & Youngstrom, E. A. (2002). Amantadine treatment of psychotropic-induced weight gain in children and adolescents: Case series. Journal of Child and Adolescent Psychopharmacology, 12, 249–257PubMedCrossRefGoogle Scholar
  38. Greenstein, R. J. (1993). Reexploration following vertical banded gastroplasty: Technical observations, and co-morbidity from dentition, smoking and esophageal pathology. Obesity Surgery, 3, 265–269PubMedCrossRefGoogle Scholar
  39. Greenstein, R. J., & Rabner, J. G. (1995). Is adolescent gastric-restrictive antiobesity surgery warranted? Obesity Surgery, 5, 138–144PubMedCrossRefGoogle Scholar
  40. Greenway, F. L., De Jonge, L., Blanchard, D., Frisard, M., & Smith, S. R. (2004). Effect of a dietary herbal supplement containing caffeine and ephedra on weight, metabolic rate, and body composition. Obesity Research, 12, 1152–1157PubMedCrossRefGoogle Scholar
  41. Grugni, G., Guzzaloni, G., Ardizzi, A., Moro, D., & Morabito, F. (1997). Dexfentluramine in the treatment of juvenile obesity. Minerva Pediatrica, 49, 109–117PubMedGoogle Scholar
  42. Hell, E., Miller, K. A., Moorehead, M. K., & Norman, S. (2000). Evaluation of health status and quality of life after bariatric surgery: Comparison of standard Roux-en-Y gastric bypass, vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding. Obesity Surgery, 10, 214–219PubMedCrossRefGoogle Scholar
  43. Howard, L., Malone, M., Michalek, A., Carter, J., Alger, S., & Van Woert, J. (1995). Gastric bypass and vertical banded gastroplasty- a prospective randomized comparison and 5-year follow-up. Obesity Surgery, 5, 55–60PubMedCrossRefGoogle Scholar
  44. Hukshorn, C. J., Westerterp-Plantenga, M. S., & Saris, W. H. (2003). Pegylated human recombinant leptin (PEG-OB) causes additional weight loss in severely energy-restricted, overweight men. American Journal of Clinical Nutrition, 77, 771–776PubMedGoogle Scholar
  45. Inge, T. H., Krebs, N. F., Garcia, V. F., Skelton, J. A., Guice, K. S., Strauss, R. S., et al. (2004). Bariatric surgery for severely overweight adolescents: Concerns and recommendations. Pediatrics, 114, 217–223PubMedCrossRefGoogle Scholar
  46. Inge, T. H., Zeller, M. H., Lawson, M. L., & Daniels, S. R. (2005). A critical appraisal of evidence supporting a bariatric surgical approach to weight management for adolescents. Journal of Pediatrics, 147, 10–19PubMedCrossRefGoogle Scholar
  47. Inge, T. H., Zeller, M., Garcia, V. F., & Daniels, S. R. (2004). Surgical approach to adolescent obesity. Adolescent Medicine Clinics, 15(3), 429–453PubMedCrossRefGoogle Scholar
  48. Kay, J. P., Alemzadeh, R., Langley, G., D'Angelo, L., Smith, P., & Holshouser, S. (2001). Beneficial effects of metformin in normoglycemic morbidly obese adolescents. Metabolism, 50, 1457–1461PubMedCrossRefGoogle Scholar
  49. Komorowski, J. M., Zwaigzne-Raczynska, J., Owczarczyk, I., Golebiowska, M., & Zarzycki, J. (1982). [Effect of mazindol (teronac) on various hormonal indicators in children with simple obesity (author's transl.)]. Pedicatria Polska, 57, 241–246Google Scholar
  50. Kuczmarski, R. J., Ogden, C. L., Grummer-Strawn, L. M., Flegal, K. M., Guo, S. S., Wei, R., et al. (2000). CDC growth charts: United States. Advance Data from Vital & Health Statistics of the National Center for Health Statistics, 314, 1–27Google Scholar
