Abstract:
Background: Childhood obesity is associated with a complex constellation of metabolic and
endocrine disturbances that, if unaddressed, predict adult chronic disease with high fidelity.
Objective: This review examines the specific metabolic pathways through which excess
adiposity in childhood leads to insulin resistance, type 2 diabetes mellitus (T2DM), dyslipidemia,
non-alcoholic fatty liver disease (NAFLD), and reproductive endocrine disorders. Methods:
Systematic narrative review of clinical studies, endocrinological investigations, and population
cohort data from 2008 to 2024. Results: Adipose tissue expansion drives inflammatory cytokine
production, free fatty acid spillover, and ectopic lipid deposition. These processes produce
hepatic and peripheral insulin resistance, progressive β-cell dysfunction, non-alcoholic
steatohepatitis, and in adolescent girls, polycystic ovarian syndrome. Conclusion: Early
identification and intervention targeting metabolic comorbidities of childhood obesity are
essential to preventing a generation-wide chronic disease epidemic.
