Body Weight - Pediatric Oncall

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Question
My 10 year old daughter went for a check up for weight gain. 37pounds in 10months. She is 5' and weighs 167. I can't explain the weight as we are very active and although her diet isn't perfect, we are very conscious about our food intake. Her pressure in her right arm was 170/65 while pressure in left arm was 150/60. She was diagnosed at 5 with an anxiety disorder and I know that going to the dr. brings on tremendous stress. How do I know i if this is an accurate reading of high blood pressure, or just brought on by stress? How high should it be, considering the white coat stress. Should we continue on with further tests? Dr. wants a chest x/ray and echo. We did an ekg in office which was normal. Please help
Answer
You have mentioned that your daughter has put on 37 pounds in 10 months which is very high. Also, her weight 10 months back was around 130 pounds which is slightly on the higher side. Since, your daughter is already 5 feet, (she must be taller than most of the children in her age group), the cause of her obesity seems most likely to be due to exogenous causes such as overeating and lack of exercise rather than any hormonal or genetic problems. You can confirm the same by doing a bone age (X rays of the hands to determine the bone age). You need to be very careful of her diet. Please read the article on "OBESITY" on www.pediatriconcall.com or from the link given below; http://www.pediatriconcall.com/forpatients/CommonChild/eating_disorders/ obesity_one.asp The blood pressure reading is definitely high. White coat stress leading to high BP is very unlikely as it is seen in office executives leading a very stressful life. You can also check her BP at home provided you have a BP apparatus at home. You definitely need to workup on the cause and complications of her high BP. Along with Chest X ray and ECHO, a renal workup may also be required. Consult your doctor for the same. Back to All Questions

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