gms | German Medical Science

Obesity in childhood and adolescents is increasing problem around the world. The WHO called this phenomenon a pandemic. In Europe, the region with the highest increase of obesity in children and adolescents is Eastern Germany. Obese children tend to become obese adults. Furthermore, obesity is associated with cardiovascular risk factors and increased intima-media thickness as an early marker of atherosclerosis already in childhood. Parallel to the increase of obesity, an increase of type 2 diabetes mellitus in adolescents occurred in Europe. Therefore, effective prevention and treatment strategies are urgently necessary. A recent Cochrane review demonstrated that prevention programs are ineffective so far. This finding seems to be caused by teaching healthy behaviour of children and families instead of changing their environment. The most effective intervention to prevent obesity was to change the “obesitogenic” environment (for example reduced suited drinks machine in schools). Lifestyle intervention in obese children was effective in a subgroup of motivated children and families. Studies have demonstrated an improvement of cardiovascular risk factor parallel to weight loss in these children. To counteract against the increase of obesity has to be an important goal of all industrialized nations which can only be effective with great impact of governments and the society.