{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:07:49Z","timestamp":1791396469980,"version":"4.3.3"},"reference-count":60,"publisher":"Bioscientifica","issue":"3","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":106,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:p>The childhood and adolescent obesity epidemic remains one of the most important and challenging health issues of the 21st century. Excess body weight affects the immediate health of children and adolescents, being associated with a higher and earlier risk of several non-communicable diseases (NCDs), such as type 2 diabetes and cardiovascular diseases, in addition to adverse psychosocial consequences and impacts on pubertal timing. Evidence dating back to the past century points to a secular trend of earlier puberty in boys and girls in various parts of the world, and this earlier onset has been attributed, at least in part, to obesity, especially in girls. In boys, this relationship is not as linear. Moreover, despite some contradictory results, most recent evidence points to earlier puberty also being associated with an excess of body weight in boys. Several mechanisms have been suggested to explain this possible relationship between puberty onset and obesity. However, the most promising link in this connection is leptin and its interaction with the kisspeptin system, in addition to an important contribution from insulin, which is frequently increased in obesity. The gut microbiota is implicated in the pathophysiology of obesity, which, in turn, is commonly associated with insulin resistance and the development of central precocious puberty, particularly in females. This review summarizes current knowledge on the relationship between obesity and the onset and progression of puberty in both sexes, as well as the pathways potentially involved in the pathophysiology of this association.<\/jats:p>","DOI":"10.1530\/ec-26-0069","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T16:48:33Z","timestamp":1773679713000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":4,"title":["The complex interaction between obesity and puberty and its implications for pubertal timing: a review of recent evidence"],"prefix":"10.1530","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5230-5936","authenticated-orcid":true,"given":"Kettyuscia","family":"Coelho e Oliveira","sequence":"first","affiliation":[{"name":"1"},{"name":"2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6271-758X","authenticated-orcid":true,"given":"Lucila Leico Kagohara","family":"Elias","sequence":"additional","affiliation":[{"name":"3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4778-8803","authenticated-orcid":true,"given":"Sonir R Rauber","family":"Antonini","sequence":"additional","affiliation":[{"name":"2"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"2026070713513208400_bib1","doi-asserted-by":"crossref","first-page":"R51","DOI":"10.1530\/JOE-19-0223","article-title":"Novel mechanisms for the metabolic control of puberty: implications for pubertal alterations in early-onset obesity and malnutrition","volume":"242","author":"Vazquez","year":"2019","journal-title":"J Endocrinol"},{"key":"2026070713513208400_bib2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1159\/000438874","article-title":"Sexual Precocity--Genetic bases of central precocious puberty and autonomous gonadal activation","volume":"29","author":"Macedo","year":"2016","journal-title":"Endocr Dev"},{"key":"2026070713513208400_bib3","doi-asserted-by":"crossref","first-page":"e932","DOI":"10.1542\/peds.2008-2491","article-title":"Recent decline in age at breast development: the Copenhagen Puberty Study","volume":"123","author":"Aksglaede","year":"2009","journal-title":"Pediatrics"},{"key":"2026070713513208400_bib4","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1542\/peds.99.4.505","article-title":"Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network","volume":"99","author":"Herman-Giddens","year":"1997","journal-title":"Pediatrics"},{"key":"2026070713513208400_bib5","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1210\/jc.2009-1478","article-title":"Recent changes in pubertal timing in healthy Danish boys: associations with body mass index","volume":"95","author":"S\u00f8rensen","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"2026070713513208400_bib6","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1093\/ije\/dyaa056","article-title":"Childhood overweight and obesity and timing of puberty in boys and girls: cohort and sibling-matched analyzes","volume":"49","author":"Brix","year":"2020","journal-title":"Int J Epidemiol"},{"key":"2026070713513208400_bib7","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.coemr.2020.08.004","article-title":"Connections between obesity and puberty: invited by Manuel Tena-Sempere, Cordoba","volume":"14","author":"Huang","year":"2020","journal-title":"Curr Opin Endocr Metab Res"},{"key":"2026070713513208400_bib8","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/j.2047-6310.2013.00176.x","article-title":"Timing of puberty and physical growth in obese children: a longitudinal study in boys and girls","volume":"9","author":"De Leonibus","year":"2014","journal-title":"Pediatr Obes"},{"key":"2026070713513208400_bib9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-018-1376-4","article-title":"Puberty timing associated