Schmidt Hannah, Menrath Ingo, Wiegand Susanna, Reinehr Thomas, Kiess Wieland, Hebebrand Johannes, von Schnurbein Julia, Holl Reinhard W, Holle Rolf, Scherag André, Wabitsch Martin, Brandt-Heunemann Stephanie
Department of Child and Adolescent Medicine, University Clinic Schleswig-Holstein (UKSH), Lübeck, Germany.
Ambulatory Obesity Center, Charité University Hospital Berlin, Berlin, Germany.
Obes Facts. 2025;18(1):21-30. doi: 10.1159/000540888. Epub 2024 Sep 18.
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.
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.
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.
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.
极度肥胖（体重指数[BMI]≥40）的青少年身心健康受损风险增加。然而，这一患者群体在研究中很少受到关注。本研究旨在分析极度肥胖青少年与轻度和中度肥胖（BMI = 30 - 39.9）青少年相比的疼痛体验和心理健康损害情况，同时考虑潜在的性别差异。
分析了431名肥胖青少年（平均年龄M = 16.6岁；标准差SD = 2.3；年龄范围 = 13 - 25岁；女性占53.1%）的横断面数据。其中，159名（36.8%）青少年患有极度肥胖。通过标准化问卷评估自我报告的社会人口统计学数据、与背部或腿部疼痛、抑郁以及健康相关生活质量（HRQoL）相关的变量。数据采用单变量检验和逻辑回归模型进行分析。
与轻度和中度肥胖的青少年相比，极度肥胖的青少年报告在过去4周内疼痛更多（p = 0.018），日常生活中与疼痛相关的损害增加（p = 0.009），与疼痛相关的缺勤天数更多（p = 0.030），抑郁得分更高（p = 0.030），HRQoL更低（p = 0.005）。在回归模型中纳入社会人口统计学变量后，极度肥胖与过去4周内疼痛之间的关联仍然存在。在极度肥胖青少年亚组（n = 159）中，女性（n = 83）与男性（n = 76）相比，报告在过去4周内疼痛更多（p = 0.001），抑郁得分更高（p < 0.001），HRQoL更低（p < 0.001）。即使在控制了社会人口统计学变量和抑郁之后，女性与疼痛之间的关联在回归模型中仍然显著。
这些发现凸显了对疼痛和心理健康进行标准化评估的必要性，特别是在治疗极度肥胖的女性青少年时。未来的研究应分析疼痛与心理健康的相互作用，因为两者都是生活方式改变和减肥的重要障碍。
