Overweight Teens: Weight/Shape Concern & Bone Density

Abstract

Adolescent Health| December 01 2009 Overweight Teens: Weight/Shape Concern & Bone Density AAP Grand Rounds (2009) 22 (6): 68. https://doi.org/10.1542/gr.22-6-68 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Overweight Teens: Weight/Shape Concern & Bone Density. AAP Grand Rounds December 2009; 22 (6): 68. https://doi.org/10.1542/gr.22-6-68 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: bone mineral density, overweight Source: Schvey NA, Tanofsky-Kraff M, Yanoff LB, et al. Disordered-eating attitudes in relation to bone mineral density and markers of bone turnover in overweight adolescents. J Adolesc Health. 2009;45(1):33–39; doi:10.1016/jadohealth.2008.12.020 Using baseline data from adolescents recruited for a weight-loss treatment study, investigators from the National Institutes of Health performed a cross-sectional study to determine the relationship between disordered-eating attitudes and both bone mineral density (BMD) and markers of bone turnover in overweight participants aged 12 to 17 years. Inclusion criteria included having a body mass index (BMI, kg/m2) greater than or equal to the National Health and Nutrition Examination Survey (NHANES) II 95th percentile for age, race, and gender and the presence of at least one quantifiable obesity-related comorbidity (including hypertension, type 2 diabetes or impaired glucose tolerance, hyperinsulinism, hyperlipidemia, hepatic steatosis, or sleep apnea). Adolescents were excluded if they had significant medical conditions unrelated to obesity, had a psychiatric disorder that would impede study compliance, used an anorexiant in the past six months, or had recent significant weight loss. Participating adolescents were interviewed using the Eating Disorder Examination version 12OD/C.2, a semistructured interview assessing disordered attitudes and behaviors as well as items designed to diagnose specific Diagnostic and Statistical Manual of Mental Disorders IV-TR eating disorders. Participants also completed the Eating Inventory, a self-completed questionnaire measuring cognitive eating restraint (the intent to restrict or limit food intake), disinhibition (identifying the tendency to overeat), and perceived hunger. Participants underwent dual energy X-ray absorptiometry to measure total lumbar spine BMD and measurements of fasting serum bone-specific alkaline phosphatase and osteocalcin. Urine measurements of N-telopeptides and free cortisol were also obtained. One hundred thirty-seven participants aged 12 to 17 years were studied; 66.4% were female, 55.5% African American, and 44.5% Caucasian. Mean age was 14.39 ± 1.41 years, and mean BMI was 39.9 ± 6.8 kg/m2. After accounting for demographics, height, weight, serum 25-hydroxy vitamin D, and depressive symptoms, adolescent weight concern was significantly and positively associated with urine free cortisol. Shape concern was inversely and significantly associated with lumbar spine BMD. Cognitive dietary restraint was not a predictor in any of the authors’ models. The authors conclude that among severely overweight adolescents, dissatisfaction with shape and weight may be salient stressors that negatively impact BMD. Dr Levine has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. The prevalence of overweight adolescents (defined as a BMI ≥95th percentile for age and gender) has steadily increased, reaching 17% according to the 2003–2004 NHANES.1 At the same time, there is a growing appreciation of the importance of bone health in adolescents. Low bone mass and bone area for weight has been demonstrated in overweight and obese adolescents.2 The relationship between cognitive eating restraint and bone health is thought to be mediated, at least in part, by increased levels of stress hormones, including cortisol, that have... You do not currently have access to this content.