Beneficial Effects of Setmelanotide in a 5-Year-Old Boy With POMC Deficiency and on His Caregivers.

The melanocortin-4 receptor agonist setmelanotide is now recommended for the treatment of genetic obesity due to proopiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency in patients aged 6 years and older. Here, we describe the clinical benefit of setmelanotide administration in a 5-year-old child with severe hyperphagia and obesity due to POMC deficiency. Daily administration of 0.5 mg setmelanotide for 12 months resulted in significant weight loss of -30 kg from baseline (-36% of weight loss) and improvements in hyperphagia and metabolic status. No major side effects were observed, except for hyperpigmentation and transient spontaneous erections. Interestingly, the clinical improvement of the child was associated with a remarkable improvement in the quality of life of the parents, along with a decrease in their emotional scores. This observation supports the early use of setmelanotide in young children with melanocortin pathway variants, in order to limit the adverse consequences of early and extreme weight gain, and to improve the quality of life of patients and of their relatives.

Does the use of color coding facilitate parents' understanding of body mass index curves?

BACKGROUND: In France, national guidelines recommend early detection and management of overweight and obesity in children, with multi-year systematic generation of children's body mass index (BMI) curves in primary care. It is important for the parents to understand the BMI curves displayed in the child's health notebook and to become involved in the care with health professionals. OBJECTIVE: The aim of the current study was to compare parents' understanding of a BMI curve displayed using color coding versus their understanding of the same curve displayed without color coding. METHODS: An observational, cross-sectional, comparative study was performed between February 1, 2021 and November 15, 2021. Adult parents with at least one child attending primary school were included. Two questionnaires testing parents' understanding were completed: one showing BMI curves without color coding (five questions) and one showing BMI curve with color coding (five questions). The primary endpoint was the proportion of parents achieving fully correct answers. Comparisons of endpoints between the color-coded and non-color-coded curve were performed using the McNemar test. Factors associated with the primary endpoint were investigated by mixed logistic regression models with the subject as a random effect. RESULTS: The 109 participants (45.4% response rate) had an average age of 39.4 ± 6.6 years; 81.7% were women. A total of 214 complete questionnaires were compared: The proportion of participants with fully correct responses was significantly higher using the BMI curve with color coding compared to the curve without color coding (86.0% vs. 54.2%, p<0.0001). In multivariate analysis, the use of color coding was significantly associated with a higher likelihood of achieving fully correct responses (odds ratio: 5.9, 95% CI: 3.0-11.2, p<0.0001). CONCLUSION: The use of color coding improved parents' understanding of BMI curves. Further research should explore equally the benefits and risks associated with weight loss and mental health when using a colored BMI curve for the detection and management of overweight and obese children.