In addition, during the COVID-19 pandemic, children and adolescents with obesity have been more likely to have severe COVID-19 requiring hospitalization and mechanical ventilation 3. The prevalence of child and adolescent obesity remains high and continues to rise in low-income and middle-income countries (LMICs) at a time when these regions are also contending with under-nutrition in its various forms 1, 2. Development and implementation of interventions to prevent paediatric obesity in children should focus on interventions that are feasible, effective and likely to reduce gaps in health inequalities. Prevention of obesity requires a whole-system approach and joined-up policy initiatives across government departments. In adolescents in particular, adjunctive therapies can be valuable, such as more intensive dietary therapies, pharmacotherapy and bariatric surgery. Treatment incorporates a respectful, stigma-free and family-based approach involving multiple components, and addresses dietary, physical activity, sedentary and sleep behaviours. Comorbidities of obesity, including type 2 diabetes mellitus, fatty liver disease and depression, are more likely in adolescents and in those with severe obesity. Health-related quality of life is reduced in those with obesity. Obesity arises when a mix of genetic and epigenetic factors, behavioural risk patterns and broader environmental and sociocultural influences affect the two body weight regulation systems: energy homeostasis, including leptin and gastrointestinal tract signals, operating predominantly at an unconscious level, and cognitive–emotional control that is regulated by higher brain centres, operating at a conscious level. obesity reviews © 2012 International Association for the Study of Obesity.The prevalence of child and adolescent obesity has plateaued at high levels in most high-income countries and is increasing in many low-income and middle-income countries. The EPODE logic model presented here can be used as a reference for future and follow-up research to support future implementation of EPODE in communities as a tool in the engagement of stakeholders and to guide the construction of a locally tailored evaluation plan. With input from international experts, this model was scaled down to a concise logic model covering four critical components: political commitment, public and private partnerships, social marketing and evaluation. Retrieved data were coded, themed and placed in a four-level logic model. EPODE's process manuals and documents were collected and interviews were held with professionals involved in the planning and delivery of EPODE. The objective of this study is to gain insight in the dynamics and key elements of EPODE and to represent these in a schematic logic model. Although based on emergent practice and scientific knowledge, EPODE, as many community programs, lacks a logic model depicting key elements of the approach. Since 2004, EPODE has been implemented in over 500 communities in six countries. EPODE ('Ensemble Prévenons l'Obésité De Enfants' or 'Together let's Prevent Childhood Obesity') is a large-scale, centrally coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity.
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