with obesity and central obesity in Chinese Han girls","volume":"19","author":"Lian","year":"2019","journal-title":"BMC Pediatr"},{"key":"2026070713513208400_bib10","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1515\/jpem-2019-0119","article-title":"BMI relationship to the onset of puberty: assessment of growth parameters and sexual maturity changes in Egyptian children and adolescents of both sexes","volume":"33","author":"Abou El Ella","year":"2020","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2026070713513208400_bib11","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1001\/jamapediatrics.2019.2315","article-title":"Secular trends in pubertal growth acceleration in Swedish boys born from 1947 to 1996","volume":"173","author":"Ohlsson","year":"2019","journal-title":"JAMA Pediatr"},{"key":"2026070713513208400_bib12","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2015-0164","article-title":"Timing of puberty in overweight versus obese boys","volume":"137","author":"Lee","year":"2016","journal-title":"Pediatrics"},{"key":"2026070713513208400_bib13","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1001\/archpediatrics.2009.258","article-title":"Body mass index and timing of pubertal initiation in boys","volume":"164","author":"Lee","year":"2010","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2026070713513208400_bib14","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1542\/peds.110.5.903","article-title":"Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls","volume":"110","author":"Wang","year":"2002","journal-title":"Pediatrics"},{"key":"2026070713513208400_bib15","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1159\/000455968","article-title":"Putative effects of obesity on linear growth and puberty","volume":"88","author":"Shalitin","year":"2017","journal-title":"Horm Res Paediatr"},{"key":"2026070713513208400_bib16","doi-asserted-by":"crossref","first-page":"E1519","DOI":"10.1210\/jc.2014-1384","article-title":"Sexual dimorphisms in the associations of BMI and body fat with indices of pubertal development in girls and boys","volume":"99","author":"Crocker","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"2026070713513208400_bib17","article-title":"Overweight\/obesity in childhood and the risk of early puberty: a systematic review and meta-analysis","volume":"10","author":"Zhou","year":"2022","journal-title":"Front Pediatr"},{"key":"2026070713513208400_bib18","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/S2352-4642(18)30306-7","article-title":"Is there a causal relationship between obesity and puberty?","volume":"3","author":"Reinehr","year":"2019","journal-title":"Lancet Child Adolesc Health"},{"key":"2026070713513208400_bib19","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.jpeds.2005.10.020","article-title":"Pubertal correlates in black and white girls","volume":"148","author":"Biro","year":"2006","journal-title":"J Pediatr"},{"key":"2026070713513208400_bib20","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1001\/archpedi.155.9.1022","article-title":"Secondary sexual characteristics in boys: estimates from the national health and nutrition examination survey III, 1988\u20131994","volume":"155","author":"Herman-Giddens","year":"2001","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2026070713513208400_bib21","doi-asserted-by":"crossref","DOI":"10.1001\/jamapediatrics.2019.5881","article-title":"Worldwide secular trends in age at pubertal onset assessed by breast development among girls: a systematic review and meta-analysis","volume":"174","author":"Eckert-Lind","year":"2020","journal-title":"JAMA Pediatr"},{"key":"2026070713513208400_bib22","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1159\/000516171","article-title":"Associations of obesity with linear growth and puberty","volume":"95","author":"Shalitin","year":"2022","journal-title":"Horm Res Paediatr"},{"key":"2026070713513208400_bib23","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1126\/science.169.3943.397","article-title":"Height and weight at menarche and a hypothesis of critical body weights and adolescent events","volume":"169","author":"Frisch","year":"1970","journal-title":"Science"},{"key":"2026070713513208400_bib24","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1093\/oxfordjournals.humrep.a136582","article-title":"Body fat, menarche, fitness and fertility","volume":"2","author":"Frisch","year":"1987","journal-title":"Hum Reprod"},{"key":"2026070713513208400_bib25","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/j.1365-2826.2011.02230.x","article-title":"Sex steroids and the control of the Kiss1 system: developmental roles and major regulatory actions","volume":"24","author":"Garc\u00eda-Galiano","year":"2012","journal-title":"J Neuroendocrinol"},{"key":"2026070713513208400_bib26","doi-asserted-by":"crossref","DOI":"10.1111\/obr.13005","article-title":"Adipokines: a gear shift in puberty","volume":"21","author":"Nieuwenhuis","year":"2020","journal-title":"Obes Rev"},{"key":"2026070713513208400_bib27","doi-asserted-by":"crossref","first-page":"3434","DOI":"10.3390\/nu13103434","article-title":"The \u201cAdipo-Brain\u201d dialogue in childhood obesity: focus on growth and puberty. Physiopathological and nutritional aspects","volume":"13","author":"Bruno","year":"2021","journal-title":"Nutrients"},{"key":"2026070713513208400_bib28","first-page":"941","article-title":"Evaluation