Huong experienced rapid weight gain over the past four years. She visited Tam Anh General Hospital Hanoi, measuring 140 cm tall and weighing 51,8 kg, and was diagnosed with first-degree obesity. Master of Science, Doctor Do Tien Son, from the Department of Pediatrics, observed acanthosis nigricans on the child's nape, a common sign in individuals with insulin resistance. Lab results showed a fasting blood sugar level of 6,02 mmol/L (normal is 5,6 mmol/L), a fasting insulin level of 99,66 μIU/mL, approximately four times higher than normal, and a HOMA-IR index of 26,58, indicating severe insulin resistance.

Doctors diagnosed the child with pre-diabetes and elevated uric acid levels. Metabolic disorders are closely linked to being overweight and obese, so weight management became a priority for her.

Doctor Tran Quyen An, a nutrition specialist at Tam Anh General Hospital Hanoi, developed a balanced nutrition plan for Huong, eliminating high-energy foods and adjusting her diet to include sufficient vegetables, fiber, protein, and micronutrients. The child gradually reduced sugary drinks, processed foods, and high-fat dishes.

Doctor An advising on diet for an obese child. *Photo: Tam Anh General Hospital*

In addition to diet, she engaged in physical activity for at least 60 minutes daily, limited screen time, and ensured adequate and timely sleep. After more than two months, Huong lost 5,5 kg, her waist circumference decreased by 10 cm, body fat percentage dropped from 45,6% to 35,1%, and she gained muscle mass while reducing visceral fat.

Over two months, Huong grew an additional 5 cm, increasing her height from 140 cm to 145 cm. Doctor An noted that proper weight management does not hinder growth; instead, it supports a child's normal physical and height development. Tests after two months revealed her fasting insulin level decreased to 21,55 μIU/mL. Both her fasting blood sugar and HbA1c index (average blood sugar over two to three months) returned to normal limits.

According to Doctor An, the key objectives in treating childhood obesity are to reduce excess fat, maintain muscle mass, improve metabolic indicators, and ensure age-appropriate growth.

Doctor Son advised parents not to worry about their children being thin or growing slowly and to avoid independently supplementing high-energy products such as: weight-gain milk, high-calorie formula from unverified sources, or sugary drinks, nor should they increase meal portions beyond a child's age-appropriate needs. Prolonged energy surplus combined with low physical activity can lead to excess fat accumulation, causing obesity and early metabolic disorders like: insulin resistance, fatty liver, dyslipidemia, elevated uric acid, or pre-diabetes.

If a child experiences abnormal rapid weight gain, especially with a large waist, develops acanthosis nigricans on the neck, shows fatigue, has low physical activity, or has a family history of diabetes, parents should seek early medical consultation for assessment and timely intervention.

Hoang Duong

*Patient's name has been changed