* Exogenous obesity (most common) –No demonstrable disease as the cause –Excessive weight gain from imbalance between caloric intake and energy expenditure –Linear growth is robust and frequently accelerated

* Hormonal causes –Associated with poor linear growth –Hypercortisolism: Cushing syndrome is any type of glucocorticoid excess (endogenous or exogenous); Cushing disease describes pituitary ACTH overproduction –Hypothyroidism –Growth hormone deficiency

• Insulinoma
• Hypothalamic obesity –Tumors (e.g., craniopharyngiomas) –Following neurosurgery or irradiation –Head trauma –Infiltrative/inflammatory
• Genetic syndromes –Prader-Willi syndrome –Laurence-Moon-Bardet-Biedl syndrome –Alström syndrome –Cohen syndrome –Down syndrome –Carpenter syndrome –Grebe syndrome –Beckwith-Wiedemann syndrome o Defects in metabolic/eating regulatory pathways is an area of intense investigation; multiple mutations are theoretically possible, but only a few have actually been discovered in humans –Congenital leptin deficiency (extremely rare) –Leptin resistance (more common than deficiency) o Drugs –Chronic glucocorticoids –Neuropsychotropic medications o Adiposogenital dystrophy syndrome

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These home medical tests may be relevant to Abdominal obesity metabolic syndrome:

• High Cholesterol: Home Testing: o Home Cholesterol Tests o Home Triglycerides Tests o Home Blood Pressure Tests
• High Blood Pressure: Home Testing o Home Blood Pressure Monitors o Home Heart Tests
• Heart Health: Home Testing: o Heart Rate Monitors o Irregular Heartbeat Detection o Heart Electrocardiogram (ECG)
• Thyroid: Home Testing: o Home Thyroid Function Tests o Home TSH Tests o Home Adrenal Function Tests
• Diet & Weight Loss: Home Testing: o Home Weight Testing o Home Body Fat Testing (BMI) o Home Body Fat Monitoring o Home Fitness Testing
• Diabetes: Related Home Testing: o Home Diabetes Tests o Home Blood Glucose Tests o Home Urine Glucose Tests o Home Urine Ketone Tests o Home Diabetes HbA1c Tests o Home Microalbumin Tests (Kidney) o Home Urine Protein Tests (Kidney) o Home Kidney Tests o Home Eye Tests

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• o If syndrome or no known disease as etiology –Nutritional education and diet manipulation –Exercise regimen (energy expenditure must exceed intake) –Behavior modification involving family o Hormonal etiology –Hormone replacement for hypothyroidism or growth hormone deficiency –Surgical intervention if hypercortisolism caused by tumor –Decrease exogeneous glucorticoids if not medically contraindicated
• Leptin treatment in leptin deficiency (therapeutic trials)
• If patient also has type II diabetes mellitus, insulin or oral medications may be required in addition to improved diet and exercise

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