  51. Lawson, M. L., Kirk, S., Mitchell, T., Chen, M. K., Loux, T. J., Daniels, S. R., et al. (2006). One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: A multicenter study from the Pediatric Bariatric Study Group. Journal of Pediatric Surgery, 41, 137–143PubMedCrossRefGoogle Scholar
  52. Lee, A., & Morley, J. E. (1998). Metformin decreases food consumption and induces weight loss in subjects with obesity with type II non-insulin-dependent diabetes. Obesity Research, 6, 47–53PubMedGoogle Scholar
  53. Lessig, M. C., Shapira, N. A., & Murphy, T. K. (2001). Topiramate for reversing atypical antipsychotic weight gain. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1364PubMedCrossRefGoogle Scholar
  54. Lorber, J. (1966). Obesity in childhood. A controlled trial of anorectic drugs. Archives of Disease in Childhood, 41, 309–312PubMedCrossRefGoogle Scholar
  55. Lustig, R. H., Hinds, P. S., Ringwald-Smith, K., Christensen, R. K., Kaste, S. C., Schreiber, R. E., et al. (2003). Octreotide therapy of pediatric hypothalamic obesity: A double-blind, placebo-controlled trial. Journal of Clinical Endocrinology and Metabolism, 88, 2586–2592PubMedCrossRefGoogle Scholar
  56. Lutjens, A., & Smit, J. L. (1977). Effect of biguanide treatment in obese children. Helvetica Paediatrica Acta, 31, 473–480PubMedGoogle Scholar
  57. Malecka-Tendera, E., Koehler, B., Muchacka, M., Wazowski, R., & Trzciakowska, A. (1996). [Efficacy and safety of dexfenfluramine treatment in obese adolescents (author's translation)]. Pedicatria Polska, 71, 431–436Google Scholar
  58. Mathew, G., & Lifshitz, F. (1974). Hyperuricemia in a child: A complication of treatment of obesity. Pediatrics, 54, 370–371PubMedGoogle Scholar
  59. McDuffie, J. R., Calis, K. A., Booth, S. L., Uwaifo, G. I., & Yanovski, J. A. (2002). Effects of orlistat on fat-soluble vitamins in obese adolescents. Pharmacotherapy, 22, 814–822PubMedCrossRefGoogle Scholar
  60. McDuffie, J. R., Calis, K. A., Uwaifo, G. I., Sebring, N. G., Fallon, E. M., Frazer, T. E., et al. (2004). Efficacy of orlistat as an adjunct to behavioral treatment in overweight African American and Caucasian adolescents with obesity-related co-morbid conditions. Journal of Pediatric Endocrinology and Metabolism, 17, 307–319PubMedGoogle Scholar
  61. McDuffie, J. R., Calis, K. A., Uwaifo, G. I., Sebring, N. G., Fallon, E. M., Hubbard, V. S., et al. (2002). Three-month tolerability of orlistat in adolescents with obesity-related comorbid conditions. Obesity Research, 10, 642–650PubMedCrossRefGoogle Scholar
  62. Merritt, R. J., Blackburn, G. L., Bistrian, B. R., Palombo, J., & Suskind, R. M. (1981). Consequences of modified fasting in obese pediatric and adolescent patients: Effect of a carbohydrate-free diet on serum proteins. American Journal of Clinical Nutrition, 34, 2752–2755PubMedGoogle Scholar
  63. Michiel, R. R., Sneider, J. S., Dickstein, R. A., Hayman, H., & Eich, R. H. (1978). Sudden death in a patient on a liquid protein diet. New England Journal of Medicine, 298, 1005–1007PubMedCrossRefGoogle Scholar
  64. Mittendorfer, B., Ostlund, R. E., Jr., Patterson, B. W., & Klein, S. (2001). Orlistat inhibits dietary cholesterol absorption. Obesity Research, 9, 599–604PubMedCrossRefGoogle Scholar
  65. Molnar, D., Torok, K., Erhardt, E., & Jeges, S. (2000). Safety and efficacy of treatment with an ephedrine/caffeine mixture. The first double-blind placebo-controlled pilot study in adolescents. International Journal of Obesity and Related Metabolic Disorders, 24, 1573–1578PubMedCrossRefGoogle Scholar
