Delayed puberty generally means absence of breast development by approximately 13 years in girls, absence of testicular enlargement by approximately 14 years in boys, or failure of puberty to progress normally once initiated.
Constitutional delay is common, particularly in boys, but chronic systemic and endocrine disease must be excluded.
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Childhood obesity is excessive adiposity associated with increased risk of type 2 diabetes, hypertension, dyslipidaemia, fatty liver disease, obstructive sleep apnoea and later cardiovascular disease.
BMI must be interpreted according to age and sex specific centiles or Z scores, rather than adult thresholds in younger children.
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