Q: Our grandson is obese due to heredity and poor eating habits, as one side of his relatives are all large and overweight and diabetes is in that family. A teenager, he weighs between 250 and 300 pounds and is 5’11”.
I have observed a three inch ring of velvety brown skin with multiple dark skin tags around his neck. I do not know if he has them anywhere else. Eating healthier and exercising will possibly help his obesity, but what will help the dark skin and skin tags? We suspect he has metabolic syndrome. How can we help him?
A: You and your grandson have a tough road ahead but it can be done, despite his family history. Metabolic syndrome is a constellation of at least three conditions that may include high blood pressure, obesity, high blood sugar levels that lead to diabetes, hypercholesterolemia, and excess body fat. This is not to imply he suffers from everything listed, but any of these conditions can increase a person’s risk of heart disease, stroke and diabetes.
Risk factors for metabolic syndrome include race with Hispanics and Asians being at greater risk than other ethnic groups; the individual’s body mass index (BMI) which is a measure of a person’s percentage of body fat based on height and weight; being over 60 years of age, although younger individuals are also susceptible; non-alcoholic fatty liver disease which is an accumulation of fat in the liver of individuals who drink little-to-no alcohol; and polycystic ovary syndrome, a rather common hormonal disorder that affects women of reproductive age.
The band of brown skin to which you refer could be acanthosis nigricans, a brown/black hyperpigmentation of skin found in body folds such as in the neck, groin, navel, forehead, and armpits. The condition is divided into two forms – benign and malignant. The benign form is related to heredity, obesity and an endocrine form of acanthosis nigricans. The majority of reported cases are associated with obesity and are most frequently found in individuals with darker skin and in those who have used nicotinic acid, growth hormone therapy, glucocorticoid products, and more. Acanthosis nigricans is reported to improve when the known cause, such as obesity, is successfully treated.
Initially, if your grandson wants to overcome his weight problem and avoid potential medical concerns down the road, let him know you will be there to support him. It’s not enough for you to want to help if he isn’t willing to work toward that goal. The place to begin might be with his family physician who should perform a complete examination, do an EKG, order lab testing to determine if there is an issue with high cholesterol levels, diabetes, thyroid disease, or other concerns that require aggressive addressing. If he is physically cleared, he can then advance to an exercise program that might begin with walking, swimming, biking, sports such as basketball, or other activity. His diet should be reviewed with the assistance of a nutritionist who can give him appropriate direction on foods to avoid and those to enjoy to help him grow into a healthy, physically-fit individual.
Readers who would like related information can order Dr. Gott’s Health Report “A Strategy for Losing Weight: An Introduction to the No Flour, No Sugar Diet” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
