Adolesc Med 028 (2017) xiiioYJW
Obesity and Diabetes in the Adolescent
It is unquestionable that among the greatest threats to human health are obesity
and diabetes, the focus of this issue of AM:STARs. What makes these 2 categories
of disease unique is the importance of early and thorough prevention, assess-
ment, and treatment, making them high priority areas for providers caring for
children and adolescents.
Our understanding of the pathophysiology of obesity has grown tremendously
over the past 2 decades. The simplistic “calories in calories out” model for under-
standing weight, still clung to by many, is woefully inadequate in explaining the
obesity epidemic. Hormone resistance, environment, genetics and epigenetics,
prenatal factors, gut bacteria, socioeconomics, and behavioral and emotional
factors all play a role in the pathogenesis of obesity. No child makes a conscious
decision to have obesity. No adolescent makes a conscious decision to suffer from
insulin resistance or from weight-based victimization, which is all too common
in this population. In the articles that follow, our aim is to provide concise up-
dates on key areas in obesity medicine, including genetics, emotional health, ef-
fects on growth and puberty, and treatment and nutrition. It is almost impossible
to review every obesity-related topic in one AM:STARs issue, and we refer you
to recent publications for a review of dyslipidemia (“Screening and Treatment of
Common Lipid Disorders in Adolescents”, AM:STARs: Advances in the Treatment
of Endocrine Disorders in Adolescents, 2015;26(2):365–381) and bariatric surgery
(“Bariatric Surgery for Adolescents”, AM:STARs: Hot Topics in Adolescent Health,
2014;25(2):279–293). Obesity treatment resources for the primary care provider
or adolescent specialist continue to grow, and many are housed at the American
Academy of Pediatrics Section on Obesity ( and the Institute
for Healthy Childhood Weight ( Web sites.
Important reviews of type 1 and type 2 diabetes are also included in this ­
issue. Once a rarity in adolescents, type 2 diabetes now makes up approximately
one-third of all new cases of diabetes in this age group. This can often present a
diagnostic challenge for the clinician: does a 15-year-old with obesity and new
onset diabetes have type 1 or type 2? Indeed, a careful approach is necessary in
these scenarios to ensure accurate diagnosis and appropriate treatment.
The burden of type 1 diabetes in adolescents also continues to grow. In this is-
sue we review type 1 diabetes topics including important transition of care issues,
as well as powerful and life-changing technologies that have emerged in recent
Copyright © 2017 American Academy of Pediatrics. All rights reserved. ISSN 1934-4287
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