Youths with Extreme Obesity: A High-Risk Group for Pain and Mental Health Impairments

Hannah Schmidt; Ingo Menrath; Susanna Wiegand; Thomas Reinehr; Wieland Kiess; Johannes Hebebrand; Julia von Schnurbein; Reinhard W Holl; Rolf Holle; André Scherag; Martin Wabitsch; Stephanie Brandt-Heunemann

doi:10.1159/000540888

Youths with Extreme Obesity: A High-Risk Group for Pain and Mental Health Impairments

Obes Facts. 2024 Sep 18:1-10. doi: 10.1159/000540888. Online ahead of print.

Authors

Hannah Schmidt¹, Ingo Menrath¹, Susanna Wiegand², Thomas Reinehr³, Wieland Kiess⁴, Johannes Hebebrand⁵, Julia von Schnurbein^{6

7}, Reinhard W Holl⁸, Rolf Holle⁹, André Scherag¹⁰, Martin Wabitsch^{6

7}, Stephanie Brandt-Heunemann^{6

7}

Affiliations

¹ Department of Child and Adolescent Medicine, University Clinic Schleswig-Holstein (UKSH), Lübeck, Germany.
² Ambulatory Obesity Center, Charité University Hospital Berlin, Berlin, Germany.
³ Vestische Children's Hospital Datteln, University Witten/Herdecke, Witten, Germany.
⁴ Department of Women and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.
⁵ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, Duisburg, Germany.
⁶ Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany.
⁷ Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, German Center for Child and Adolescent Health (DZKJ), Partner Site Ulm, Ulm, Germany.
⁸ Institute for Epidemiology and Medical Biometry, CAQM, Ulm University, Ulm, Germany.
⁹ Faculty of Medicine, Institute of Medical Data Processing, Biometrics and Epidemiology (IBE), Ludwig Maximilian University Munich, Munich, Germany.
¹⁰ Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany.

PMID: 39293412
DOI: 10.1159/000540888

Abstract

Introduction: Youths with extreme obesity (body mass index [BMI] ≥40) are at increased risk for physical and mental health impairments. Nevertheless, this patient group has received little attention in research. This study aimed to analyze the pain experience and mental health impairments of youths with extreme obesity compared to those with mild and moderate obesity (BMI = 30-39.9) while also considering potential gender differences.

Methods: Cross-sectional data of 431 obese youths (M = 16.6 years; SD = 2.3; range = 13-25 years; 53.1% female) were analyzed. Of these, 159 (36.8%) youths had extreme obesity. Self-reported sociodemographic data, variables related to back or leg pain, depression, and health-related quality of life (HRQoL) were assessed with standardized questionnaires. Data were analyzed with univariate tests and logistic regression models.

Results: Youths with extreme obesity reported more pain in the last 4 weeks (p = 0.018), increased pain-related impairments in daily life (p = 0.009), more pain-related days of absence (p = 0.030), higher depression scores (p = 0.030), and reduced HRQoL (p = 0.005) compared to youths with mild and moderate obesity. The association between extreme obesity and pain in the last 4 weeks remained associated after including sociodemographic variables in the regression model. In the subgroup of youth with extreme obesity (n = 159), women (n = 83) reported more pain in the last 4 weeks (p = 0.001), higher depression scores (p < 0.001), and lower HRQoL (p < 0.001) compared to men (n = 76). The association between female gender and pain remained significant in the regression models, even after controlling for sociodemographic variables and depression.

Conclusion: These findings highlight the need for standardized assessments of pain and mental health, particularly in the treatment of female youths with extreme obesity. Upcoming studies should analyze the reciprocal interactions of pain and mental health, since both are important barriers to lifestyle changes and weight loss.

Keywords: Extreme obesity; Mental health; Pain; Youths.