Adolescent Obesity and Puberty: The "Perfect Storm"

Obesity is the most serious long‐term health risk currently facing America's adolescents. Weight gain during adolescence carries a higher risk for adult obesity and the metabolic syndrome. This review highlights early adolescence as a particularly high‐risk time for weight gain due to the syner...

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Bibliographic Details
Published in:Annals of the New York Academy of Sciences 2008-06, Vol.1135 (1), p.265-279
Main Authors: Jasik, Carolyn Bradner, Lustig, Robert H.
Format: Article
Language:English
Subjects:
Adolescent
adolescent obesity
Adult
Breast Neoplasms - etiology
estrogen
Estrogens - blood
Female
Humans
Hypothalamo-Hypophyseal System
insulin
Insulin Resistance
leptin
Leptin - blood
leptin, insulin
menstrual cycle
Metabolic Syndrome - etiology
obesity
Obesity - complications
overweight
pediatric obesity
Polycystic Ovary Syndrome - etiology
Puberty
Risk Factors
Weight Gain
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Summary:Obesity is the most serious long‐term health risk currently facing America's adolescents. Weight gain during adolescence carries a higher risk for adult obesity and the metabolic syndrome. This review highlights early adolescence as a particularly high‐risk time for weight gain due to the synergy of naturally occurring metabolic changes along with increasing behavioral risk factors. One of the first potential health effects of abnormal weight gain during this period is earlier puberty, usually manifested as thelarche. The obesity epidemic is clearly implicated in the national trend toward earlier thelarche, although the data are not as strong in relation to menarche. Leptin activation of the hypothalamic‐pituitary axis, combined with insulin resistance, and increased adiposity may result in the higher estrogen levels that are linked to breast development. Young adolescents also experience a sharp decline in their level of physical activity, worsening nutritional habits, and other important psychosocial and developmental risk factors that may contribute to obesity and estrogen‐dependent disease in later life, including polycystic ovary syndrome and breast cancer. Unfortunately, the very psychosocial factors that contribute to abnormal weight gain during early adolescence make prevention and treatment in this population particularly challenging. Therefore, intervening prior to pubertal onset becomes even more important given the risk factors present once puberty begins.
ISSN:0077-8923
1749-6632
DOI:10.1196/annals.1429.009