Skip to main content
SpringerLink
Log in

Impact of Obesity on Female Puberty

  • Chapter
  • First Online:
Abnormal Female Puberty

  • 731 Accesses

Abstract

Childhood and adolescent obesity is an ongoing epidemic in the United States and other industrialized countries, with 16.9 % of children ages 2–19 years in the United States currently classified as obese. The causes for the high prevalence of obesity in America’s youth are multifactorial and include a combination of genetics, poor nutrition, sedentary lifestyle, and environmental and social factors. In addition to having numerous medical and psychosocial complications for teenagers, obesity in young girls also has an effect on puberty and normal reproductive development. Studies have demonstrated that obese girls are more likely to enter puberty earlier and experience menarche at a younger age than their normal weight peers. The earlier onset of puberty in young obese girls is due to a complex interplay of hormones with leptin, a hormone secreted by adipocytes, playing an essential role in the neuroendocrine events that initiate puberty. Early pubertal development carries multiple health risks for young females, including higher rates of depression, substance use, behavior issues, and promiscuity as teenagers and higher rates of type 2 diabetes, hypertension, breast cancer, and increased overall mortality as adults. Furthermore, obese girls are at higher risk for menstrual irregularities secondary to hyperandrogenism and polycystic ovary syndrome, a diagnosis that carries its own set of complications. Prevention and treatment of obesity remains at the forefront of our nation’s healthcare agenda and presents an ongoing challenge for healthcare practitioners.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

BMI:

Body mass index

DHEAS:

Dehydroepiandrosterone sulfate

FSH:

Follicle stimulating hormone

GnRH:

Gonadotropin-releasing hormone

HOMA-IR:

Homeostasis model assessment of IR

IR:

Insulin resistance

LH:

Luteinizing hormone

MCH:

Melanin-concentrating hormone

NHANES:

National Health and Nutrition Examination Survey

NPY:

Neuropeptide Y

PCOS:

Polycystic ovary syndrome

SHBG:

Sex hormone-binding globulin

YRBS:

Youth Risk Behavior Surveillance

References

  1. Childhood obesity facts [Internet] 2014 Sep 3 [updated 2014 Sep 3; cited 2014 Nov 5]. http://www.cdc.gov/obesity/data/childhood.html.

  2. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Childhood obesity facts [Internet] 2014 Aug 13 [updated 2014 Aug 13; cited 2015 Jan 5]. http://www.cdc.gov/healthyyouth/obesity/facts.htm.

  4. Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002;360:473–82.

    Article  PubMed  Google Scholar 

  5. Jasik CB, Lustig RH. Adolescent obesity and puberty: the “perfect storm”. Ann N Y Acad Sci. 2008;1135:265–79.

    Article  CAS  PubMed  Google Scholar 

  6. Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA. 2003;289(14):1813–9.

    Article  PubMed  Google Scholar 

  7. Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T. Do obese children become obese adults? A review of the literature. Prev Med. 1993;22(2):167–77.

    Article  CAS  PubMed  Google Scholar 

  8. Biro FM, Wien M. Childhood obesity and adult morbidities. Am J Clin Nutr. 2010;91(5):1499S–505.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kann L, Kinchen S, Shanklin SL, Flint KH, Kawkins J, Harris WA, Lowry R, Olsen EO, McManus T, Chyen D, Whittle L, Taylor E, Demissie Z, Brener N, Thornton J, Moore J, Zaza S. Centers for Disease Control and Prevention (CDC). Youth risk behavior surveillance—United States, 2013. Morb Mortal Wkly Rep Surveill Summ. 2014;63 Suppl 4:1–168.

    Google Scholar 

  10. Bowman SA, Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DS. Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Pediatrics. 2004;113(1 Pt 1):112–8.

    Article  PubMed  Google Scholar 

  11. Borzekowski DL, Robinson TN. The 30-second effect: an experiment revealing the impact of television commercials on food preferences of preschoolers. J Am Diet Assoc. 2001;101(1):42–6.

    Article  CAS  PubMed  Google Scholar 

  12. Neumark-Sztainer D, Hannan PJ, Story M, Croll J, Perry C. Family meal patterns: associations with sociodemographic characteristics and improved dietary intake among adolescents. J Am Diet Assoc. 2003;103(3):317–22.

    Article  PubMed  Google Scholar 

  13. Silventoinen K, Rokholm B, Kaprio J, Sorensen TIA. The genetic and environmental influences on childhood obesity: a systematic review of twin and adoption studies. Int J Obes (Lond). 2009;34:29–40.

