The prevalence of childhood and adolescent obesity has significantly increased in the United States and worldwide since the 1970s, a trend that has been accelerated by the COVID-19 pandemic. The complications of obesity range from negative effects on the cardiovascular, endocrine, hepatobiliary, and musculoskeletal systems to higher rates of mental health conditions such as depression and eating disorders among affected individuals. Among adolescent girls, childhood obesity has been associated with the earlier onset of puberty and menarche, which can result in negative psychosocial consequences, as well as adverse effects on physical health in adulthood. The hormones leptin, kisspeptin and insulin, and their actions on the hypothalamic-pituitary-ovarian axis, have been implicated in the relationship between childhood obesity and the earlier onset of puberty. Obesity in adolescence is also associated with greater menstrual cycle irregularity and the polycystic ovary syndrome (PCOS), which can result in infrequent or absent menstrual periods, and heavy menstrual bleeding. Hyperandrogenism, higher testosterone and fasting insulin levels, and lower levels of sex hormone-binding globulin, similar to the laboratory findings seen in patients with PCOS, are also seen in individuals with obesity, and help to explain the overlap in phenotype between patients with obesity and those with PCOS. Finally, obesity has been associated with higher rates of premenstrual disorders, including premenstrual syndrome and premenstrual dysphoric disorder, and dysmenorrhea, although the data on dysmenorrhea appears to be mixed. Discussing healthy lifestyle changes and identifying and managing menstrual abnormalities in adolescents with obesity are key to reducing the obstetric and gynecologic complications of obesity in adulthood, including infertility, pregnancy complications, and endometrial cancer.

自 1970 年代以来，美国和全世界儿童和青少年肥胖症的患病率显着增加，COVID-19大流行加速了这一趋势。肥胖的并发症包括对心血管、内分泌、肝胆和肌肉骨骼系统的负面影响，以及受影响个体中抑郁和饮食失调等心理健康状况的高发率。在青春期女孩中，儿童肥胖与青春期和月经初潮的提早有关，这可能导致负面的社会心理后果，并对成年后的身体健康产生不利影响。荷尔蒙瘦素， kisspeptin和胰岛素，以及它们对下丘脑-垂体-卵巢轴的作用，与儿童肥胖和青春期提前开始之间的关系有关。青春期肥胖还与更严重的月经周期不规律和多囊卵巢综合征 (PCOS) 相关，后者可导致月经稀少或不来，以及月经大量出血。高雄激素血症，更高的睾丸激素和空腹胰岛素水平，以及较低水平的性激素结合球蛋白，类似于 PCOS 患者的实验室检查结果，也见于肥胖患者，这有助于解释肥胖患者和 PCOS 患者表型的重叠. 最后，肥胖与较高的经前期疾病发生率有关，包括经前期综合征和经前期烦躁障碍，以及痛经，尽管关于痛经的数据似乎参差不齐。讨论健康的生活方式改变以及识别和管理肥胖青少年的月经异常是减少成年期肥胖引起的妇产科并发症的关键，包括不孕症、妊娠并发症和子宫内膜癌。