Fatty Liver Appears in Half of Pediatric Obese Patients... Risk of Liver Cirrhosis if Neglected

Many parents neglect weight gain in childhood, believing it is simply a natural part of the growth process. However, pediatric obesity not only has a high probability of leading to adult obesity but also requires special attention as it can cause 'fatty liver,' where fat accumulates in the liver even at a young age.

Professor Kim Ri-a of the Department of Pediatrics at Seoul National University Hospital explained the dangers of pediatric obesity and the importance of fatty liver management through a Seoul National University Hospital TV video. According to Professor Kim, fatty liver appears in about half of pediatric obesity patients, and its prevalence is also on a gradual increasing trend.

Simply being chubby is different from medical obesity

Judging a child's body type as simply 'chubby' differs from medical standards. Whether a child is obese is not determined solely by appearance, but is judged based on the Body Mass Index (BMI) considering age and height. If the BMI value is at or above the 85th percentile for the age group, it is classified as overweight, and if it is at or above the 95th percentile, it is classified as obese. Therefore, a process of checking the exact condition using the child's growth curve must precede diagnosis.

The reason obesity is dangerous is not because of the immediate appearance. Obesity increases the risk of metabolic diseases such as hypertension, diabetes, and hyperlipidemia, and can cause various physical complications such as sleep disorders, joint problems, and menstrual irregularities. Additionally, it can lead to psychological issues such as low self-esteem or depression, making appropriate management during the growth process essential.

Pediatric fatty liver with no symptoms, regular checkups are key

Pediatric fatty liver mostly has no specific noticeable symptoms. Occasionally, fatigue or abdominal discomfort may be felt, but in most cases, there are no symptoms, and it is often discovered only after an increase in liver enzymes is confirmed through health checkups or blood tests.

In South Korea, regular checkups are conducted through student health examinations during the periods of 1st grade and 4th grade in elementary school, 1st grade in middle school, and 1st grade in high school. At this time, height and weight are measured to check for obesity, and if necessary, blood sugar, cholesterol, and liver enzymes are tested. If obesity is suspected from the examination results, one should visit a hospital to further confirm the presence of fatty liver through ultrasound examinations, etc.

The key to treating fatty liver is 'lifestyle correction' rather than medication. Professor Kim recommended reducing the intake of foods high in sugar and increasing moderate or higher physical activity. Additionally, behavioral correction, such as limiting the use of electronic devices like TVs, smartphones, and computers to less than 2 hours a day, must be carried out in parallel. There are no drugs currently recommended for fatty liver itself, and drug treatment for obesity control must be decided carefully after consulting with medical staff.

"It will heal naturally when they grow up" is a misconception that could lead to liver cirrhosis

Many parents expect fatty liver to disappear naturally as the child grows, but this can be a dangerous thought. If pediatric fatty liver is neglected, there is a possibility that it may progress to liver inflammation, fibrosis, or even liver cirrhosis. Furthermore, it is closely related to metabolic diseases such as diabetes or hypertension, increasing the risk of cardiovascular disease in the long term.

In particular, during puberty, fatty liver can occur more easily due to changes in sex hormones and decreased insulin sensitivity. Professor Kim mentioned that around age 8 is an appropriate time to start early diagnosis and intervention, emphasizing that active interest from parents and medical staff is needed during this period.

Meanwhile, obesity is also influenced by genetic factors. Genes involved in energy metabolism or appetite control can create a constitution that is prone to gaining weight. However, genetics do not determine all of obesity. This is because environmental factors such as eating habits, amount of exercise, sleep, and stress act together. In particular, high-fat diets or excessive use of electronic devices are often habits shared by the family, so rather than the child trying alone, the most effective method is for the entire family to practice healthy lifestyle habits.