of Kisspeptin levels in prepubertal obese and overweight children: sexual dimorphism and modulation of antioxidant levels","volume":"25","author":"Mancini","year":"2021","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2026070713513208400_bib29","doi-asserted-by":"crossref","first-page":"4652","DOI":"10.1210\/endo.139.11.6297","article-title":"The stimulatory effect of leptin on the neuroendocrine reproductive axis of the monkey","volume":"139","author":"Finn","year":"1998","journal-title":"Endocrinology"},{"key":"2026070713513208400_bib30","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.molmet.2016.08.003","article-title":"Defining a novel leptin-melanocortin-kisspeptin pathway involved in the metabolic control of puberty","volume":"5","author":"Manfredi-Lozano","year":"2016","journal-title":"Mol Metab"},{"key":"2026070713513208400_bib31","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1038\/s41586-021-04088-9","article-title":"MC3R links nutritional status to childhood growth and the timing of puberty","volume":"599","author":"Lam","year":"2021","journal-title":"Nature"},{"key":"2026070713513208400_bib32","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.100722.4","article-title":"POMC neurons control fertility through differential signaling of MC4R in kisspeptin neurons","volume":"13","author":"Talbi","year":"2025","journal-title":"eLife"},{"key":"2026070713513208400_bib33","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.fertnstert.2016.06.041","article-title":"Influence of increasing body mass index on semen and reproductive hormonal parameters in a multi-institutional cohort of subfertile men","volume":"106","author":"Bieniek","year":"2016","journal-title":"Fertil Steril"},{"key":"2026070713513208400_bib34","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1038\/s42255-022-00610-z","article-title":"Glial cells as integrators of peripheral and central signals in the regulation of energy homeostasis","volume":"4","author":"Nampoothiri","year":"2022","journal-title":"Nat Metab"},{"key":"2026070713513208400_bib35","doi-asserted-by":"crossref","DOI":"10.1111\/jne.70029","article-title":"Increase of astrocyte apposition on GnRH neurons in early puberty onset induced by high fat diet","volume":"37","author":"Rodrigues-Santos","year":"2025","journal-title":"J Neuroendocrinol"},{"key":"2026070713513208400_bib36","doi-asserted-by":"crossref","first-page":"E10758","DOI":"10.1073\/pnas.1802053115","article-title":"Metabolic regulation of female puberty via hypothalamic AMPK-Kisspeptin signaling","volume":"115","author":"Roa","year":"2018","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2026070713513208400_bib37","doi-asserted-by":"crossref","first-page":"4194","DOI":"10.1038\/s41467-018-06459-9","article-title":"SIRT1 mediates obesity- and nutrient-dependent disruption of pubertal timing by epigenetically controlling Kiss1 expression","volume":"9","author":"Vazquez","year":"2018","journal-title":"Nat Commun"},{"key":"2026070713513208400_bib38","doi-asserted-by":"crossref","first-page":"4390","DOI":"10.1210\/jc.2018-02747","article-title":"Sex differences in effects of obesity on reproductive hormones and glucose metabolism in early puberty","volume":"104","author":"Nokoff","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"2026070713513208400_bib39","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1210\/endo.141.4.7402","article-title":"Effect of leptin on CYP17 enzymatic activities in human adrenal cells: new insight into the onset of adrenarche","volume":"141","author":"Biason-Lauber","year":"2000","journal-title":"Endocrinology"},{"key":"2026070713513208400_bib40","doi-asserted-by":"crossref","DOI":"10.1002\/jcla.24420","article-title":"Obesity and gut-microbiota-brain axis: a narrative review","volume":"36","author":"Asadi","year":"2022","journal-title":"J Clin Lab Anal"},{"key":"2026070713513208400_bib41","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.1000919","article-title":"Precocious puberty and microbiota: the role of the sex hormone-gut microbiome axis","volume":"13","author":"Calcaterra","year":"2022","journal-title":"Front Endocrinol"},{"key":"2026070713513208400_bib42","doi-asserted-by":"crossref","first-page":"941","DOI":"10.3389\/fendo.2019.00941","article-title":"The association of gut microbiota with idiopathic central precocious puberty in girls","volume":"10","author":"Dong","year":"2020","journal-title":"Front Endocrinol"},{"key":"2026070713513208400_bib43","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.1051797","article-title":"Gut microbiota and its derived SCFAs regulate the HPGA to reverse obesity-induced precocious puberty in female rats","volume":"13","author":"Wang","year":"2022","journal-title":"Front Endocrinol"},{"key":"2026070713513208400_bib44","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-80140-8","article-title":"Gut flora influences the hypothalamic-gonadal axis to regulate the pathogenesis of obesity-associated precocious puberty","volume":"14","author":"Qian","year":"2024","journal-title":"Sci Rep"},{"key":"2026070713513208400_bib45","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1186\/s12866-024-03461-8","article-title":"Alterations in the gut microbiota community are associated with childhood obesity and precocious puberty","volume":"24","author":"Wang","year":"2024","journal-title":"BMC