Obesity and Growth Disorders

Festschrift Dedicated to George A. Burghen

Abstract

This summary was presented at the Festschrift dedicated to George A. Burghen, MD, who has devoted his career at the University of Tennessee, Memphis, to improving care of children with disorders of glucose metabolism, including obesity and type 1 and type 2 diabetes mellitus.

This article reviews the mechanisms associating growth disorders with obesity. Most commonly, obesity (overnutrition) leads to accelerated growth rate and tall stature during childhood with early achievement of normal adult height. Small stature associated with obesity during childhood and as an adult can result from a diverse set of conditions. These include being born small for gestational age, postnatal malnutrition, hormone abnormalities such as deficiencies of growth hormone or thyroid hormone, late effects after childhood cancer, certain medications, and genetic syndromes. Common features of growth disorders in the context of obesity include limited growth hormone or thyroid hormone or their action, or limited sensitivity to insulin action. Finally, abnormalities of leptin and newly identified appetite-regulating peptides also lead to poor growth and overweight. Obesity in the general population is much more likely to result from excess calories and sedentary lifestyle than from any of the conditions discussed above.