Physical Examination : Children and adolescents with overweight and obesity are higher for the age conclusion of puberty and a height above the 90th PERCENTILE in general. Biological age and growth may accelerate both or remained in obesity. In general, we propose to consider a body Less than the 50 percentile for age and sex, so remarkably low for a Child with marked obesity. In these cases, it may further diagnosis. Stretch marks are located on the upper arms, chest, abdomen and thighs often found in overweight children. Obese boys are often portrayed as the Gynecomastia and small genitalia. The majority of cases of pseudogy-necomastia and pseudohypogenitalism. The pseudogynecomastia by extensive subcutaneous fat. In addition, the mammary gland itself hypertrophic can, which may be partly explained by the associated with obesity may Hyperestrogenemia. The main reason for the fairly common pseudo-genital hypoism is the greatly increased subcutaneous fat depot, in which the penis and Scrotum are immersed. In connection with the accelerated growth of the skeleton, secondary Sexual characteristics may be delayed in obese boys. Pubertal development in girls with marked obesity begins at a young age Menarche is relatively young. Can the development of a subset of these girls hirsutism and later abnormalities in the menstrual cycle. Characteristic for these patients show a pattern of abdominal fat distribution (WHR> 0.85), and cardiovascular risk factor profile. If abdominal pain occurs in obese children gallstones are held Ered as an important differential diagnosis, which are confirmed by ultra-Ultrasound.
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