Risk Management Pitfalls For Obesity In The Emergency Department
“I recommended dieting and exercise in that preschool child with a history of infantile hypotonia with poor suck and poor weight gain, mild short stature, developmental delay, hyperphagia, tantrums, and compulsive behaviors.”
While poor diet and lack of exercise are the usual culprits for childhood obesity, a small, but significant, number of children have an underlying predisposing disorder that may be genetic, endocrinologic, metabolic, or psychological. Several genetic syndromes include childhood-onset obesity as a symptom. The most common are Prader-Willi syndrome, Fragile X syndrome, and Bardet-Biedl syndrome. Prader-Willi syndrome includes early childhood-onset obesity following infantile hypotonia with poor suck and poor weight gain. Mild short stature, hypogonadism, characteristic facial appearance, developmental delay, hyperphagia, tantrums, and compulsive behaviors are also characteristic of Prader-Willi syndrome. A better recommendation for this patient is evaluation by a geneticist.
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