Claudia Fox

Claudia's statements about Pediatric Obesity 26 statements

Pharmacology: Pediatric Obesity 2017

▶ Ep 4 · 9:30

epidemiological Of 12-year-olds with BMI at 99th percentile, all will grow up to have BMIs greater than 30, 88% will have BMIs greater than 35, and 2/3 will have class 3 obesity, according to the Bogalusa Heart Study. ↗

▶ Ep 4 · 13:00

guideline Severe obesity is defined as BMI greater than 1.2 times the 95th percentile. ↗

▶ Ep 4 · 15:30

clinical Only 2% of teenagers with severe obesity demonstrated clinically significant BMI reduction with lifestyle modification therapy. ↗

▶ Ep 4 · 17:00

clinical In a study comparing inpatient (6 months) versus outpatient lifestyle modification therapy followed for 2 years, there was no statistically significant difference in outcomes at 2 years despite better response during inpatient treatment. ↗

▶ Ep 4 · 21:00

clinical Mutations in the melanocortin 4 receptor (MC4R) account for the most common single gene mutation causing early onset severe obesity in pediatrics. ↗

▶ Ep 4 · 22:00

clinical Bupropion-naltrexone combination works by bupropion stimulating POMC cells to secrete alpha-MSH (which stimulates MC4 receptors to decrease hunger), while naltrexone blocks the auto-inhibitory feedback from beta-endorphin, allowing relatively more alpha-MSH activity. ↗

▶ Ep 4 · 28:00

clinical When people lose weight, they experience increased hunger, decreased satiety, increased preference for highly palatable foods, and increased metabolic efficiency—all promoting weight regain. ↗

▶ Ep 4 · 29:00

clinical Bariatric surgery is currently the most effective and durable treatment for severe obesity in adolescents. ↗

▶ Ep 4 · 30:00

clinical Orlistat is a lipase inhibitor that blocks absorption of about 30% of fat, is FDA approved for children 12 and older, and in the largest RCT of about 500 patients showed placebo-subtracted BMI difference of about 0.8 units at one year. ↗

▶ Ep 4 · 31:00

clinical Phentermine is FDA approved for age 16 and older (from 1950s approval), but there have been no RCTs in adolescents longer than 1 month duration. ↗

▶ Ep 4 · 31:30

clinical Among adults, phentermine produces mean weight loss of about 3.5 kg. ↗

▶ Ep 4 · 32:00

clinical In studies of adults on phentermine, there have been no withdrawal symptoms upon abruptly stopping and no reports of increased blood pressure, probably because patients are losing weight. ↗

▶ Ep 4 · 33:00

clinical In a chart review of 25 patients on phentermine only for 6 months plus lifestyle modification, compared to 274 receiving only lifestyle modification, there was about a 4% decrease in BMI favoring the phentermine group. ↗

▶ Ep 4 · 34:10

clinical After many studies of metformin, we can expect about a one unit decrease in BMI. ↗

▶ Ep 4 · 34:40

clinical Liraglutide, a GLP-1 agonist, has recently been FDA approved for obesity in adults. ↗

▶ Ep 4 · 35:20

clinical In a pilot study of exenatide (GLP-1 agonist) with about 25 patients, during the first 3 months double-blinded portion, there was a placebo-subtracted effect of about 3% in BMI favoring the exenatide group. ↗

▶ Ep 4 · 36:30

clinical In a chart review of patients taking topiramate only (no other medications) with lifestyle modification therapy, there was about a 6% decrease in BMI at 6 months. ↗

▶ Ep 4 · 37:10

clinical In an RCT of topiramate 75mg/day after meal replacement induction phase, there was no statistically significant effect between topiramate and placebo groups by study end. ↗

▶ Ep 4 · 38:50

clinical Topiramate is FDA approved down to age 2 for seizures and has been used in pediatrics for decades. ↗

▶ Ep 4 · 39:00

clinical Topiramate at 75mg/day was safe in adolescents, with extensive neurocognitive testing showing no signal of cognitive deficits. ↗

▶ Ep 4 · 39:55

quote These medications do not work in a vacuum. They help you adhere to your eating plan. If you don't have an eating plan, they do nothing. ↗

