For Ilene Fennoy, the Hardest Question in Childhood Obesity Is When to Step In

NEW YORK. Ilene Fennoy went into pediatric endocrinology partly because of babies who arrive too small. Black infants are more likely to be born small for gestational age, and she wanted to understand what that early start meant for a child's health years later. The interest in growth never left her. Over more than four decades it carried her toward one of the most stubborn problems in children's medicine: obesity, and the slide from obesity into type 2 diabetes.

Her schooling mapped out the mix of fields she would later bring together. She studied psychology at Stanford University, graduating in 1968, then earned her medical degree at the University of California San Francisco School of Medicine in 1973. She trained as an intern and resident at Montefiore Hospital in the Bronx, completed a fellowship in human nutrition at Columbia University and worked as a clinical associate at the National Institute of Child Health and Human Development. In 1993 Columbia awarded her a master's degree in public health, with a concentration in health policy and administration.

Harlem shaped much of her early practice. At Harlem Hospital she rose to chief of pediatric endocrinology, and she later took on system wide responsibility as vice president of clinical affairs for the New York City Health and Hospitals Corporation. After directing the pediatric endocrinology division at St. Luke's Roosevelt Hospital, she returned to Columbia. Today she teaches as a professor of pediatrics at the Vagelos College of Physicians and Surgeons and treats patients at NewYork Presbyterian Morgan Stanley Children's Hospital and at Harlem Hospital Center.

At Columbia she directs the POWER Program for Overweight Education and Reduction and is medical director of the Comprehensive Adolescent Bariatric Surgery Program. Both deal with obesity and the heart and metabolic trouble that tends to follow it, and both place weight on reaching families who have long had the hardest time getting specialty care.

She is frank about what diet and exercise alone can do for the sickest teenagers. A young patient who weighs more than 300 pounds and manages to lose ten or fifteen percent of that weight is still facing serious medical risk, along with real strain on emotional wellbeing and friendships, she has explained. That is why she regards surgery as a strong choice for adolescents with severe obesity. Even successful lifestyle programs can demand about 26 visits over a year, a pace that many families and clinics struggle to keep.

The newest obesity medicines interest her, and she approaches them with care. Some are approved for patients 12 and older, yet long term evidence in young people is still limited, she does not expect the drugs to help every child, and insurers seldom cover them, so a prescription costing close to $1,000 a month is out of reach for many households. What she most wants to pin down is timing. Type 2 diabetes tends to move faster in children than in adults, and complications can appear while patients are still in their 20s and 30s.

Prevention, she argues, has to start in schools, which offer the cheapest way to teach large numbers of children about food and physical activity. Because there are too few nutritionists to meet demand, she also wants more of that teaching built into primary care. Her research has followed the same line, including a school based study of nutrition lessons and exercise among middle school students.

Her reach extends well beyond Columbia. The Endocrine Society appointed her to the committee that produced its clinical practice guideline on pediatric obesity, and she is one of the guideline's authors. She also serves on the Obesity Task Force of the Pediatric Endocrine Society. In July 2025 she helped lead a symposium at ENDO 2025 in San Francisco called "Obesity Management Across the Lifespan: Special Considerations."

Widening the doors of the profession has been a second mission. After time on the Endocrine Society's Minority Affairs Committee, she founded the Pediatric Endocrine Society's Equity, Diversity and Inclusion Task Force, which she still helps lead, and she started the effort to bring the Endocrine Society's FLARE and ExCEL programs to pediatric endocrinologists. She serves on the board of the Women in Medicine Legacy Foundation and chairs its Alma Dea Morani Awards Committee. Of everything she has done, she counts the fellows she has trained among her proudest results. Several of them now run pediatric obesity programs.

The Endocrine Society selected her as a 2025 Laureate and gave her its award for Outstanding Leadership in Endocrinology, calling her a pioneer and innovator in pediatric obesity as well as in diversity, equity and inclusion. Her other honors include a certificate of appreciation from the American Academy of Pediatrics and the Alumni Community Service Award from Northfield Mount Hermon School.

Dynamo Times recognizes Ilene Fennoy, MD, MPH, for a career spent bringing expert endocrine care to children who were too often left out of it, and for training the physicians who will carry that work forward.