Endocrine/Reproductive - Obesity

Question 1

Aetiology

Answer 1

• If a child is obese + short = endogenous cause e.g. hypothyroidism and Cushing’s syndrome
• If child obese + learning difficulties or who are dysmorphic = an underlying syndrome may be present e.g. Prada-Willi (obesity, hyperphagia, poor linear growth, dysmorphic facial features, hypotonia and undescended testes in males)
• Severely obese children < 3 yrs = genetic defects e.g. Leptin deficiency

Question 2

Treatment

Answer 2

Orlistat = lipase inhibitor = reduces absorption of dietary fat and thus produces steatorrhoea
- should not be used for children under 12 but may be indicated if there are co-morbidities or severe psychological disturbances:
- orthopaedic
- sleep apnoea