▶ Ep 4 · 40:20

clinical Early success in weight management predicts long-term weight loss success, according to adult literature. ↗

▶ Ep 4 · 40:50

opinion Obesity is a chronic disease requiring indefinite medication treatment; stopping the medication results in weight regain, similar to stopping antihypertensive medication causing blood pressure to rise. ↗

▶ Ep 4 · 40:55

quote You don't develop dependence on it, you don't rely on it, any more than you would develop a reliance on an antihypertensive agent to treat your high blood pressure. ↗

▶ Ep 4 · 41:40

opinion Bariatric surgery is seen as more acceptable than pharmacotherapy for pediatric obesity, despite being arguably riskier and irreversible. ↗

▶ Ep 4 · 41:40

clinical Recently FDA-approved medications for adult obesity (age 18+) include topiramate-phentermine combination, liraglutide, naltrexone-bupropion combination, and lorcaserin, approved for BMI >30 or >27 with weight-related comorbidities. ↗

Claudia's statements about Pediatric Obesity 26 statements

Open the Pediatric Obesity collection →

Pharmacology: Pediatric Obesity 2017

▶ Ep 4 · 9:30

epidemiological Of 12-year-olds with BMI at 99th percentile, all will grow up to have BMIs greater than 30, 88% will have BMIs greater than 35, and 2/3 will have class 3 obesity, according to the Bogalusa Heart Study. ↗

▶ Ep 4 · 13:00

guideline Severe obesity is defined as BMI greater than 1.2 times the 95th percentile. ↗

▶ Ep 4 · 15:30

clinical Only 2% of teenagers with severe obesity demonstrated clinically significant BMI reduction with lifestyle modification therapy. ↗

▶ Ep 4 · 17:00

clinical In a study comparing inpatient (6 months) versus outpatient lifestyle modification therapy followed for 2 years, there was no statistically significant difference in outcomes at 2 years despite better response during inpatient treatment. ↗

▶ Ep 4 · 21:00

clinical Mutations in the melanocortin 4 receptor (MC4R) account for the most common single gene mutation causing early onset severe obesity in pediatrics. ↗

▶ Ep 4 · 22:00

clinical Bupropion-naltrexone combination works by bupropion stimulating POMC cells to secrete alpha-MSH (which stimulates MC4 receptors to decrease hunger), while naltrexone blocks the auto-inhibitory feedback from beta-endorphin, allowing relatively more alpha-MSH activity. ↗

▶ Ep 4 · 28:00

clinical When people lose weight, they experience increased hunger, decreased satiety, increased preference for highly palatable foods, and increased metabolic efficiency—all promoting weight regain. ↗

▶ Ep 4 · 29:00

clinical Bariatric surgery is currently the most effective and durable treatment for severe obesity in adolescents. ↗

▶ Ep 4 · 30:00

clinical Orlistat is a lipase inhibitor that blocks absorption of about 30% of fat, is FDA approved for children 12 and older, and in the largest RCT of about 500 patients showed placebo-subtracted BMI difference of about 0.8 units at one year. ↗

▶ Ep 4 · 31:00

clinical Phentermine is FDA approved for age 16 and older (from 1950s approval), but there have been no RCTs in adolescents longer than 1 month duration. ↗

▶ Ep 4 · 31:30

clinical Among adults, phentermine produces mean weight loss of about 3.5 kg. ↗

▶ Ep 4 · 32:00

clinical In studies of adults on phentermine, there have been no withdrawal symptoms upon abruptly stopping and no reports of increased blood pressure, probably because patients are losing weight. ↗

▶ Ep 4 · 33:00

clinical In a chart review of 25 patients on phentermine only for 6 months plus lifestyle modification, compared to 274 receiving only lifestyle modification, there was about a 4% decrease in BMI favoring the phentermine group. ↗

▶ Ep 4 · 34:10

clinical After many studies of metformin, we can expect about a one unit decrease in BMI. ↗

▶ Ep 4 · 34:40

clinical Liraglutide, a GLP-1 agonist, has recently been FDA approved for obesity in adults. ↗

▶ Ep 4 · 35:20

clinical In a pilot study of exenatide (GLP-1 agonist) with about 25 patients, during the first 3 months double-blinded portion, there was a placebo-subtracted effect of about 3% in BMI favoring the exenatide group. ↗