Microbiol"},{"key":"2026070713513208400_bib46","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3390\/microorganisms12020323","article-title":"Exploring the mechanistic interplay between gut microbiota and precocious puberty: a narrative review","volume":"12","author":"Yue","year":"2024","journal-title":"Microorganisms"},{"key":"2026070713513208400_bib47","doi-asserted-by":"crossref","DOI":"10.1016\/j.yfrne.2024.101154","article-title":"Astrogenesis in the hypothalamus: a life-long process contributing to the development and plasticity of neuroendocrine networks","volume":"75","author":"Sharif","year":"2024","journal-title":"Front Neuroendocrinol"},{"key":"2026070713513208400_bib48","doi-asserted-by":"crossref","DOI":"10.1172\/JCI172908","article-title":"Kisspeptin signaling in astrocytes modulates the reproductive axis","volume":"134","author":"Torres","year":"2024","journal-title":"J Clin Investig"},{"key":"2026070713513208400_bib49","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1111\/j.1365-2605.2005.00602.x","article-title":"Influence of obesity on timing of puberty","volume":"29","author":"Biro","year":"2006","journal-title":"Int J Androl"},{"key":"2026070713513208400_bib50","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1136\/adc.44.235.291","article-title":"Variations in pattern of pubertal changes in girls","volume":"44","author":"Marshall","year":"1969","journal-title":"Arch Dis Child"},{"key":"2026070713513208400_bib51","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1542\/peds.2008-0146","article-title":"Thelarche, pubarche, and menarche attainment in children with normal and elevated body mass index","volume":"123","author":"Rosenfield","year":"2009","journal-title":"Pediatrics"},{"key":"2026070713513208400_bib52","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1590\/2359-3997000000021","article-title":"Puberty in a sample of Brazilian schoolgirls: timing and anthropometric characteristics","volume":"59","author":"Feibelmann","year":"2015","journal-title":"Arch Endocrinol Metab"},{"key":"2026070713513208400_bib53","doi-asserted-by":"crossref","first-page":"e663","DOI":"10.1210\/clinem\/dgad202","article-title":"The association of accelerated early growth, timing of puberty, and metabolic consequences in children","volume":"108","author":"Jee","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"2026070713513208400_bib54","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jped.2024.03.002","article-title":"Nutritional status and age at menarche in Amazonian students","volume":"100","author":"Oliveira","year":"2024","journal-title":"J Pediatr"},{"key":"2026070713513208400_bib55","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1159\/000336325","article-title":"Recent secular trends in pubertal timing: implications for evaluation and diagnosis of precocious puberty","volume":"77","author":"S\u00f8rensen","year":"2012","journal-title":"Horm Res Paediatr"},{"key":"2026070713513208400_bib56","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.jpag.2018.05.002","article-title":"Age of menarche in a longitudinal US cohort","volume":"31","author":"Biro","year":"2018","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2026070713513208400_bib57","article-title":"Prediction of body mass index and skeletal maturity for early menarche risk at menarche onset: a cross-sectional study of Chinese girls","volume":"14","author":"Li","year":"2024","journal-title":"BMJ Open"},{"key":"2026070713513208400_bib58","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1136\/adc.45.239.13","article-title":"Variations in the pattern of pubertal changes in boys","volume":"45","author":"Marshall","year":"1970","journal-title":"Arch Dis Child"},{"key":"2026070713513208400_bib59","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/ajcn\/nqaa304","article-title":"Revisiting the critical weight hypothesis for regulation of pubertal timing in boys","volume":"113","author":"Bygdell","year":"2021","journal-title":"Am J Clin Nutr"},{"key":"2026070713513208400_bib60","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1210\/clinem\/dgab064","article-title":"Total and central adiposity are associated with age at gonadarche and incidence of precocious gonadarche in boys","volume":"106","author":"Pereira","year":"2021","journal-title":"J Clin Endocrinol Metab"}],"container-title":["Endocrine Connections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ec.bioscientifica.com\/view\/journals\/ec\/15\/3\/EC-26-0069.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/15\/3\/EC-26-0069.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/ec\/article-pdf\/doi\/10.1530\/EC-26-0069\/504202\/ec-26-0069.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/ec\/article-pdf\/doi\/10.1530\/EC-26-0069\/504202\/ec-26-0069.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T17:53:30Z","timestamp":1783446810000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/ec\/article\/15\/3\/e260069\/75344\/The-complex-interaction-between-obesity-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,1]]},"references-count":60,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,1]]}},"URL":"https:\/\/doi.org\/10.1530\/ec-26-0069","relation":{},"ISSN":["2049-3614"],"issn-type":[{"value":"2049-3614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,1]]},"article-number":"e260069"}}