青少年肥胖

Adolescent Obesity

兒童肥胖的成因很多，現代人不健康的生活型態，包括身體活動量不足、靜態性活動，以及過度 攝取熱量等，都是造成我們的下一代肥胖問題暴增的主因。教育部的調查顯示 2016年國小學童肥胖比率為 14.9%（男童 17.4%及女童 12.2%）；國中生肥胖比率為16.8%（男生 20.0%、女生 13.2%）。肥胖會引發准 患各式各樣的合併症，如心血管疾病、脂肪肝疾病、代謝症候群、第二型糖尿病、睡眠呼吸中止與癌症 等疾病。這些非傳染性疾病是現代社會國民增加長期健康風險與致死的主因。對於成長中的兒童來說， 更會有生活品質降低、被嘲笑及霸凌與社會孤立等心理層次的長期影響。由於兒童肥胖與其健康危害在全球與我國都迅速地惡化中，因此兒童肥胖防治已經是迫切需要全民介入的一大挑戰治療，兒科醫學會與建議兒童青少年肥胖的處置可採取漸進的四階段模式來處理，包括：（1）階段一，加強性預防；（2）階段二，結構式體重管理；（3）階段三，全方位跨領域團隊介入；（4）階段四，第三級醫療照 護介入。經由這樣的階段性模式，可以提供各種不同肥胖嚴重程度的兒童青少年一個可以具體執行的減 重計畫架構。

There are many causes of childhood obesity. The unhealthy lifestyles, including insufficient physical activity, sedentary lifestyle, and excessive calorie intake, are the main reasons for the explosion of obesity in our next generation. Based on the survey by the Ministry of Education in 2016, the obesity rate of elementary school children was 14.9% (17.4% for boys and 12.2% for girls); the obesity rate for junior high school students was 16.8% (20.0% for boys and 13.2% for girls). Obesity can cause a variety of comorbidities, such as cardiovascular disease, fatty liver disease, metabolic syndrome, type 2 diabetes, sleep apnea, and cancer. These non-communicable diseases are the main cause of the increase of long-term health risks and death among the citizens of modern society. For growing children, there will be long-term psychological effects such as reduced quality of life, ridicule, bullying and social isolation. Since childhood obesity and its health hazards are rapidly deteriorating both globally and in Taiwan, the prevention and treatment of childhood obesity has become a major challenge that urgently requires the intervention of the whole people. Regarding the treatment of childhood obesity, the American Academy of Pediatrics recommends that obesity in children and adolescents can be treated in a progressive four-stage model, which includes: (1) Phase 1, Prevention Plus (2) Phase 2, Structured Weight Management; (3) Phase III, Comprehensive Multidisciplinary Intervention; (4) Phase IV, Tertiary Care Intervention. Through such a phased model, it is possible to provide children and adolescents with various obesity severity a weight loss program framework that can be feasibly implemented.