According to the World Health Organization, obesity should be regarded as a disease rather than a lifestyle problem. The prevalence of obesity is on the increase in the adult and childhood population worldwide. Although genetic factors play a role in the individual predisposition to obesity, monogenic causes of severe obesity are rare. The lack of physical activity and sedentary lifestyle in the population are important contributing factors in the obesity epidemic worldwide. The body mass index (BMI) has been proposed as a good clinical measure for the definition of obesity in children and adolescents. Using an international BMI reference derived from 6 population studies, 10.3% and 6.3% of 15-year-old boys and girls in Hong Kong were found to be overweight or obese. Even in childhood and adolescents, obesity-related comorbidities exist including the metabolic syndrome, hypertension, pulmonary complications and musculoskeletal problems. Childhood obesity can lead to significant psychosocial consequences including negative self-mage, low self esteem and poor quality of life. Psychosocial distress and psychiatric disorder in children and adolescents may be more associated with parental psychosocial and psychiatric problem than the child's own BMI, age or sex. Approximately 10-30% of obese persons who seek weight reduction suffer from binge eating. Unfortunately, there is currently limited high quality data on the effectiveness of obesity prevention programmes. Numerous long-term and short-term studies have been conducted to assess the effectiveness of educational, psychological and behavioural therapy, for the individual and family focussing on diet, physical activity, social support and lifestyle changes and the results have not been encouraging. Studies on the metabolic and psychological sequalae of childhood and adolescent obesity are needed in Hong Kong. Targeted screening for type 2 diabetes mellitus in obese children and adolescents is indicated.
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