Obesity
Obesity is the accumulation of excessive body fat.
Obesity is twice as common in adolescents as it was 30 years ago. Although most of the complications of obesity occur in adulthood (see Section 12, Chapter 156), obese adolescents are more likely than other adolescents to have high blood pressure and type 2 diabetes. Although fewer than one third of obese adults were obese as adolescents, most obese adolescents remain obese in adulthood.
The factors that influence obesity among adolescents are the same as those among adults. Parents often are concerned that obesity is the result of some type of endocrine disease, such as hypothyroidism, but such disorders are rarely the cause. Adolescents with weight gain caused by endocrine disorders are usually of small stature and have other signs of the underlying condition. Most obese adolescents simply eat too much and exercise too little. Because of society's stigma against obesity, many obese adolescents have a poor self-image and become increasingly sedentary and socially isolated.
Intervention for obese adolescents should be focused on developing healthy eating and exercise habits rather than on losing a specific amount of weight. Caloric intake is reduced by establishing a well-balanced diet of ordinary foods, making permanent changes in eating habits, and increasing physical activity. Summer camps for obese adolescents usually help them lose a significant amount of weight, but without continuing effort, the weight is usually regained. Counseling to help adolescents cope with their problems, including poor self-esteem, may be helpful.
Drugs that help reduce weight are generally not used during adolescence because of concerns about safety and possible abuse. One exception is for obese adolescents with a strong family history of type 2 diabetes; they are at high risk for developing diabetes. The drug metformin, which is used to treat diabetes, may help them lose weight and also lower their risk of becoming diabetic.
| 
