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Dear Ann Landers: The letter from "No Name Out East" prompted me to write. The woman was concerned about her overweight 6-year-old granddaughter and thought the girl should be put on a diet.

Ann, that little girl is not being self-indulgent. She probably feels terrible about her weight already and doesn't need any more pressure. I was an overweight child and have battled the bulge all my life. Now, at age 40, I have finally been properly diagnosed with an inherited metabolic disorder called hyperinsulinemia. This disorder causes the body to overproduce insulin.

Insulin is the hormone responsible for turning carbohydrates into fat, so with that much extra insulin, even "diet" carbohydrates like rice cakes and carrots can cause weight gain. The extra insulin starves the brain of needed glucose and disrupts the entire endocrine system, which creates food cravings, mood swings and constant fatigue.

I experienced delayed puberty, infertility and a hopeless battle with weight as I endured one high-carbohydrate, low-fat diet after another, only making myself sicker. I am now on a low-carbohydrate, high-protein diet and doing much better. I regret all those years I blamed myself for being weak when in reality I had a medical problem.

-- Santa Barbara, Calif.

Dear Santa Barbara: I was surprised at the number of readers who expressed concern for that child and suggested that she might have some kind of medical problem. Keep reading for a couple of other possibilities:

From Tilden, Neb.: That grandmother who has the 6-year-old overweight grandchild should know about Prader-Willi syndrome, a congenital disorder. One of the symptoms of Prader-Willi syndrome is compulsive overeating. In extreme cases, parents have had to padlock refrigerators to keep children from eating themselves to death. Not long ago, a woman was prosecuted when her 600-pound teen-age daughter died from what was probably Prader-Willi. The mother narrowly escaped prison.

I realize this may not be the source of the 6-year-old girl's weight problem, but it is a possibility that shouldn't be ignored. Please tell your readers that many life-threatening diseases, including extreme obesity, are genetic in origin.

From Virginia Beach, Va.: When my daughter was 10, she turned from a chubby little girl into a very chunky pre-teen, with most of the weight in her tummy area. She put herself on a healthy diet and was physically active, playing on two sports teams and participating in gym class every day. Nothing worked.

Finally I found a doctor who ran some tests and discovered she had an underactive thyroid and high cholesterol. (The thyroid affects the cholesterol level.) Her condition is now controlled by daily medication.

Dear Nebraska and Virginia: Thank you for providing some insight into the problem. I hope the mother of that little girl will see this column and take her to the pediatrician for a complete evaluation. I love the way my readers take care of one another.

Problems? Dump on Ann. Write her at The Buffalo News, P.O. Box 100, Buffalo, N.Y. 14240.

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