▶ Ep 4 · 36:30

clinical In a chart review of patients taking topiramate only (no other medications) with lifestyle modification therapy, there was about a 6% decrease in BMI at 6 months. ↗

▶ Ep 4 · 37:10

clinical In an RCT of topiramate 75mg/day after meal replacement induction phase, there was no statistically significant effect between topiramate and placebo groups by study end. ↗

▶ Ep 4 · 38:50

clinical Topiramate is FDA approved down to age 2 for seizures and has been used in pediatrics for decades. ↗

▶ Ep 4 · 39:00

clinical Topiramate at 75mg/day was safe in adolescents, with extensive neurocognitive testing showing no signal of cognitive deficits. ↗

▶ Ep 4 · 39:55

quote These medications do not work in a vacuum. They help you adhere to your eating plan. If you don't have an eating plan, they do nothing. ↗

▶ Ep 4 · 40:20

clinical Early success in weight management predicts long-term weight loss success, according to adult literature. ↗

▶ Ep 4 · 40:50

opinion Obesity is a chronic disease requiring indefinite medication treatment; stopping the medication results in weight regain, similar to stopping antihypertensive medication causing blood pressure to rise. ↗

▶ Ep 4 · 40:55

quote You don't develop dependence on it, you don't rely on it, any more than you would develop a reliance on an antihypertensive agent to treat your high blood pressure. ↗

▶ Ep 4 · 41:40

clinical Recently FDA-approved medications for adult obesity (age 18+) include topiramate-phentermine combination, liraglutide, naltrexone-bupropion combination, and lorcaserin, approved for BMI >30 or >27 with weight-related comorbidities. ↗

▶ Ep 4 · 41:40

opinion Bariatric surgery is seen as more acceptable than pharmacotherapy for pediatric obesity, despite being arguably riskier and irreversible. ↗

Claudia's statements about Severe Obesity 26 statements

Open the Severe Obesity collection →

Pharmacology: Pediatric Obesity 2017

▶ Ep 1 · 9:30

epidemiological Of 12-year-olds with BMI at 99th percentile, all will grow up to have BMIs greater than 30, 88% will have BMIs greater than 35, and 2/3 will have class 3 obesity, according to the Bogalusa Heart Study. ↗

▶ Ep 1 · 13:00

guideline Severe obesity is defined as BMI greater than 1.2 times the 95th percentile. ↗

▶ Ep 1 · 15:30

clinical Only 2% of teenagers with severe obesity demonstrated clinically significant BMI reduction with lifestyle modification therapy. ↗

▶ Ep 1 · 17:00

clinical In a study comparing inpatient (6 months) versus outpatient lifestyle modification therapy followed for 2 years, there was no statistically significant difference in outcomes at 2 years despite better response during inpatient treatment. ↗

▶ Ep 1 · 21:00

clinical Mutations in the melanocortin 4 receptor (MC4R) account for the most common single gene mutation causing early onset severe obesity in pediatrics. ↗

▶ Ep 1 · 22:00

clinical Bupropion-naltrexone combination works by bupropion stimulating POMC cells to secrete alpha-MSH (which stimulates MC4 receptors to decrease hunger), while naltrexone blocks the auto-inhibitory feedback from beta-endorphin, allowing relatively more alpha-MSH activity. ↗

▶ Ep 1 · 28:00

clinical When people lose weight, they experience increased hunger, decreased satiety, increased preference for highly palatable foods, and increased metabolic efficiency—all promoting weight regain. ↗

▶ Ep 1 · 29:00

clinical Bariatric surgery is currently the most effective and durable treatment for severe obesity in adolescents. ↗

▶ Ep 1 · 30:00

clinical Orlistat is a lipase inhibitor that blocks absorption of about 30% of fat, is FDA approved for children 12 and older, and in the largest RCT of about 500 patients showed placebo-subtracted BMI difference of about 0.8 units at one year. ↗

▶ Ep 1 · 31:00

clinical Phentermine is FDA approved for age 16 and older (from 1950s approval), but there have been no RCTs in adolescents longer than 1 month duration. ↗

