Obesity: assessment, complications and treatment — branching viva

Branching viva on BMI-for-age classification with adult crossover, systematic comorbidity screening across six systems, selective secondary-cause exclusion, staged treatment from lifestyle through pharmacotherapy to surgery, and parallel comorbidity-directed care.

branching clinical structured oral4 min readVerification in progress

Prompt

You are the paediatric registrar in the endocrinology clinic. The examiner will move from classification and comorbidity screening through secondary-cause exclusion to staged treatment and comorbidity-directed care, including the role of pharmacotherapy and surgery.

Stem

The examiner will test whether you can reason through childhood obesity classification under pressure, integrate systematic comorbidity screening and selective secondary-cause exclusion, and defend a staged, weight-neutral management plan that escalates appropriately for severe disease. [1] [2]

Paediatrics Fellowship Pro

You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References8Show ledger

[1]Hampl SE, Hassink SG, Skinner AC Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics, 2023.PMID 36622115
[2]Styne DM, Arslanian SA, Connor EL Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. Journal of clinical endocrinology and metabolism, 2017.PMID 28359099
[4]Simmonds M, Llewellyn A, Owen CG Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obesity reviews, 2016.PMID 26696565
[5]Kelly AS, Barlow SE, Rao G Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation, 2013.PMID 24016455
[6]Inge TH, Laffel LM, Jenkins TM Comparison of Surgical and Medical Therapy for Type 2 Diabetes in Severely Obese Adolescents. JAMA pediatrics, 2018.PMID 29532078
[7]Vos MB, Abrams SH, Barlow SE NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children. Journal of pediatric gastroenterology and nutrition, 2017.PMID 28107283
[12]Kelly AS, Auerbach P, Barrientos-Perez M A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity. New England Journal of Medicine, 2020.PMID 32233338
[13]Weghuber D, Barrett T, Barrientos-Pérez M, et al. Once-Weekly Semaglutide in Adolescents with Obesity. New England Journal of Medicine, 2022.PMID 36322838