Nutritional management, dietary intervention, and long‐term monitoring in pediatric Prader–Willi syndrome: A 3‐year case‐based clinical observation

Nutritional management is fundamental in Prader-Willi syndrome (PWS), but longitudinal data from routine pediatric practice are limited. We describe a 3-year nutritional follow-up of a boy with PWS complicated by obesity, insulin resistance, dyslipidemia, hyperuricemia, and fatty liver. Management consisted of an energy-restricted, nutritionally balanced diet, structured meal timing, portion control, family-based supervision, exercise guidance, and serial monitoring of anthropometry, body composition, metabolic markers, liver enzymes, growth, and pubertal development. Weight and metabolic status improved initially, but weight later showed a U-shaped trajectory during puberty, likely related to slower growth, delayed pubertal progression, and reduced adherence after school transition. These findings support the need for ongoing, developmentally tailored nutritional monitoring in children with PWS.