Childhood obesity and insulin resistance

Abstract

Childhood obesity is a chronic, multifactorial condition resulting from an imbalance between energy intake and expenditure, influenced by genetic, prenatal, and social factors. Its prevalence is higher in boys and in children with a family history of obesity, while early life – particularly the first 1000 days – is critical for shaping long-term metabolic risk. Major complications include arterial hypertension, metabolic syndrome, type 2 diabetes, pubertal disturbances, and psychosocial problems. Insulin resistance plays a central role, being highly prevalent among obese children and serving as a key pathophysiological mechanism leading to cardiometabolic complications. Diagnosis is based on anthropometric indicators, mainly body mass index (BMI) for children aged 2-18 years, while WHO growth charts are recommended for infants. Management requires a comprehensive approach including lifestyle modification, healthy diet, regular physical activity, optimized sleep, psychosocial support, and, when necessary, pharmacotherapy. This review summarizes current evidence on childhood obesity, with a particular focus on insulin resistance as a pivotal link in the development of long-term metabolic and cardiovascular complications. Childhood obesity and the associated insulin resistance remain a major public health challenge with significant long-term consequences for quality of life and life expectancy.