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Review
. 2024 Oct;71(5):761-779.
doi: 10.1016/j.pcl.2024.06.003. Epub 2024 Jul 23.

Overview of Pediatric Obesity as a Disease

Stephanie W Waldrop  1 , Awab Ali Ibrahim  2 , Jacqueline Maya  3 , Carmen Monthe-Dreze  4 , Fatima Cody Stanford  5
Affiliations
Review

Overview of Pediatric Obesity as a Disease

Stephanie W Waldrop et al. Pediatr Clin North Am. 2024 Oct.

Abstract

The authors highlight well-known and hypothesized pathophysiologic mechanistic links underlying obesity and the various pediatric disorders across multiple organ systems with which it is associated. Obesity is attributed to an imbalance in energy intake versus expenditure; there is growing knowledge regarding its multifactorial origins, dysfunctional physiologic processes, and adverse health consequences. Individuals with obesity exhibit variations in metabolic rate, genetic predisposition, and hormonal regulation, influencing diverse responses in regulating energy balance. Understanding the complex mechanistic relationships surrounding the pathophysiology of obesity assists in its consideration as a disease process, allowing pediatric health practitioners to manage its sequelae more effectively.

Keywords: Inflammation; Metabolic dysfunction; Pathophysiology; Pediatric obesity.

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Conflict of interest statement

Disclosure F.C. Stanford has served as a consultant to Calibrate, GoodRx, Pfizer, Eli Lilly, Boehringer Ingelheim, Gelesis, Vida Health, Life Force, Ilant Health, Melli Cell, Novo Nordisk. Other sources of support: University of Colorado School of Medicine–Anschutz Medical Campus and the University of Colorado Nutrition Obesity Research Center, The Nutrition Obesity Research Center at the University of Colorado, Harvard University School of Medicine, Harvard University (NORCH), and the NORCH Diversity Scholars Program. Authors' contributions: S.W. Waldrop, A.A. Ibrahim, J. Maya, and C. Monthe-Dreze contributed equally to writing and editing this work. F.C. Stanford provided editorial and supervisory expertise.

Figures

Figure 1.
Figure 1.
Pathophysiologic mechanisms linking obesity to cardiovascular disease. Abbreviations: SNS - sympathetic nervous system, RAAS - renin-angiotensin aldosterone system, LV- left ventricular, NO – nitric oxide, PPARγ - Peroxisome proliferator-activated receptor-gamma, Na - sodium, ECF - extracellular fluid
Figure 2.
Figure 2.
Postulated relationships between energy balance and accelerated puberty. Abbreviations: Kiss – kissipeptin, GnRH – gonadotropin releasing hormone, LH – lutenizing hormone, FSH – follicle stimulating hormone, SHBG – sex hormone binding globulin, DHEAS – dihydroepiandosterone sulfate
Figure 3.
Figure 3.
Shared neurobiological pathways and outcomes linking energy balance and attentional dysregulation
Figure 4.
Figure 4.
Dermatologic manifestations of obesity
See this image and copyright information in PMC

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