    Article  Google Scholar 

  14. Rankinen T, Zuberi A, Chagnon YC, Weisnagel SJ, Argyropoulos G, Walts B, Perusse L, Bouchard C. The human obesity gene map: the 2005 update. Obesity. 2006;14(4):529–644.

    Article  PubMed  Google Scholar 

  15. Ntalla I, Panoutsopoulou K, Vlachou P, Southam L, William Rayner N, Zeggini E, Dedoussis GV. Replication of established common genetic variants for adult BMI and childhood obesity in Greek adolescents: the TEENAGE study. Ann Hum Genet. 2013;77(3):268–74.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ong KK, Ahmed ML, Dunger DB. Lessons from large population studies on timing and tempo of puberty (secular trends and relation to body size): the European trend. Mol Cell Endocrinol. 2006;254-255:8–12.

    Google Scholar 

  17. Kaplowitz PB. Link between body fat and the timing of puberty. Pediatrics. 2008;121 Suppl 3:S208–17.

    Article  PubMed  Google Scholar 

  18. Kaplowitz PB, Slora EJ, Wasserman RC, Pedlow SE, Herman-Giddens ME. Earlier onset of puberty in girls: relation to increased body mass index and race. Pediatrics. 2001;108(2):347–53.

    Article  CAS  PubMed  Google Scholar 

  19. Ahmed ML, Ong KK, Dunger DB. Childhood obesity and the timing of puberty. Trends Endocrinol Metab. 2009;20(5):237–42.

    Article  CAS  PubMed  Google Scholar 

  20. Biro FM, McMahon RP, Striegel-Moore R, Crawford PB, Obarzanek E, Morrison JA, Barton BA, Falkner F. Impact of timing of pubertal maturation on growth in black and white female adolescents: The National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr. 2001;138(5):636–43.

    Article  CAS  PubMed  Google Scholar 

  21. Herman-Giddens ME, Slora EJ, Wasserman RC, Bourdony CJ, Bhapkar MV, Koch GG, Hasemeier CM. Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network. Pediatrics. 1997;99(4):505–12.

    Article  CAS  PubMed  Google Scholar 

  22. Freedman DS, Kettel Khan L, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS. Relation of age at menarche to race, time period, and anthropometric dimensions: the Bogalusa heart study. Pediatrics. 2002;4:110(4). Available at: www.pediatrics.org/cgi/content/full/110/4/e43.

    Google Scholar 

  23. Wattigney WA, Srinivasan SR, Chen W, Greenlund KJ, Berenson GS. Secular trend of earlier onset of menarche with increasing obesity in black and white girls: the Bogalusa Heart Study. Ethn Dis. 1999 Spring-Summer;9(2):181–9.

    Google Scholar 

  24. Moran A, Jacobs Jr DR, Steinberger J, Hong CP, Prineas R, Luepker R, Sinaiko AR. Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes. 1999;48(10):2039–44.

    Article  CAS  PubMed  Google Scholar 

  25. Caprio S, Plewe G, Diamond MP, Simonson DC, Boulware SD, Sherwin RS, Tamborlane WV. Increased insulin secretion in puberty: a compensatory response to reductions in insulin sensitivity. J Pediatr. 1989;114(6):963–7.

    Article  CAS  PubMed  Google Scholar 

  26. Pilia S, Casini MR, Foschini ML, Minerba L, Musiu MC, Marras V, Civolani P, Loche S. The effect of puberty on insulin resistance in obese children. J Endocrinol Invest. 2009;32(5):401–5.

    Article  CAS  PubMed  Google Scholar 

  27. Pinhas-Hamiel O, Lerner-Geva L, Copperman NM, Jacobson MS. Lipid and insulin levels in obese children: changes with age and puberty. Obesity. 2007;15(11):2825–31.

    Article  CAS  PubMed  Google Scholar 

  28. Davison KK, Susman EJ, Birch LL. Percent body fat at age 5 predicts earlier pubertal development among girls at age 9. Pediatrics. 2003;111(4 Pt 1):815–21.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Lee JM, Appugliese D, Kaciroti N, Corwyn RF, Bradley RH, Lumeng JC. Weight status in young girls and the onset of puberty. Pediatrics. 2007;119(3):e624–30.

