Pediatric Obesity: Advice from Endocrinologist

Over the past decade, excess body weight has emerged as one of the leading global public health challenges. Endocrinologist Dr. Lasha Uchava notes that the issue is particularly pressing in Georgia: according to current statistics, 10% of children are classified as obese, and more than 25% are overweight.

It is essential to recognize that excess weight gained in childhood is not merely a visible physical change. It triggers physiological alterations that can lay the groundwork for a range of hormonal and systemic disorders.

What occurs in the body during this period?

When a child’s body accumulates excessive adipose tissue, that tissue begins to function as an independent endocrine organ, producing its own biologically active substances and hormones. Dr. Lasha Uchava emphasizes that this process adversely affects health in several significant ways. In particular:

• Metabolic disturbances – excess adipose tissue interferes with the body’s ability to regulate and utilize glucose efficiently. As a result, the pancreas is forced to work under increased strain, elevating the long-term risk of developing diabetes;
• Hormonal imbalance – obesity disrupts the natural processes of growth and maturation. It may contribute to the premature onset of puberty or, conversely, to delayed pubertal development;
• Organ strain – from a mechanical perspective, excess weight places additional pressure on the still-developing skeletal system and spine, while compelling the heart to work harder to maintain adequate circulation.

What factors have contributed to the rising rates of childhood obesity?

According to the specialist, the growth in obesity prevalence over the past decade is closely linked to environmental and lifestyle changes:

• Diet quality – a nutritional pattern dominated by fast food, confectionery, sugary beverages, and foods high in refined carbohydrates produces rapid energy spikes that children often do not have the opportunity to expend;
• Reduced physical activity – active play has increasingly been replaced by prolonged screen time. An energy imbalance—when caloric intake consistently exceeds expenditure—remains the primary mechanism underlying weight gain;
• Disrupted eating patterns – irregular meal timing and insufficient sleep directly affect the hormonal regulation of hunger and satiety.

Prevention and Solutions

Addressing excess weight in children should begin not with strict prohibitions or rigid control, but with deliberate adjustments to the family environment. When a child observes that healthy choices are integrated into the daily life of the entire family, change becomes a natural transition rather than a form of punishment. For this reason, emphasis should be placed on comprehensive lifestyle habits—nutrition, physical activity, and structured daily routines.

Dietary modification is most effective when introduced progressively. Abrupt, drastic changes often provoke resistance or stress, which undermines sustainable outcomes. Instead, gradual and consistent steps are advisable: replacing sugary drinks with water, limiting high-calorie snacks, and increasing the intake of vegetables and other fiber-rich foods. This approach facilitates adaptation to new flavors and reduces the psychological effect associated with restriction.

Physical activity should be framed as enjoyment and a constructive outlet for energy, rather than an obligation. It is particularly important that children associate movement with play and positive emotional experiences. Regular walks, cycling, and active games in outdoor settings support not only energy expenditure but also healthy musculoskeletal development and metabolic regulation. International guidelines recommend a minimum of one hour of moderate to vigorous physical activity daily.

It is also important to acknowledge that obesity is not invariably attributable to lifestyle factors alone. In some cases, it may be associated with underlying hormonal or metabolic disturbances. Consultation with an endocrinologist is therefore advisable. A specialist can evaluate the child’s overall health, exclude latent endocrine conditions, and design an individualized management plan that includes nutritional guidance and behavioral recommendations. Professional supervision is particularly crucial when weight gain is rapid or lacks a clear explanation.

Childhood obesity represents a serious health concern; however, many of its complications can be prevented through timely and sustained lifestyle modification. The key consideration is that this approach is not a temporary dietary measure, but a long-term commitment to safeguarding a child’s health.