Influences of Childhood Obesity on Pubertal Development

Abstract

The process of pubertal development is only partly understood but is thought to be influenced by many partially unknown factors. During the 20th century, there was a secular trend towards earlier pubertal development. Due to the rising epidemic of childhood obesity, the relationship between body composition in childhood and the tempo and timing of puberty needs to be better understood. Studies have shown that there is a clear relation between reaching a critical body weight and pubertal onset and course. Moreover, a rapid and early weight gain during infancy, and even during foetal life, is associated with an earlier onset of menarche, an earlier pubertal growth spurt, an earlier thelarche in girls, an earlier pubarche in both sexes and an earlier increase in testicular volume in boys. Furthermore, there is a clear correlation between increasing body mass index and earlier pubertal development in girls. In boys, controversial data exist. The majority of studies propose that puberty and voice break occur earlier in obese boys when compared with normal-weight peers, but interestingly, a few studies show the opposite finding. The earlier onset of puberty that occurs in obese individuals could be mediated by factors that are directly linked to adipose tissue or could be an indirect effect of genetic and/or environmental factors. This review presents the current evidence on this topic, highlighting inconsistencies and opportunities for future research.