Volume 30, Issue 173, July 2026

Childhood obesity – when to suspect an endocrine cause?

Julia Kupczak^1♦, Mikhail Kazachok², Szymon Paruszewski², Aleksandra Dybcio³, Katarzyna Kupczyk², Mikołaj Jońca⁵, Natasza Kurys⁴, Dorota Szydłowska⁶, Adam Kubisa⁵, Mateusz Mikulski⁵

¹Lazarski University, Warsaw, Poland
²Medical University of Warsaw, Warsaw, Poland
³Medical University of Lublin, Lublin, Poland
⁴Medical University of Lodz, Łódź, Poland
⁵Pomeranian Medical University, Szczecin, Poland
⁶Medical University of Opole, Opole, Poland

^♦Corresponding author
Julia Kupczak, Lazarski University, Warsaw, Poland

ABSTRACT

Obesity in children represents a growing health problem of a global nature. It is associated with numerous metabolic and hormonal complications. The vast majority of childhood obesity cases are primary in nature and result from a longterm excessive energy balance. However, in a small percentage of cases, pathogenic factors cause secondary obesity. This work aims to present the principles and rules for differentiating between simple and secondary obesity and to indicate the socalled "red flags" that should prompt a physician to perform in-depth hormonal diagnostics. When excessive weight gain occurs alongside a slowing growth rate, it serves as an alarm signal indicating an endocrinological basis for obesity. Additional symptoms are also of significant importance: the onset of obesity in early childhood, disorders of sexual maturation, excessive hair growth (hirsutism), and skin changes. The following article discusses the most common endocrine causes of obesity in children, including hypothyroidism and Cushing's syndrome, along with their clinical presentation and diagnostic basics. A diagnostic workflow is outlined. It encompasses patient history, physical examination, and laboratory tests. This article focuses on the diagnosis of childhood obesity. This work allows physicians to avoid unnecessary, excessive diagnostic testing in children with primary obesity. In children whose obesity is caused by comorbidities, it also allows these conditions to be overlooked. Early diagnosis of the endocrine basis of obesity allows for early treatment, significantly improving prognosis.

Keywords: obesity, endocrine diseases, hypothyroidism, Cushing's syndrome

Medical Science, 2026, 30, e133ms3864

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Published: 27 July 2026