Can a head trauma increase the risk of obesity in a child?

Question

Hello doctor,

My nephew is six years old. In the last four to five months, he gained about 20 pounds and looks overweight. Kids his age usually weigh normally and are very active, but he is not. He also sleeps a lot during the day and always feels tired. The strange thing is, he eats very little. I don’t understand why he is gaining so much weight.

He had a head injury about four years ago and was on medication for it. Could this be related to his weight gain?

I read online about something called hypothalamic obesity.

Could this be what he has?
What are the chances of that?
If yes, what tests should we do?
Can it be treated?
Is this a serious problem?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

The hypothalamus is an important part of the brain that controls:

Hunger.
Metabolism.
Energy balance.

Hypothalamic obesity can happen after an injury or damage to the hypothalamus, like the head injury your nephew had at age four. This condition is rare but can develop after damage to this area.

Even though your nephew eats very little, his body may still store extra fat because of hormone problems.

Damage to the hypothalamus can also affect sleep patterns and energy levels.

Because of these signs, hypothalamic obesity could be a possible cause, but other health issues should also be checked to make sure of the diagnosis.

Here are some tests I recommend:
Leptin.
Insulin.
Cortisol.
Thyroid hormones (free T3, T4, and TSH).
Blood sugar (glucose).
MRI (brain scan).
Sleep study (polysomnography).

Treatment options include:

Metformin helps with insulin resistance and might help control weight gain.
GLP-1 agonists (like Liraglutide) help reduce appetite.
Consulting a pediatric nutritionist for help with managing weight.

I also suggest:

Eating low-glycemic-index foods.
Eating more protein.
Having small, frequent meals.
Getting regular physical activity.

Possible health problems linked to this condition include:

Type 2 diabetes.
Heart disease.
Sleep problems (like sleep apnea).
Emotional and psychological stress.

I recommend making an appointment with your nephew’s pediatrician or a pediatric endocrinologist to start testing and treatment.

He should have a full physical exam and proper tests done in a hospital.

Kindly consult a physician, discuss with them, and start taking the medications with their consent.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.