    Article  PubMed  Google Scholar 

  30. Chehab FF. 20 years of leptin: leptin and reproduction: past milestones, present undertakings, and future endeavors. J Endocrinol. 2014;223(1):T37–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Hassink SG, Sheslow DV, de Lancey E, Opentanova I, Considine RV, Caro JF. Serum leptin in children with obesity: relationship to gender and development. Pediatrics. 1996;98(2 Pt 1):201–3.

    CAS  PubMed  Google Scholar 

  32. Chehab FF, Mounzih K, Lu R, Lim ME. Early onset of reproductive function in normal female mice treated with leptin. Science. 1997;275(5296):88–90.

    Article  CAS  PubMed  Google Scholar 

  33. Chehab FF, Lim ME, Lu R. Correction of the sterility defect in homozygous obese female mice by treatment with the human recombinant leptin. Nat Genet. 1996;12(3):318–20.

    Article  CAS  PubMed  Google Scholar 

  34. Clement K, Vaisse C, Lahlou N, Cabrol S, Pelloux V, Cassuto D, Gourmelen M, Dina C, Chambaz J, Lacorte JM, Basdevant A, Bougneres P, Lebouc Y, Froguel P, Guy-Grand B. A mutation in the human leptin receptor gene causes obesity and pituitary dysfunction. Nature. 1998;392(6674):398–401.

    Article  CAS  PubMed  Google Scholar 

  35. Matkovic V, Ilich JZ, Skugor M, Badenhop NE, Goel P, Clairmont A, Klisovic D, Nahhas RW, Landoll JD. Leptin is inversely related to age at menarche in human females. J Clin Endocrinol Metab. 1997;82(10):3239–45.

    CAS  PubMed  Google Scholar 

  36. Farooqi IS, Jebb SA, Langmack G, Lawrence E, Cheetham CH, Prentice AM, Hughes IA, McCamish MA, O'Rahilly S. Effects of recombinant leptin therapy in a child with congenital leptin deficiency. N Engl J Med. 1999;341(12):879–84.

    Article  CAS  PubMed  Google Scholar 

  37. Nagatani S, Guthikonda P, Thompson RC, Tsukamura H, Maeda KI, Foster DL. Evidence for GnRH regulation by leptin: leptin administration prevents reduced pulsatile LH secretion during fasting. Neuroendocrinology. 1998;67(6):370–6.

    Article  CAS  PubMed  Google Scholar 

  38. Yu WH, Kimura M, Walczewska A, Karanth S, McCann SM. Role of leptin in hypothalamic-pituitary function. Proc Natl Acad Sci U S A. 1997;94(3):1023–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Cheung CC, Thornton JE, Kuijper JL, Weigle DS, Clifton DK, Steiner RA. Leptin is a metabolic gate for the onset of puberty in the female rat. Endocrinology. 1997;138(2):855–8.

    Article  CAS  PubMed  Google Scholar 

  40. Reynoso R, Ponzo OJ, Szwarcfarb B, Rondina D, Carbone S, Rimoldi G, Scacchi P, Moguilevsky JA. Effect of leptin on hypothalamic release of GnRH and neurotransmitter amino acids during sexual maturation in female rats. Exp Clin Endocrinol Diabetes. 2003;111(5):274–7.

    Article  CAS  PubMed  Google Scholar 

  41. Quennell JH, Mulligan AC, Tups A, Liu X, Phipps SJ, Kemp CJ, Herbison AE, Grattan DR, Anderson GM. Leptin indirectly regulates gonadotropin-releasing hormone neuronal function. Endocrinology. 2009;150(6):2805–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Lee Y, Styne D. Influences on the onset and tempo of puberty in human beings and implications for adolescent psychological development. Horm Behav. 2013;64(2):250–61.

    Article  PubMed  Google Scholar 

  43. Kaltiala-Heino R, Kosunen E, Rimpela M. Pubertal timing, sexual behaviour and self-reported depression in middle adolescence. J Adolesc. 2003;26(5):531–45.

    Article  PubMed  Google Scholar 

  44. Zehr JL, Culbert KM, Sisk CL, Klump KL. An association of early puberty with disordered eating and anxiety in a population of undergraduate women and men. Horm Behav. 2007;52(4):427–35.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Johansson T, Ritzen EM. Very long-term follow-up of girls with early and late menarche. Endocr Dev. 2005;8:126–36.

