Severe obesity in children and adolescents: implications for treatment.

: The prevalence of clinically severe obesity in adults has been rising rapidly. We completed a needs assessment that examined the prevalence of severe obesity in a tertiary pediatric weight management clinic. The Arkansas Children's Hospital (ACH) Fitness Clinic, a specialty clinic treating overweight children and adolescents, is offered in partnership with the University of Arkansas for Medical Sciences Child and Adolescent Bariatrics Center. Our hypothesis is that the ACH Fitness Clinic has a large proportion of severely overweight children and that these patients are in need of more aggressive adjuvant therapies to improve their health status. The study reported here is part of an ongoing feasibility study regarding the need for pharmacologic and surgical options for Fitness patients who are morbidly overweight and are not responding well to a behavior treatment program alone. Of the 701 overweight (BMI >95th percentile for age and gender) children and adolescents seen in Fitness Clinic over a 29-month period, 72% had a Body Mass Index (BMI) >35, which is considered severe obesity in adults.