June 26, 2000 -- Being fat when you're a kid can do more than harm your self-esteem. Childhood obesity has now been shown to lead to yet another disease in children: liver disease. Even more alarming is the finding that obese teens who drink even modest amounts of alcohol are at even higher risk for developing chronic liver problems, according to a recent study.
Obese teens are at increased risk for developing a condition known as nonalcoholic steatohepatitis, in which fat is built up in the liver and eventually causes scar tissue to form. This scar tissue increases the risk of developing a severe liver disease, called cirrhosis, in later life.
Although more common in adults, nonalcoholic steatohepatitis is being seen more frequently in children because of the growing number of children who are either overweight or obese.
In the study from a recent issue of TheJournal of Pediatrics, Richard S. Strauss, MD, and other researchers found that 8% of obese adolescents aged 12 to 18 reported modest alcohol intake of at least four drinks per month. Of these, half had an abnormal liver function test.
Children of normal weight who consumed the same amount of alcohol showed no such abnormalities in liver functioning. In addition, obese teens who drank regularly were 10 times more likely to have abnormalities than obese teens who drank less or not at all. Overall, 92% of these obese teens regularly drinking were boys.
The interaction between obesity and teen drinking "is particularly important because adolescent alcohol ingestion may lead to the rapid development of cirrhosis," write Strauss and colleagues.
Teen-agers, their parents, and pediatricians should be aware of this risk, talk openly about it, and work to overcome problems with obesity and teen drinking, says Ronald J. Sokol, MD, in an editorial that accompanied the study.
Sokol stresses the importance of managing obesity in children, stressing that it not only causes problems in childhood but may also foreshadow health problems as adults.
"As a result of this epidemic of childhood obesity, a multitude of chronic illnesses and risk factors for adult disease are now starting in childhood rather than in adulthood," he writes, adding that childhood obesity is associated not only with liver problems, but with gall bladder disease, type 2 diabetes, high blood pressure, and orthopaedic problems.
A co-author of the study, Sarah E. Barlow, MD, tells WebMD that weight loss in adolescents is key. "Changes in liver function are probably common in overweight kids. It's important for parents to know that even if liver enzyme levels are modestly elevated in their overweight kids, it is most likely related to the children being overweight. If the children will lose weight and repeat the liver function tests, they will usually normalize." Barlow is assistant professor of pediatrics at St. Louis University School of Medicine, in Missouri.
"Our changing lifestyle, high-fat and fast foods, and developing computer-based technology with increased reliance on the Internet will most likely keep this childhood epidemic [obesity] around for a long time," Sokol writes, "despite current efforts toward improving nutritional health and raising the activity level of our youth."