From Risks to Roots: The Multifactorial Etiopathogenesis of Childhood Obesity

Pediatric obesity has shown a marked upward trend over the past decade, with a particularly significant impact in certain regions, to the extent that it is increasingly regarded as a global epidemic. The factors involved in its development and progression are highly diverse and complex. From genetic predisposition to the influence of epigenetic mechanisms, environmental exposures, nutritional patterns, psychosomatic factors, and endocrinological status, current evidence highlights multiple interacting pathways contributing to excessive weight gain in children. Although numerous studies have explored specific mechanisms and interventions, there remains a need for a comprehensive synthesis that integrates recent pathophysiological insights with practical clinical implications. This narrative review was undertaken to fill this gap by summarizing and analyzing the current literature on the mechanisms underlying pediatric obesity, emphasizing novel findings and evidence-based approaches. In light of recent advances in the field, this narrative review provides a comprehensive overview of the latest pathophysiological principles associated with childhood obesity, with particular emphasis on clinically relevant aspects. The review focuses on potential strategies to mitigate the impact of modifiable risk factors and highlights current trends in clinical research. The included studies were selected to cover the most relevant evidence on genetic, epigenetic, environmental, and psychosomatic determinants of pediatric obesity, providing a synthesis that informs both research and clinical practice. Its aim is to enhance the dissemination of knowledge regarding the underlying mechanisms involved in the development of pediatric obesity. In parallel, the review addresses evidence-based therapeutic approaches that may contribute to limiting the increasing incidence of the condition and its associated complications. Expanding the scope of scientifically grounded interventions may reduce obesity-related morbidity and substantially improve long-term outcomes in pediatric populations.