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What Causes Difficulty In Losing Weight And Lack Of Energy In Children?
Question: My son aged 11 years and 2 months is 145 cm tall and weighs over 51 kg despite not taking lots of junk food or fatty foods. He also has a problem that looks like gynecomastia that makes him feel extremely embarrassed in situations that require him to take of his shirt. His weight is also not coming down despite conscious effort by him in the form of indoor exercises and dance (Xbox with kinect sensor). He is generally less energetic than other children of his age and tends to lean to any support or sit or lie down. Most of the time he is irritated and tends to be a loner except when his mates listen to him. He also has a somewhat awkward belly with a distinct XXXXXXX I guess it is hormonal issue and want him to undergo any diagnostics before meeting an endocrinologist. I would be glad to know of the tests that can be done safely for his problem.
Brief Answer:
This is a prudent course to take but ...
Detailed Answer:
Dear XXXXXXX,
First of all, thank you for once again approaching HCM for your queries. You have consulted a pediatrician some years ago too, as I can see.
The first thing I want to say is: yes, it is a good thing that you are sufficiently concerned about your son to want to visit an endocrinologist. Your use of the words "gynecomastia" and other jargon tells me that you might be a medico yourself. Be that as it may, you might want to know that body frames of all humans come in 3 basic sizes - your son is probably endomorphic in shape. (Thin individuals are called ectomorphs, and those that fall in between are called mesomorphs.)
Endomorphs are, however, generally physically active, so it is unusual that he is not active and gets tired easily. Hence, it may be the right call to check if he has an endcrine problem. The most common reason for obesity and decreased activity is a low thyroid function (hypothyroidism), but intrinsic or endogenous depression comes a close second. Other hormonal disturbances - such as those of the pituitary gland, the adrenals, or others - do not produce the exact spectrum of effects that your son has. Thus, the basic tests should include checking his blood for anemia (low hemoglobin), his stool for worms, his urine for silent infection, and his blood for thyroid hormones. If he has a fever or is losing weight, then you might add an X-ray of his chest to rule out tuberculosis.
Please do not venture to do any other tests without a formal endocrine consultation.
For his gynecomastia, it is possible to do plastic surgery if it is causing too much embarrassment. The abdomen can be left alone for the time being, as treatment of the cause of the obesity is more important and will resolve his weight gain problems at the same time.
Hope this helps.
Do revert to me once you have done those basic tests. We can carry on with the online consultation after that.
Dr Taher
This is a prudent course to take but ...
Detailed Answer:
Dear XXXXXXX,
First of all, thank you for once again approaching HCM for your queries. You have consulted a pediatrician some years ago too, as I can see.
The first thing I want to say is: yes, it is a good thing that you are sufficiently concerned about your son to want to visit an endocrinologist. Your use of the words "gynecomastia" and other jargon tells me that you might be a medico yourself. Be that as it may, you might want to know that body frames of all humans come in 3 basic sizes - your son is probably endomorphic in shape. (Thin individuals are called ectomorphs, and those that fall in between are called mesomorphs.)
Endomorphs are, however, generally physically active, so it is unusual that he is not active and gets tired easily. Hence, it may be the right call to check if he has an endcrine problem. The most common reason for obesity and decreased activity is a low thyroid function (hypothyroidism), but intrinsic or endogenous depression comes a close second. Other hormonal disturbances - such as those of the pituitary gland, the adrenals, or others - do not produce the exact spectrum of effects that your son has. Thus, the basic tests should include checking his blood for anemia (low hemoglobin), his stool for worms, his urine for silent infection, and his blood for thyroid hormones. If he has a fever or is losing weight, then you might add an X-ray of his chest to rule out tuberculosis.
Please do not venture to do any other tests without a formal endocrine consultation.
For his gynecomastia, it is possible to do plastic surgery if it is causing too much embarrassment. The abdomen can be left alone for the time being, as treatment of the cause of the obesity is more important and will resolve his weight gain problems at the same time.
Hope this helps.
Do revert to me once you have done those basic tests. We can carry on with the online consultation after that.
Dr Taher
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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