    Article  PubMed  Google Scholar 

  46. Mueller NT, Duncan BB, Barreto SM, Chor D, Bessel M, Aquino EM, Pereira MA, Schmidt MI. Earlier age at menarche is associated with higher diabetes risk and cardiometabolic disease risk factors in Brazilian adults: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cardiovasc Diabetol. 2014;13:22.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Dreyfus JG, Lutsey PL, Huxley R, Pankow JS, Selvin E, Fernandez-Rhodes L, Franceschini N, Demerath EW. Age at menarche and risk of type 2 diabetes among African-American and white women in the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia. 2012;55(9):2371–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Lakshman R, Forouhi NG, Sharp SJ, Luben R, Bingham SA, Khaw KT, Wareham NJ, Ong KK. Early age at menarche associated with cardiovascular disease and mortality. J Clin Endocrinol Metab. 2009;94(12):4953–60.

    Article  CAS  PubMed  Google Scholar 

  49. Velie EM, Nechuta S, Osuch JR. Lifetime reproductive and anthropometric risk factors for breast cancer in postmenopausal women. Breast Dis. 2005–2006;24:17–35.

    Google Scholar 

  50. Charalampopoulos D, McLoughlin A, Elks CE, Ong KK. Age at menarche and risks of all-cause and cardiovascular death: a systematic review and meta-analysis. Am J Epidemiol. 2014;180(1):29–40.

    Article  PubMed  PubMed Central  Google Scholar 

  51. McCartney CR, Blank SK, Prendergast KA, Chhabra S, Eagleson CA, Helm KD, Yoo R, Chang RJ, Foster CM, Caprio S, Marshall JC. Obesity and sex steroid changes across puberty: evidence for marked hyperandrogenemia in pre- and early pubertal obese girls. J Clin Endocrinol Metab. 2007;92(2):430–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. McCartney CR, Prendergast KA, Chhabra S, Eagleson CA, Yoo R, Chang RJ, Foster CM, Marshall JC. The association of obesity and hyperandrogenemia during the pubertal transition in girls: obesity as a potential factor in the genesis of postpubertal hyperandrogenism. J Clin Endocrinol Metab. 2006;91(5):1714–22.

    Article  CAS  PubMed  Google Scholar 

  53. Knudsen KL, Blank SK, Burt Solorzano C, Patrie JT, Chang RJ, Caprio S, Marshall JC, McCartney CR. Hyperandrogenemia in obese peripubertal girls: correlates and potential etiological determinants. Obesity (Silver Spring). 2010;18(11):2118–24.

    Article  Google Scholar 

  54. Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, Welt CK. Endocrine Society. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565–92.

    Article  CAS  PubMed  Google Scholar 

  55. Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR. Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab. 2004;89(2):453–62.

    Article  CAS  PubMed  Google Scholar 

  56. Neumark-Sztainer DR, Wall MM, Haines JI, Story MT, Sherwood NE, van den Berg PA. Shared risk and protective factors for overweight and disordered eating in adolescents. Am J Prev Med. 2007;33(5):359–69.

    Article  PubMed  Google Scholar 

  57. Lebow J, Sim LA, Kransdorf LN. Prevalence of a history of overweight and obesity in adolescents with restrictive eating disorders. J Adolesc Health. 2015;56(1):19–24.

    Article  PubMed  Google Scholar 

  58. Gendall KA, Bulik CM, Joyce PR, McIntosh VV, Carter FA. Menstrual cycle irregularity in bulimia nervosa: Associated factors and changes with treatment. J Psychosom Res. 2000;49(6):409–15.

    Article  CAS  PubMed  Google Scholar 

  59. Barlow SE, Committee E. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 Suppl 4:S164–92.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Adolescent Medicine, Cohen Children’s Medical Center of New York, 410 Lakeville Road Suite 108, New Hyde Park, NY, 11042, USA

    Khalida Itriyeva M.D. & Ronald Feinstein M.D., F.A.A.P.

Authors
  1. Khalida Itriyeva M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ronald Feinstein M.D., F.A.A.P.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Hofstra Northwell School of Medicine, Manhasset, New York, USA

    Heather L. Appelbaum

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Itriyeva, K., Feinstein, R. (2016). Impact of Obesity on Female Puberty. In: Appelbaum, H. (eds) Abnormal Female Puberty. Springer, Cham. https://doi.org/10.1007/978-3-319-27225-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27225-2_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27223-8

  • Online ISBN: 978-3-319-27225-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation