Weight Issues

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Ezri’s weight has been on my mind a bit more than usual after last night, when I realized I needed to order a pair of shorts in size 7 for her. Weight issues are common to HH patients after they’ve had surgery – something happens to the hypothalamus that changes (usually slows) a person’s metabolism – and she is no exception. Ezri is 5 ½ years old and although her weight has stayed relatively stable in relation to her growth charts since her first surgery, it’s almost as if it is settling in her abdominal area more and more, and I have to buy bigger pants and shorts to fit around her. Ezri’s arms and legs are pretty normal looking, more ‘healthy’ than anything, and I don’t feel she looks terribly overweight as long as she isn’t wearing a tight shirt, but there is definitely more mass in her little body than people realize. Up until Ezri’s first surgery she was 50 percentile in both height and weight. After that, her weight moved up into 70 percentile range. After Ezri’s 2nd and 3rd surgeries, 3 months apart, her weight moved to the 80 percentile range. We watched everything she ate very carefully, rarely gave her sweets or other ‘empty calories’ and yet this seemed to be her body’s new ‘set-point’ for her natural weight. She definitely wasn’t losing weight, and as a young child probably shouldn’t have anyway, but at least she wasn’t gaining exponentially either.

A year after that 3rd surgery, I noticed it she was still wearing the same shoes as a year ago; and in fact, her 18 month younger sister’s feet were about the same size. At her endocrine appointment around that time, we realized her height had slowed down to the 25th percentile. A full endocrine panel was done – no growth hormone deficiency, no thyroid deficiency that was affecting growth – nothing could be found that might be the cause of this lack of growth. We could only speculate. Since then, Ezri continued to grow normally, just on that 25th percentile curve and that was definitely not helpful to her 80 something percentile weight – it put her BMI in the lower 90th percentile range.

Then in May 2011 Ezri had her 4th surgery. It really didn’t seem to make her gain anything initially, and I’m still not sure if it was the surgery or the addition of Lexapro as a medication soon afterwards (it can also cause a person to gain weight), but in the fall of 2011 at an endocrine appointment it was noted that Ezri’s BMI had moved up to 97th percentile – officially ‘obese.’ Our endocrine doctor, who we do really love, asked the obligatory questions any doctor would have about what Ezri ate, trying I guess to pinpoint a cause of the gain as it’s not the healthiest to be ‘obese’, but there was none. We feed her much healthier than most kids, and I believe that’s the same story for most children with HH…thankfully, Ezri has remained at this 97th percentile to the present time.

So ,for a long time, Ezri was only wearing pants one size bigger than her age, and even this year she has mostly size 6 shorts – but they are awfully tight, so yesterday, I figured she’d be a lot more comfy in size 7 and ordered them.