Growing Up Too Fast
Aug. 6, 2001 -- It's distressing to any parent when their daughter begins showing signs of puberty before she even finishes first grade. But according to a new study, it could be a premature, but normal change, if the girl is overweight.
In most girls, puberty begins between 8 and 13 years of age. But a few years ago a survey of the nation's children found that by age 8 approximately 8% of white girls and 25% of black girls have started puberty. Paul Kaplowitz, MD, one of the researchers who reported those findings, says the data now indicate that weight is a major trigger of early puberty in many white girls and is a contributing factor along with genetics and environmental factors for many black girls as well.
Until recently a 7-year-old girl, overweight or not, who is developing breasts would be diagnosed as having precocious puberty, a hormonal condition considered "abnormal", says Kaplowitz, of Virginia Commonwealth University School of Medicine in Richmond.
"When you define something as 'abnormal' it implies that you need to do something about it," he says. "[T]hen pediatricians feel like they have to start doing tests and considering treatment."
Kaplowitz's new findings linking early puberty to weight appear in the August issue of Pediatrics. He says knowing weight may be a factor helps doctors make an important distinction between girls who can be monitored closely without treatment and those who need hormone-suppressing drugs to slow down rapidly occurring abnormal changes.
Unlike girls with true precocious puberty, many overweight girls with signs of early puberty, such as breast development and pubic hair, will have a slow progression to other puberty changes, according to Kaplowitz.
"We can reassure parents that yes, puberty is starting earlier than normal, but it's not going to result in a menstrual period at 8 or 9 years of age and it probably won't have a major impact on the child's height," he says.
But parents shouldn't mistake the reassurances that their daughter's early puberty is normal as meaning the child's weight is acceptable, says William W. Wong, PhD.