One of my first disturbing observations when I returned to Greece in 2001 was the new growth curves for children and adolescents that had recently been constructed for the Greek population by Chiotis and colleagues at EKPA 1st University Pediatric Clinic. Comparison with earlier curves showed that our children grew taller but also gained weight disproportionately to their height. This is why general curves and body mass index curves were added to make the limits of overweight and obesity in children and adolescents clear. The increase in BMI in children/adolescents is a global phenomenon that began in the United States of America and spread throughout the world over the course of about two decades. The reasons for this phenomenon are numerous and include an abundance of “cheap” calories, lack of exercise, lack of sleep, lack of daily regularity in eating and sleeping, and the ongoing psycho-socio-economic stress of modern life.

The pandemic of overweight and obesity in modern life is calculated on the basis of BMI, with the curves in children and adolescents corresponding – by extrapolation of adult curves – to the classical limits of normal weight up to 25 years, overweight from 25 to 30 and obesity over 30 years. kg/m2. Unfortunately, based on BMI, our country and Cyprus are leading in childhood, adolescence and youth with overweight and obesity, with more than a third of our children having a BMI over 26.

In recent years, a very common, acute and intractable problem has arisen, exacerbated by the COVID-19 epidemic and overwhelmed pediatric, pediatric endocrinology and endocrinological practice: overweight and obese children, adolescents and young people. Unfortunately, despite intensive therapeutic efforts by specialist teams, only a small percentage of overweight and obese patients are corrected, and an even smaller percentage maintain their weight after losing it as a result of strenuous efforts. If it is possible to generalize the success of overweight/obesity response to treatment, it can be said that the more severe the obesity, the lower the success rates. This statewide treatment failure to date highlights the importance of prevention over cure at the moment.

New drug

However, fortunately, recent scientific searches for a cure for obesity have brought encouraging messages. A new class of drugs with agonistic effects on the gastrointestinal hormone receptor, GLP-1 (glucagon-like peptide 1), causes a loss of 10-15% of body weight, with many positive effects on nutritional function. and with minor complications are completely curable. The drug is administered weekly subcutaneously and has already been successfully tested in adolescents aged 12-18 who lose weight effortlessly and maintain it as long as they continue to take it. The drug will soon be available for oral administration, while new chemical analogues are being created that combine the action on the GLP-1 receptor with the simultaneous action on the receptor of another hormone of the gastrointestinal tract – GIP (gastric inhibitory polypeptide). The latter cause weight loss up to 25%. The field of obesity science is rapidly evolving, and an incredibly complex health problem with devastating comorbidities is moving towards a solution.

* Mr. Georgios P. Chroussos is Professor Emeritus of Pediatrics and Endocrinology, Director of the Research Institute for Maternal, Childhood and Precision Medicine, and Head of the UNESCO Chair in Adolescent Health and Medicine.