Metabolic syndrome – lifestyle — RACP Paediatrics MCQ

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EasyEndocrineMetabolic syndrome – lifestyleRACP Paediatrics

A 14-year-old with BMI 38 (>99th centile) has impaired fasting glucose (6.5 mmol/L), acanthosis nigricans, dyslipidaemia, and elevated ALT (fatty liver). Blood pressure is 138/88 mmHg. What is the most appropriate initial management?

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Correct answer: A — Lifestyle modification (diet + exercise)

Intensive lifestyle modification (dietary counselling, increased physical activity, behavioural strategies) is the first-line management for paediatric obesity with metabolic complications. A structured family-based programme with achievable goals is recommended. Pharmacotherapy (metformin, GLP-1 agonists) may be added if lifestyle changes alone are insufficient after 3-6 months.

Reference: RCH Melbourne – 2023 – Obesity CPG; RACP Paediatric Curriculum – Endocrine