▶ Ep 1 · 31:30

clinical Among adults, phentermine produces mean weight loss of about 3.5 kg. ↗

▶ Ep 1 · 32:00

clinical In studies of adults on phentermine, there have been no withdrawal symptoms upon abruptly stopping and no reports of increased blood pressure, probably because patients are losing weight. ↗

▶ Ep 1 · 33:00

clinical In a chart review of 25 patients on phentermine only for 6 months plus lifestyle modification, compared to 274 receiving only lifestyle modification, there was about a 4% decrease in BMI favoring the phentermine group. ↗

▶ Ep 1 · 34:10

clinical After many studies of metformin, we can expect about a one unit decrease in BMI. ↗

▶ Ep 1 · 34:40

clinical Liraglutide, a GLP-1 agonist, has recently been FDA approved for obesity in adults. ↗

▶ Ep 1 · 35:20

clinical In a pilot study of exenatide (GLP-1 agonist) with about 25 patients, during the first 3 months double-blinded portion, there was a placebo-subtracted effect of about 3% in BMI favoring the exenatide group. ↗

▶ Ep 1 · 36:30

clinical In a chart review of patients taking topiramate only (no other medications) with lifestyle modification therapy, there was about a 6% decrease in BMI at 6 months. ↗

▶ Ep 1 · 37:10

clinical In an RCT of topiramate 75mg/day after meal replacement induction phase, there was no statistically significant effect between topiramate and placebo groups by study end. ↗

▶ Ep 1 · 38:50

clinical Topiramate is FDA approved down to age 2 for seizures and has been used in pediatrics for decades. ↗

▶ Ep 1 · 39:00

clinical Topiramate at 75mg/day was safe in adolescents, with extensive neurocognitive testing showing no signal of cognitive deficits. ↗

▶ Ep 1 · 39:55

quote These medications do not work in a vacuum. They help you adhere to your eating plan. If you don't have an eating plan, they do nothing. ↗

▶ Ep 1 · 40:20

clinical Early success in weight management predicts long-term weight loss success, according to adult literature. ↗

▶ Ep 1 · 40:50

opinion Obesity is a chronic disease requiring indefinite medication treatment; stopping the medication results in weight regain, similar to stopping antihypertensive medication causing blood pressure to rise. ↗

▶ Ep 1 · 40:55

quote You don't develop dependence on it, you don't rely on it, any more than you would develop a reliance on an antihypertensive agent to treat your high blood pressure. ↗

▶ Ep 1 · 41:40

clinical Recently FDA-approved medications for adult obesity (age 18+) include topiramate-phentermine combination, liraglutide, naltrexone-bupropion combination, and lorcaserin, approved for BMI >30 or >27 with weight-related comorbidities. ↗

▶ Ep 1 · 41:40

opinion Bariatric surgery is seen as more acceptable than pharmacotherapy for pediatric obesity, despite being arguably riskier and irreversible. ↗

Claudia's statements about Severe Obesity 26 statements

Open the Severe Obesity collection →

Pharmacology: Pediatric Obesity 2017

▶ Ep 1 · 9:30

epidemiological Of 12-year-olds with BMI at 99th percentile, all will grow up to have BMIs greater than 30, 88% will have BMIs greater than 35, and 2/3 will have class 3 obesity, according to the Bogalusa Heart Study. ↗

▶ Ep 1 · 13:00

guideline Severe obesity is defined as BMI greater than 1.2 times the 95th percentile. ↗

▶ Ep 1 · 15:30

clinical Only 2% of teenagers with severe obesity demonstrated clinically significant BMI reduction with lifestyle modification therapy. ↗

▶ Ep 1 · 17:00

clinical In a study comparing inpatient (6 months) versus outpatient lifestyle modification therapy followed for 2 years, there was no statistically significant difference in outcomes at 2 years despite better response during inpatient treatment. ↗

▶ Ep 1 · 21:00

clinical Mutations in the melanocortin 4 receptor (MC4R) account for the most common single gene mutation causing early onset severe obesity in pediatrics. ↗

▶ Ep 1 · 22:00

clinical Bupropion-naltrexone combination works by bupropion stimulating POMC cells to secrete alpha-MSH (which stimulates MC4 receptors to decrease hunger), while naltrexone blocks the auto-inhibitory feedback from beta-endorphin, allowing relatively more alpha-MSH activity. ↗

