Obesity

I (W. Wertelecki, M.D.) see an obese young person. The medical question is whether it signals a specific disorder. Contrary to the present, centuries ago, obesity was rare, so much so that it became popular to call the depicted person “monstruo”. A Clinical Geneticist today would recommend molecular investigations particularly if the adiposity is concurrent with intellectual impairment and an early postnatal history of hypotonia (floppy baby). Note that Miranda, the artist who produced these extraordinary images, discretely avoids letting us determine whether the sex is male or female – in my view, focusing the attention on paternal genes located on the chromosome 15 is a priority to rule out Pradder-Willi syndrome). Note that the P-W syndrome is associated with paternal gene abnormalities and another syndrome (Angelman) is associated with similar gene anomalies but maternal origin.

The above comment illustrates that boys are boys and girls are girls – it is almost ridiculous that much of the medical literature combines observations of male and female origin.