Useful clues and red herrings in the diagnosis of secondary obesity
| Clues to diagnosis | |
|---|---|
| Cushing’s syndrome | Distinctive clues |
| Short history of obesity (months rather than years) | |
| Rapid height growth | |
| Very rapid weight gain | |
| Virilisation | |
| Lack of family history of obesity | |
| Overlap with simple obesity or PCOS (non-distinctive clues) | |
| Striae | |
| Buffalo hump | |
| Hypertension | |
| Acne | |
| Hirsutism | |
| Prader-Willi syndrome | Distinctive clues |
| Hyperphagia | |
| Learning difficulties | |
| Small feet and hands | |
| Neonatal hypotonia | |
| Non-distinctive clues | |
| Massive obesity | |
| Hypogonadism. Note that apparent hypogonadism is extremely common in obese boys due to burying of the penis in the perineal fat pad | |
| Leptin deficiency | Distinctive clues |
| Nil | |
| Non-distinctive clues | |
| Early onset of massive obesity | |
| Consanguineous parentage | |
| Melanocortin 4 receptor deficiency | Distinctive signs |
| Nil | |
| Non-distinctive clues | |
| Early onset severe obesity | |
| Hyperphagia |