Question
My daughter is now 9 years and 10 months old. She suddenly gained weight in August last year, and currently stands at 132cm tall, weighing 31kg. Although her breasts have not developed and there are no symptoms of swelling or pain, pubic hair has started to grow. Is this a case of precocious puberty or obesity?
Answer
Hello, it’s important to note that the development of breasts in overweight children may be difficult to observe. Based on the information you provided, your daughter’s ovarian volume had reached a normal developmental level by July last year, when she was under 8 years old, and she has now started to show pubic hair, which is an early sign of development. Therefore, she can be diagnosed with precocious puberty. Fortunately, her bone age is not overly advanced (usually there is a certain gap between a child’s bone age and actual age), and her height is still reasonable (unknown parent’s height). Additionally, her precocious puberty is closely related to obesity. Obesity not only accelerates the bone aging process but also causes the early appearance of pubic hair. Therefore, it can be said that obesity is the main cause of her precocious puberty. However, due to the lack of detailed medical records and physical examination findings, we cannot determine whether there are other factors at play. Elevated uric acid levels are also a consequence of obesity. In summary, you should first focus on the obesity issue. If you have already undergone related examinations (I believe you have already had a comprehensive examination in our pediatric endocrinology department), there is no need to repeat the examination at this time. In terms of precocious puberty, regular bone age checks are recommended.