OpenHealth Q&A

Concern Over My 4-Year-Old's Unexplained Weight Gain

I'm reaching out for advice regarding my 4-year-old daughter who has experienced a significant weight increase recently. Since her birth, she has consistently measured within the 95th to 99th percentiles for her head circumference, height, and weight. Until now, she seemed well-proportioned and healthy. In March, after relocating to a different state, her weight was approximately 55 pounds and her height was around 45 inches. However, during a visit to the doctor last week, she was measured at 70 pounds and 47 inches tall. Over the past year, I've started noticing an unusual odor under her arms, particularly during times of intense sweating. Washing her underarms with Hibiclens seemed effective temporarily, but the scent returned with sweat. Interestingly, she has fine blonde hair under her arms, while the hair on her lower legs is somewhat darker. As for my background, I'm a 5'10" woman who has weighed around 160 pounds for much of my life. However, I gained 70 pounds during pregnancy despite battling hyperemesis gravidarum and without gestational diabetes. After three years of unsuccessful attempts to shed the weight—where I learned about insulin, tried keto, and utilized metformin—I was diagnosed with Polycystic Ovary Syndrome (PCOS). Fortunately, I had the opportunity to use a GLP-1 medication, allowing me to lose all of that weight with minimal appetite or dietary changes. There is an ongoing discussion regarding a potential diagnosis of Non-Classical Adrenal Hyperplasia (NCAH) due to my 17 OHP levels, and I'm currently awaiting an appointment with an endocrinologist. In my youth, I was tall but did not experience any of the symptoms associated with PCOS, such as leg hair growth or unusual odors. My puberty occurred normally at age 12, I had regular menstrual cycles, and I even excelled as a college athlete—however, I always felt that my peers could consume more food without similar fatigue post-meals. In the past, I dealt with facial hirsutism and problematic acne, but I'm grateful that these issues ceased following treatment with Accutane and by adopting a gluten and dairy-free diet in college. More recently, prior to my pregnancy, I began focusing on a lower-carbohydrate eating plan. Regarding my husband, he has been overweight for a significant time; his physique resembles that of a strongman. Currently, he falls into the obese category and has poor eating habits. His family lineage also has a history of obesity, and his sister exhibits classic signs of PCOS, such as an apple-shaped body. While I recognize that my daughter may not have the best genetic predisposition, I believe her eating habits do not align with her weight increase. She does not exhibit a voracious appetite or consume oversized portions. Since our move, we’ve engaged in various "adventures" a few times weekly, during which we've occasionally indulged in carb-heavy treats like Dippin' Dots at the zoo or kids’ hot chocolate from Starbucks. Nevertheless, the majority of her meals at home remain quite healthy due to my dietary choices, characterized by a focus on vegetables and fruits while limiting carbohydrate-rich foods. We avoid keeping juice at home and do not consume it regularly. It perplexes me that other children her age seem to have less nutritious diets yet maintain smaller sizes. My daughter stays quite active, participating in daily physical activities such as swimming lessons, KidStrong sessions, gymnastics, dance classes, plus outdoor playground play. She has an endocrinology appointment scheduled for late September, but any insights or suggestions on possible questions to pose or actions to take before then would be incredibly helpful. Thank you in advance for your assistance!

Answers (1)

8/16/2025, 11:30:53 PM

OpenHealth AI

Weight gain in children can be concerning, especially when combined with other symptoms like unusual sweating and odor. It’s great that you are attentive to your daughter's well-being and have already planned an appointment with an endocrinologist.

Summary of Key Points:

1. Weight Gain and Growth: Your daughter's weight has increased significantly, and it’s important to understand the reasons behind this.
2. Unusual Odor: The odor, particularly under her arms, could be a sign of hormonal changes or other underlying conditions.
3. Genetic Background: Your family history with PCOS and other metabolic issues might play a role.

Explanation:

Children’s growth patterns can vary greatly, but significant weight gain can sometimes be linked to hormonal changes or metabolic conditions, especially given your family's history. The odor you're noticing could also indicate changes in her body due to hormonal fluctuations, which may be linked to her weight gain. It’s also essential to assess her overall health, including diet, exercise, and any emotional factors affecting her.

Next Steps:

1. Prepare for the Endocrinologist Appointment:

   • Write down a list of her symptoms: the weight gain, unusual sweating, and any other changes.
   • Note your observations about her diet and physical activity to share with the doctor.
   • Be ready to discuss your family's medical history, including any relevant conditions.

2. Monitor Symptoms:

   • Keep track of any changes in her weight, appetite, and mood over the coming weeks.
   • Pay attention to any uncomfortable symptoms, such as fatigue or changes in behavior.

3. Support Healthy Habits:

   • Continue to provide a balanced diet rich in fruits, vegetables, and whole grains.
   • Encourage physical activities she enjoys, ensuring they are regular and varied.
   • Teach her about listening to her body regarding hunger and fullness.

4. Consider Psychological Factors:

   • Recognize that stress from moving or transitions can impact a child's health. Ensure she has emotional support during this time.

5. Ask Questions at the Endocrinologist Visit:

   • Inquire about potential tests for hormonal levels, including thyroid function.
   • Ask about how her eating habits and activity levels may be reflected in her physical condition.
   • Discuss the possibility of genetic or metabolic conditions given your background.

Taking these steps can help you better understand your daughter's health and support her well-being. Remember, it's important to approach this with patience, as many children go through various growth phases. Let me know if you need more specific information or support!