  66. Morrison, J. A., Cottingham, E. M., & Barton, B. A. (2002). Metformin for weight loss in pediatric patients taking psychotropic drugs. American Journal of Psychiatry, 159, 655–657PubMedCrossRefGoogle Scholar
  67. Norgren, S., Danielsson, P., Jurold, R., Lotborn, M., & Marcus, C. (2003). Orlistat treatment in obese prepubertal children: A pilot study. Acta Paediatrica, 92, 666–670PubMedCrossRefGoogle Scholar
  68. Ozkan, B., Bereket, A., Turan, S., & Keskin, S. (2004). Addition of orlistat to conventional treatment in adolescents with severe obesity. European Journal of Pediatrics, 163, 738–741PubMedCrossRefGoogle Scholar
  69. Pavuluri, M. N., Janicak, P. G., & Carbray, J. (2002). Topiramate plus risperidone for controlling weight gain and symptoms in preschool mania. Journal of Child and Adolescent Psychopharmacology, 12, 271–273PubMedCrossRefGoogle Scholar
  70. Pedrinola, F., Cavaliere, H., Lima, N., & Medeiros-Neto, G. (1994). Is DL-fenfluramine a potentially helpful drug therapy in overweight adolescent subjects? Obesity Research, 2, 1–4PubMedGoogle Scholar
  71. Rand, C. S., & Macgregor, A. M. (1994). Adolescents having obesity surgery: A 6-year follow-up. Southern Medical Journal, 87, 1208–1213PubMedGoogle Scholar
  72. Rauh, J. L., & Lipp, R. (1968). Chlorphentermine as an anorexigenic agent in adolescent obesity. Report of its efficacy in a double-blind study of 30 teenagers. Clinical Pediatrics, 7, 138–140PubMedCrossRefGoogle Scholar
  73. Rosenbaum, M., Goldsmith, R., Bloomfield, D., Magnano, A., Weimer, L., Heymsfield, S., et al. (2005). Low-dose leptin reverses skeletal muscle, autonomic, and neuroendocrine adaptations to maintenance of reduced weight. Journal of Clinical Investigation, 115, 3579–3586PubMedCrossRefGoogle Scholar
  74. Samanin, R., & Garattini, S. (1993). Neurochemical mechanism of action of anorectic drugs. Pharmacology and Toxicology, 73, 63–68PubMedGoogle Scholar
  75. Schwartz, T. L., Nihalani, N., Virk, S., Jindal, S., & Chilton, M. (2004). Psychiatric medication-induced obesity: Treatment options. Obesity Review, 5, 233–238CrossRefGoogle Scholar
  76. Schwimmer, J. B., Middleton, M. S., Deutsch, R., & Lavine, J. E. (2005). A phase 2 clinical trial of metformin as a treatment for non-diabetic paediatric non-alcoholic steatohepatitis. Alimentary Pharmacology & Therapeutics, 21, 871–879CrossRefGoogle Scholar
  77. Soper, R. T., Mason, E. E., Printen, K. J., & Zellweger, H. (1975). Gastric bypass for morbid obesity in children and adolescents. Journal of Pediatric Surgery, 10, 51–58PubMedCrossRefGoogle Scholar
  78. Sothern, M. S., von Almen, T. K., Schumacher, H. D., Suskind, R. M., & Blecker, U. (1999). A multidisciplinary approach to the treatment of childhood obesity. Delaware Medical Journal, 71, 255–261PubMedGoogle Scholar
  79. Speiser, P. W., Rudolf, M. C., Anhalt, H., Camacho-Hubner, C., Chiarelli, F., Eliakim, A., et al. (2005). Childhood obesity. Journal of Clinical Endocrinology and Metabolism, 90, 1871–1887PubMedCrossRefGoogle Scholar
  80. Spranger, J. (1965). [Phentermine resinate in obesity. Clinical trial of Mirapront in adipose children (author's translation)]. Munch Med Wochenschr, 107, 1833–1834PubMedGoogle Scholar
  81. Stallings, V. A., Archibald, E. H., Pencharz, P. B., Harrison, J. E., & Bell, L. E. (1988). One-year follow-up of weight, total body potassium, and total body nitrogen in obese adolescents treated with the protein-sparing modified fast. American Journal of Clinical Nutrition, 48, 91–94PubMedGoogle Scholar
