According to the artice, an obese 12-year old girl has “hypothalamic obesity, which is packing on at least 2 pounds every week”. According to her mother, “the result was an immediate, unceasing weight gain even with a diet restricted to 900 to 1,400 calories a day — and with extra exercise”.
I feel sorry for the kid and her family but…why isn’t the medical and scientific community swooning over this medical breakthrough/discovery? This kid is defying both the law of thermodynamics and the law of conservation of energy. She is apparently creating energy from nothing…this is huge! And think of the implications for starvation in the world…instead of sending food aid, just a minor adjustment to a starving person’s hypothalamus will cause them to gain two pounds a week without ingesting any additional calories.
I don’t think her mother’s claim of a 900 to 1,400 calorie a day diet is very reliable. Saying that they had to padlock the cupboard indicates to me that the child has lost all self control when it come to food and unless they keep her locked up there are numerous ways she could be getting food.
That one paragraph about 900 to 1400 calories a day seems to stand against the rest of the article, which talks about her obsessive overeating. Since the whole point of the article was that the family wanted the insurance to pay for gastric bypass surgery, and this (presumably) would have no effect if she were only eating 1400 calories per day, that one paragraph is just a strange anomaly in a story that otherwise makes sense.
2 lbs is 7,000 calories per week converted into fat. (Ignoring calorie costs of the conversion itself)
7 days x 900 is only 6,300 calories.
7 days x 1400 is still only 9,800 calories.
So even with the higher estimate of diet, the girl’s metabolism would have to be lower than 400 calories a day to put 2 lbs/week as fat. Since 1000 calories is already considered a starvation diet… and we’re told that she’s exercising…
IF mom is telling the truth about her caloric intact(and I think that’s just wishful thinking on her part), then the kid is taking in between 5600 and 9800 calories a week. What’s the minimum number of calories she could possibly be burning in a week?
I think it’s more likely that this is poor reporting, rather than wishful thinking from the parent. My read is that the mom is trying to keep the kid on a highly restricted diet, but the kid is actively sabotaging it - the bit about padlocking the cupboard seems to suggest this. There’s two other kids in the house who don’t have abnormal metabolisms. I can imagine the practical difficulties (to say nothing of the emotional strain) of feeding two children normally, while a third one’s brain is convinced that she’s literally starving to death. Policing her food intake would be a constant concern, and may simply be impossible, without resorting to outright abuse.
A diet of 1400 calories a day is not the same thing as actually only eating 1400 calories a day - especially when her problem makes her ravenously hungry.
But riddle me this - which is more probable - that the laws of physics get totally falsified, or that a poor sick girl with a ravenous appetite eats stuff her parents and doctors don’t want her to?
That most people come up with the right answer to that question explains why this isn’t front page news.
I would believe it if she were in an inpatient program where they could assure that she was following the proper diet and exercise program with possible drug therapy for the hypothalmic issue before hitting the R-E-Y operation. But I can’t see Tri-Care allowing that either. Having 20+ years experience with the military medical jackasses, she is going to have to depend on some sort of donation/crowdsourcing to get anything done.
Hypothalamic obesity is to a significant degree caused by a decrease in BMR and activity, which are regulated by the hypothalamus. Kids with hypothalamic obesity need about 3/4th the calories of other kids their size. Measured average is about 1600 calories and the kids are indeed obese from it.
Depending on her lean body mass it is completely consistent with what we know about hypothalamic obesity that a child could be eating less than 1400 a day and becoming more and more obese. 2 pounds a week may be a bit of an overestimate but the concept that she can be experiencing rapid weight gain while taking in fairly little is in fact well established in this condition.
By the way, kids with some central forms of obesity, such as Prader-Wili, will pry the locks off. Not sure why that is funny.
More about the emerging role of bariatric surgery for the treatment of hypothalamic obesity, its possible mechanisms, and the lack of efficacy of most other approaches.
Note that the child in the case report when from a BMI of 25 to one of over 60 as a result of hypothalamic obesity. Other treatment approaches failed and bariatric surgery worked.