The Role of Endocrine Factors in Childhood Obesity

Childhood obesity represents a complex global health challenge in which excess adipose tissue functions as an active endocrine organ, disrupting appetite regulation, growth, and metabolic homeostasis. This review synthesises current evidence on how hormonal disturbances—principally insulin resistance, leptin resistance, ghrelin dysregulation and altered adipokine signalling—both arise from and perpetuate adiposity, driving progression to metabolic syndrome and related comorbidities. The majority of cases reflect multifactorial aetiology, yet a clinically meaningful minority stems from discrete endocrine or genetic disorders such as hypothyroidism, Cushing syndrome or monogenic leptin-melanocortin pathway defects. Practical, phenotype-driven guidance is provided for recognising clinical red flags that warrant targeted investigation rather than routine screening. Management strategies span family-focused lifestyle interventions, evidence-based pharmacotherapies such as glucagon-like peptide-1 receptor agonists, and precision treatments for specific genetic disorders, with practical considerations for resource-limited settings. Bariatric surgery is reserved for severely affected adolescents with significant comorbidities. The chapter emphasises the vital roles of nurses in screening, anthropometry and family education, and of family physicians in comprehensive assessment, comorbidity screening and care coordination. Integrating clinical management with public health policy, including healthier school environments and reduced access to obesogenic exposures, is essential to reducing the lifelong consequences of paediatric obesity and improving health outcomes globally, particularly in low- and middle-income countries where the epidemic is accelerating rapidly.