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Adolescent obesity

Severely obese adolescents have limited physical function

Condition also impacts quality of life

Researchers participating in the ‘Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study have reported that adolescents with severe obesity have musculoskeletal pain that limits their physical function and quality of life. Published in JAMA Pediatrics, the investigators noted that while paediatric obesity is more common now and is associated with other diseases, very little is known about the consequences of the most severe forms of obesity on the musculoskeletal system.

The authors of the current study found that severely obese teens that carry excess weight, have specific musculoskeletal abnormalities including pain and experience functional difficulties performing routine tasks.

Sharon Bout-Tabaku

"Musculoskeletal and specifically lower extremity pain in severely obese adolescents may be a risk factor and herald a pre-disease state of osteoarthritis, which may be reversible at early stages following bariatric surgery," lead author of the study, Dr Sharon Bout-Tabaku, Assistant Professor and Pediatric Rheumatologist at Nationwide Children's Hospital and The Ohio State University College of Medicine in Columbus. "For clinicians working with obese adolescents, awareness of lower extremity pain and its impact on functional ability, including adherence to exercise and other physical activity recommendations, is extremely important and needs to be treated appropriately."

Teen-LABS is a multi-centre clinical study funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health (NIH) that is examining the safety and health effects of surgical weight loss procedures. In this paper, the researchers examined baseline data from 233 patients between February  2007 and December 2011. We excluded adolescents with Blount disease and slipped capital femoral epiphyses.

The mean (SD) age at surgery was 17.1 (1.56) years and the median BMI50.4. Participants were predominantly female (77%), white (73%), and non-Hispanic (93%). Among the participants, 49% had poor functional status and 76% had musculoskeletal pain. Lower back pain was prevalent (63%), followed by ankle/foot (53%), knee (49%), and hip (31%) pain; 26% had pain at all 4 sites. In adjusted analyses, compared with pain-free participants, those reporting lower extremity pain had greater odds of having poor physical function according to scores on the Health Assessment Questionnaire Disability Index (p<0.01).

Compared with pain-free participants, those reporting lower extremity pain had significantly lower Impact of Weight on Quality of Life–Kids total scores (p<0.01) and physical comfort scores (p<0.01). After adjustment, no significant relationship was observed between musculoskeletal pain and high-sensitivity C-reactive protein level.

The researchers added that long-term follow-up will reveal whether bariatric surgery reverses pain and physical functional limitations and improves quality of life.

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