Bridging the gap: recommendations to accomplish transition from pediatric to adult care in adolescents living with obesity.

Childhood obesity is a significant concern and its chronic nature results in an increased risk of adulthood obesity. Poorly planned transition from pediatric to adult care may contribute to poor outcomes. Failed transition may result in loss to follow-up or inadequate treatment adherence. In other chronic diseases, the transition is well organized. However, although obesity societies highlight its importance, no specific guidelines are available to properly accomplish this procedure. In order to fill this gap, an interdisciplinary group consisting of pediatric endocrinologists, adult endocrinologists and primary care practitioners combined forces to develop a set of agreed recommendations to guide the transition of adolescents living with obesity (AlwOs) from pediatric to adult healthcare. Three well-defined phases were identified: preparation of transfer, transfer and reception in adult care. Specific suggestions, accompanied by infographic support, are provided for each one of them. The authors agreed to underline several important issues: there is no ideal age to initiate transition, which is contingent upon individual characteristics; the figure of a transition coordinator is pivotal; pre-transfer sessions with participation of pediatric and adult teams are required to guarantee continuity of care; transfer should start only if AlwO/caregivers agree; transfer sessions should start under control of the pediatric provider, and leadership should be progressively taken over by the adult doctor, who should be adequately trained to manage patients with a troublesome condition at a critical age; at reception in adult care, a detailed long-term management and follow-up plan has to be agreed with the AlwO. Finally, tools to assess quality of the procedure are provided. In summary, guidance to manage the AlwO's transition in the daily practice is supplied.