You have probably heard about our country’s obesity epidemic. Here in Tennessee, about one-third of children are classified as overweight or obese. Many factors contribute to the increasing rates of obesity including decreased physical activity and easy access to high calorie foods. Unfortunately, popular culture has stereotyped obese people as lazy and gluttonous and many overweight children are subject to bullying. It’s important to remember that in some cases, childhood obesity may be due to a medical condition.
Here are some signs that a child may have a medical problem causing weight gain:
- They are not growing taller at a normal rate
- The excessive weight gain began in the first year of life
- They have developmental delays (motor or verbal)
- There is a strong family history of excessive weight gain in childhood
At Vanderbilt, we are doing research to understand how the hypothalamus regulates body weight and how to better treat children with early-onset obesity. The hypothalamus is an area of the brain that regulates body weight, similar to how the thermostat in your house regulates the room temperature. It tries to balance the number of calories burned with how much you eat in a day.
In some people, the hypothalamus doesn’t work properly, leading to excessive weight gain. This can be due to a genetic problem or from damage to the hypothalamus, such as a brain tumor or traumatic brain injury.
Hormone problems, such as hypothyroidism or Cushing’s syndrome, are very rarely the cause of weight gain in children. At this time, we do not recommend routine genetic testing for most children with obesity unless it is part of research study.
Currently, we do not have medical treatments for children with obesity syndromes. These children have to exercise more and eat less, even though their brain tells them that they are always hungry or their metabolism is unusually slow. Our goal for the future is to tailor the medical treatment to fix the reason that each patient is gaining weight, using specialized diets or medication.
Dr. Ashley Shoemaker is a Pediatric Endocrinologist at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Her research focuses on understanding and treating early-onset obesity. When she’s not at Vanderbilt she enjoys ice skating, soccer and spending time with her kids.