Clinico-etiological Profile and Metabolic Complications in Pediatric Early Onset Obesity - Experience from a Tertiary Care Centre in India

ObjectivesTo describe the clinical and metabolic profile and associated risk factors in children with early onset obesity (presenting before five years of age). To identify features that would differentiate primary from secondary obesity in under-five children.MethodsA retrospective study analyzed the medical records of children diagnosed with early onset obesity between June 2015 to December 2023 to ascertain the etiological diagnosis and identify the risk predictors. Laboratory profiles and genetic studies, wherever available, were studied. Association of various factors with underlying etiology was done using standard statistical methods.ResultsOut of 530 children presenting with obesity during the study period, 77 (14.5%) were aged less than 5 years. Primary obesity was found in 55 (71.4%) children. Genetic causes of obesity were confirmed in 14 (18.18%) children. Increased screen time (more than 2 hours per day) and acanthosis nigricans correlated positively with the presence of primary obesity. Additionally, a significant association was observed between the presence of obesity in parents and early onset primary obesity, indicating a combined influence of an unhealthy lifestyle and a genetic predisposition.ConclusionPrimary obesity was more common in early onset obesity. Obesity in parents, excess screen time and presence of acanthosis nigricans were significantly associated with primary obesity suggesting a combination of genetic predisposition and unhealthy lifestyle as risk factors.