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[Obesity in infants. A series of 14 cases]
Insights
Early-onset obesity in infants is rare but challenging to manage. Severely restricted diets can reduce weight but are poorly tolerated, leading to high patient dropout rates.
Area of Science:
- Pediatrics
- Endocrinology
- Public Health
Context:
- Infants under two years are rarely truly obese, often exhibiting only overweight.
- Early-onset obesity presents unique diagnostic and management challenges in pediatrics.
Purpose:
- To describe the characteristics and outcomes of 14 infants with early-onset obesity.
- To evaluate the efficacy and tolerability of a severely restricted diet for infant obesity management.
Summary:
- This study analyzed 14 infants with early-onset obesity (mean weight +4.54 SD for height).
- A very low-calorie diet (50-60 cal/kg/day) combined with hospital care reduced weight excess significantly (+2.66 SD).
- Despite positive results, the diet was poorly accepted, leading to a high loss to follow-up rate (10/14).
Impact:
- Highlights the distinction between infant overweight and true early-onset obesity.
- Demonstrates the difficulty in managing severe pediatric obesity and the need for better-tolerated interventions.
- Underscores the limited understanding and research on infant obesity management strategies.
Abstract:
The infants aged less than two years, though often overweight, are seldom obese with a weight exceeding 2.5 SD above average for their height. This study includes 14 cases of obesity with early onset. The children were referred at age 17 +/- 5.7 months, with a mean height of +1.07 +/- 1.15 SD for age and a mean weight of +4.54 +/- 2.44 SD for height. They were reported as overfed, without any associated abnormality in their prenatal and postnatal history, and without emotional disturbances. In 8 cases, one of the parents was obese. For obtaining a weight decrease in these very young patients, a severely restricted diet has been necessary, with 50-60 cal/kg/day, corresponding in fact to 65-85 cal/kg of the average weight for height when the weight excess is 4 to 9 SD, and sometimes less, and hospital care. This diet, continued for 1 to 8 months, has allowed to reduce the weight excess at the level of +2.66 +/- 1.38 SD for height. It has been harmless, but not well accepted, so that in spite of the good results 10 of the 14 babies and mothers were lost for follow-up. The data show that true obesity is different from common weight excess in infants, is rare and very difficult to manage, and is poorly understood.