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Teenage obesity may cause permanent bone loss

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Teenagers who are obese may suffer irreparable damage to their bones, according to research presented at this week’s annual meeting of the Radiological Society of North America (RSNA).

In an ongoing study, researchers are looking at how excess weight in young people may affect bone structure.

Evidence suggests that having a high amount of visceral fat (the deep fat in the abdomen that surrounds the internal organs) and a low amount of muscle mass may lead to bone loss in obese adolescents.

“While obesity was previously believed to be protective of bone health, recent studies have shown a higher incidence of forearm fractures in obese youths,” said the study’s lead author, Dr Miriam A. Bredella, radiologist at Massachusetts General Hospital and associate professor of radiology at Harvard Medical School in Boston.

For the study, Dr Bredella and colleagues recruited 23 obese adolescents with a mean age of 17 years and a mean body mass index (BMI) of 44 kg/m2.

The researchers performed 3D HR-pQCT — a type of computed tomography exam designed specifically for measuring bone mineral density and bone microarchitecture in the arms and legs — to determine the bone structure of the distal radius, an area of the forearm near the wrist. They also performed dual-energy x-ray absorptiometry (DXA) exams to determine body composition, including lean mass and visceral fat mass.

“There are several mechanisms by which visceral fat exerts negative effects on bone,” Dr Bredella explained. “Visceral fat secretes substances that promote chronic inflammation, and chronic inflammation stimulates formation of osteoclasts, which are the cells that resorb or break-down bone. In addition, vitamin D, which is important for bone health, is soluble in adipose tissue and gets trapped within fat cells.”

Results showed that BMI was positively associated with the thickness and area of cortical bone, which forms the outer shell of most bones. Greater visceral fat mass was positively associated with cortical porosity, the researchers found.

Meanwhile, lean mass was positively associated with trabecular density, volume and integrity. Trabecular bone is a spongy inner layer of bone that provides support and flexibility.

Dr Bredella noted that growth hormone, which is important for bone health, is also lower in adolescents with visceral obesity.

The findings suggest that having a high amount of visceral fat and a low amount of muscle mass puts adolescents at risk for weakened bone structure, RSNA said.