Obesity in Child
Pediatric obesity increases in prevalence with age. In the United States, approximately 14% of preschool children and 21% of adolescents are obese. Severe obesity also increases in prevalence with age. Approximately 2% of preschool children and 7%-10% of adolescents are severely obese. Risk factors include ethnicity (Native American, African American, and Mexican American patients are at increased risk), low socioeconomic class, low education level, and living in a rural community. In the United States, childhood obesity rates have been rising for the last several decades. Obesity tends to persist into adulthood.
The majority of obese children are obese due to a net-positive energy balance resulting from high caloric intake and insufficient physical activity.
There are many risk factors for the development of pediatric obesity. In rare instances, a specific genetic, hypothalamic, or endocrine disorder will predispose a patient to obesity. Specific mutations in GNAS and their effects on G protein-coupled receptor (GPCR) signaling have been identified. More often, environmental factors such as high consumption of sugar-rich beverages, physical inactivity, and excess screen time all contribute to a net-positive caloric balance that leads to obesity. The role of epigenetics in obesity is an emerging field of research for which specific causality has yet to be defined.
The following common skin conditions are seen more frequently in obese pediatric patients: hyperhidrosis and bromhidrosis, bacterial and candidal skin infections, onychomycosis, acne vulgaris, hirsutism, hidradenitis suppurativa, psoriasis, and rosacea.
E66.9 – Obesity, unspecified
414916001 – Obesity
Endocrine and hypothalamic disorders should also be considered:
- Cushing syndrome, including exogenous corticosteroid exposure
- Growth hormone deficiency
- Panhypopituitarism (post-craniopharyngioma resection)
- ROHHADNET syndrome: rapid onset obesity, hypothalamic dysfunction, hypoventilation, autonomic dysregulation, and neuroendocrine tumors