▶ Ep 1 · 28:00

clinical When people lose weight, they experience increased hunger, decreased satiety, increased preference for highly palatable foods, and increased metabolic efficiency—all promoting weight regain. ↗

▶ Ep 1 · 29:00

clinical Bariatric surgery is currently the most effective and durable treatment for severe obesity in adolescents. ↗

▶ Ep 1 · 30:00

clinical Orlistat is a lipase inhibitor that blocks absorption of about 30% of fat, is FDA approved for children 12 and older, and in the largest RCT of about 500 patients showed placebo-subtracted BMI difference of about 0.8 units at one year. ↗

▶ Ep 1 · 31:00

clinical Phentermine is FDA approved for age 16 and older (from 1950s approval), but there have been no RCTs in adolescents longer than 1 month duration. ↗

▶ Ep 1 · 31:30

clinical Among adults, phentermine produces mean weight loss of about 3.5 kg. ↗

▶ Ep 1 · 32:00

clinical In studies of adults on phentermine, there have been no withdrawal symptoms upon abruptly stopping and no reports of increased blood pressure, probably because patients are losing weight. ↗

▶ Ep 1 · 33:00

clinical In a chart review of 25 patients on phentermine only for 6 months plus lifestyle modification, compared to 274 receiving only lifestyle modification, there was about a 4% decrease in BMI favoring the phentermine group. ↗

▶ Ep 1 · 34:10

clinical After many studies of metformin, we can expect about a one unit decrease in BMI. ↗

▶ Ep 1 · 34:40

clinical Liraglutide, a GLP-1 agonist, has recently been FDA approved for obesity in adults. ↗

▶ Ep 1 · 35:20

clinical In a pilot study of exenatide (GLP-1 agonist) with about 25 patients, during the first 3 months double-blinded portion, there was a placebo-subtracted effect of about 3% in BMI favoring the exenatide group. ↗

▶ Ep 1 · 36:30

clinical In a chart review of patients taking topiramate only (no other medications) with lifestyle modification therapy, there was about a 6% decrease in BMI at 6 months. ↗

▶ Ep 1 · 37:10

clinical In an RCT of topiramate 75mg/day after meal replacement induction phase, there was no statistically significant effect between topiramate and placebo groups by study end. ↗

▶ Ep 1 · 38:50

clinical Topiramate is FDA approved down to age 2 for seizures and has been used in pediatrics for decades. ↗

▶ Ep 1 · 39:00

clinical Topiramate at 75mg/day was safe in adolescents, with extensive neurocognitive testing showing no signal of cognitive deficits. ↗

▶ Ep 1 · 39:55

quote These medications do not work in a vacuum. They help you adhere to your eating plan. If you don't have an eating plan, they do nothing. ↗

▶ Ep 1 · 40:20

clinical Early success in weight management predicts long-term weight loss success, according to adult literature. ↗

▶ Ep 1 · 40:50

opinion Obesity is a chronic disease requiring indefinite medication treatment; stopping the medication results in weight regain, similar to stopping antihypertensive medication causing blood pressure to rise. ↗

▶ Ep 1 · 40:55

quote You don't develop dependence on it, you don't rely on it, any more than you would develop a reliance on an antihypertensive agent to treat your high blood pressure. ↗

▶ Ep 1 · 41:40

clinical Recently FDA-approved medications for adult obesity (age 18+) include topiramate-phentermine combination, liraglutide, naltrexone-bupropion combination, and lorcaserin, approved for BMI >30 or >27 with weight-related comorbidities. ↗

▶ Ep 1 · 41:40

opinion Bariatric surgery is seen as more acceptable than pharmacotherapy for pediatric obesity, despite being arguably riskier and irreversible. ↗

Featured statements

Pharmacology: Pediatric Obesity 2017

Pharmacology: Pediatric Obesity 2017

Pharmacology: Pediatric Obesity 2017

Pharmacology: Pediatric Obesity 2017

Summaries Claudia gave as host · 8 summaries

Pharmacology: Pediatric Obesity 2017

Pharmacology: Pediatric Obesity 2017

Pharmacology: Pediatric Obesity 2017

Pharmacology: Pediatric Obesity 2017