Down the Metabolic Rabbit Hole

The last few posts have encompassed a number of subjects related to obesity, which also seem to be related, to a greater or lesser degree, to each other. This one contains an assortment of odds and ends connected to those subjects.

That’s what the multifactorial concept is all about. Factors to the left, factors to the right, factors all over the place.

The metabolic syndrome is also known as insulin resistance syndrome and is a collection of characteristics rather than a disease. The thing to know is, it increases risk for type 2 diabetes and heart disease.

The National Institutes of Health list five characteristics of metabolic syndrome, while the Mayo Clinic notes that criteria for diagnosis may vary, dependent on the patient (whether currently being treated with medication or not) having three or more of them.

The first is large waist circumference, defined as at least 35″ for women and 40″ for men (and those numbers differ depending on whom you ask). The second is a high level of triglycerides in the blood; the third is reduced HDL or “good cholesterol; and then, elevated fasting blood sugar and increased blood pressure.

Knowing that metabolic syndrome can be a predictor of cardiovascular disease, Swedish researchers decided to try to get a jump on it by looking at very young children. One thing they found was that waist circumference is a better indicator of metabolic syndrome than BMI. Also,

Based on the results of this study, a significant percentage of 6-year-old children exhibited abnormal metabolic profiles, including insulin resistance, which raised their risk of cardiovascular disease.

Last month, Otology & Neurotology published a report whose title says it all:

Adolescent obesity is an independent risk factor for sensorineural hearing loss: Results from the national health and nutrition examination survey 2005 to 2010

Hearing loss! Is there any body part or system not affected by obesity? Childhood Obesity News already talked about viciously assertive inflammatory breast cancer, which is strongly affiliated with obesity.

Very recent research, funded by the non-profit Susan G. Komen organization and published by The Journal of Clinical Investigation, concerned estrogen receptor (or ER+) breast tumors. It indicates that “obesity promotes the way ER+ tumors progress and become resistant to endocrine therapy through a protein called FGFR1.”

Here are a few of the takeaways from an piece: Obese children in weight-loss programs have a one-in-four to one-in-three chance of also being depressed.

A relationship exists between depression and screen time. Low income, no father, and obesity are also closely associated with depression.

The writer also reminds parents and medical professionals that “Many children and teenagers won’t talk about their feelings.” So parents are urged to observe their children to detect signs of depression. Now, if there is one thing young people tend to push back against it is the perception of being observed, surveilled, analyzed, and categorized. And the more interested adults try to hide the intrusive nature of their interest the worse the situation gets.

Another important point is, although there is an identified patient, the child or teenager, in the very vast majority of cases the whole family needs sorting out. Change and challenge are also discussed.

Your responses and feedback are welcome!

Source: “Metabolic Syndrome,”
Source: “Longitudinal birth cohort study found that a significant proportion of children had abnormal metabolic profiles and insulin resistance at 6 years of age,”, 10/19/18
Source: “Adolescent obesity is an independent risk factor for sensorineural hearing loss: Results from the national health and nutrition examination survey 2005 to 2010,”, 10/03/18
Source: “Susan G. Komen-funded research reveals how obesity impacts breast cancer treatment and patient outcomes,”, 07/26/18
Source: “Depression Is Common in Children with Obesity,”, 04/24/15
Photo credit: Valerie Hinojosa (valkyrieh116) on Visualhunt/CC BY-SA

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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