The obesity epidemic has not spared adolescents, and as Cardel and colleagues1 note in this issue of JAMA Pediatrics, there are unique aspects to developing effective treatments for adolescents. Adolescence includes a wide age, 11 to 21 years, which spans developmental periods. There are unique psychological challenges during the journey from childhood to adulthood, which include the drive for autonomy, shift from parental/adult influence to peer influence, and challenges associated with the maturation from immature to mature impulse control systems balanced by a mature reward system. There are also important physical changes, including sexual dimorphism, differential sex-specific hormone changes often occurring prematurely in youth with obesity, and natural insulin resistance that is enhanced in an overweight state. Cardel and colleagues1 provide a broad overview of behavioral, pharmacologic, and surgical/device interventions for adolescent obesity, highlighting progress in each of the areas. However, the authors point out that most treatments lack a focus on behavioral or physiological factors that make adolescence unique. There are exceptions, including the intervention by Lloyd-Richardson and colleagues2 that focused on peer influence to strengthen positive behavior change.
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Epstein LH, Quattrin T. Ideas for Next-Generation Treatments of Adolescent Obesity. JAMA Pediatr. Published online March 23, 2020. doi:10.1001/jamapediatrics.2020.0034
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