  82. Stanford, A., Glascock, J. M., Eid, G. M., Kane, T., Ford, H. R., Ikramuddin, S., et al. (2003). Laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents. Journal of Pediatric Surgery, 38, 430–433PubMedCrossRefGoogle Scholar
  83. Stewart, D. A., Bailey, J. D., & Patell, H. (1970). Tenuate dospan as an appetitie suppressant in the treatment of obese children. Applied Therapeutics, 12(5), 34–36PubMedGoogle Scholar
  84. Strauss, R. S., Bradley, L. J., & Brolin, R. E. (2001). Gastric bypass surgery in adolescents with morbid obesity. Journal of Pediatrics, 138, 499–504PubMedCrossRefGoogle Scholar
  85. Stumvoll, M., Nurjhan, N., Perriello, G., Dailey, G., & Gerich, J. E. (1995). Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. New England Journal of Medicine, 333, 550–554PubMedCrossRefGoogle Scholar
  86. Sugerman, H. J., Sugerman, E. L., DeMaria, E. J., Kellum, J. M., Kennedy, C., Mowery, Y., et al. (2003) Bariatric sugery for severely obese adolescents. Journal of Gastrointestinal Surgery, 7, 102–107PubMedCrossRefGoogle Scholar
  87. Suskind, R. M., Sothern, M. S., Farris, R. P., von Almen, T. K., Schumacher, H., Carlisle, L., et al. (1993). Recent advances in the treatment of childhood obesity. Annals of the New York Academy of Science, 699, 181–199CrossRefGoogle Scholar
  88. Towbin, A., Inge, T. H., Garcia, V. F., Roehrig, H. R., Clements, R. H., Harmon, C. M., et al. (2004). Beriberi after gastric bypass surgery in adolescence. Journal of Pediatrics, 145, 263–267PubMedCrossRefGoogle Scholar
  89. Whitlock, E. P., Williams, S. B., Gold, R., Smith, P. R., & Shipman, S. A. (2005). Screening and interventions for childhood overweight: A summary of evidence for the US Preventive Services Task Force. Pediatrics, 116, 125–144CrossRefGoogle Scholar
  90. Widhalm, K., Dietrich, S., & Prager, G. (2004). Adjustable gastric banding surgery in morbidly obese adolescents: Experiences with eight patients. International Journal of Obesity and Related Metabolic Disorders, 28 (Suppl. 3), 42–45CrossRefGoogle Scholar
  91. Yanovski, J. A. (2001). Intensive therapies for pediatric obesity. Pediatric Clinics of North America, 48, 1041–1053PubMedCrossRefGoogle Scholar
  92. Zelissen, P. M., Stenlof, K., Lean, M. E., Fogteloo, J., Keulen, E. T., Wilding, J., et al. (2005). Effect of three treatment schedules of recombinant methionyl human leptin on body weight in obese adults: A randomized, placebo-controlled trial. Diabetes Obesity and Metabolic Diseases, 7, 755–761CrossRefGoogle Scholar
  93. Zhi, J., Melia, A. T., Guerciolini, R., Chung, J., Kinberg, J., Hauptman, J. B., et al. (1994). Retrospective population-based analysis of the dose-response (fecal fat excretion) relationship of orlistat in normal and obese volunteers. Clinical Pharmacology and Therapeutics, 56, 82–85PubMedGoogle Scholar
  94. Zhi, J., Moore, R., & Kanitra, L. (2003). The effect of short-term (21-day) orlistat treatment on the physiologic balance of six selected macrominerals and microminerals in obese adolescents. Journal of the American College of Nutrition, 22, pp.357–362PubMedGoogle Scholar

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© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Joan C. Han
    • 1
  • Jack A. Yanovski
    • 1
  1. 1.National Institute of Child Health and Human Development National Institutes of HealthBethesda

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