Abstract
Physiological regulation of eating behaviour together with regular physical activity represents the natural prevention from pathological fat deposition and obesity in children. This regulation may be disrupted by hypothyroidism, cortisol excess, growth hormone deficiency, pseudohypoparathyroidism, hypothalamic lesions and in several genetic syndromes.
The monogenic causes of obesity include disorders of leptin, leptin receptor and melanocortin-4 receptor. However, all these conditions are rare.
A vast majority of cases of childhood obesity has is caused by environmental factors, which lead to abnormal eating patterns with excess intake of energy-rich food in connection with lacking physical exercise. The evaluation of an obese child consists of three steps.
Firstly, the estimation of the severity of obesity, using weight-height ratio, body mass index or measurements of body composition; secondly, estimation of the causes of obesity with the aim to exclude severe endogenous disorders; and finally, estimation of complications of obesity in the more severe cases.