Musculoskeletal Problems in Obese Children - An Overview

Introduction:

Young children and kids are more prone to obesity these days, while this is seen as a commonly prevailing condition. The complications obesity can induce in a child are immense. Childhood obesity is often seen to affect kids in several parts of the body, leading them to a lot of physical distress. While various systems are involved, one such system aligned with obesity is the musculoskeletal system or the part of the body that involves the muscles and the bones and has a serious impact on it due to the increase in weight.

What Is Obesity?

Obesity is a term given to children or people when their weight exceeds the average weight considered normal according to their height and weight; obesity is often calculated using reference indexes like the body mass index (BMI). It is the scale that determines the weight a person should have depending on their height and current weight or the basal metabolic rate (BMR) which is the scale that gives the amount of calories a person can consume in a day based on their rate of metabolism. Here, both these indexes are beneficial in maintaining the weight at bay and are calculated once a year. This is differentiated into two ways, and they are:

Children are said to be overweight when the BMI is equal to or greater than 85 percent but below 95 percent. However, children above a BMI of 95 percent are considered obese.

What Are the Factors Causing Childhood Obesity?

The amount of child and adolescent obesity seen in the last two decades is huge and in the last two decades, has been tremendously increasing around the world. However, this leads to various medical issues, creating a compromise in the children's health. Although childhood obesity is a major complication, it just does not happen overnight, rather childhood obesity is a simulation of various medical conditions. Here are some of the factors that lead to childhood obesity.

• Increased availability of unhealthy and sugary foods and drinks.

• Unmonitored increased consumption of carbohydrates.

• Unbalanced meal portions.

• Decrease in protein consumption.

• Decrease In outside games.

• Increased sedentary lifestyle.

• Increase in portion sizes.

• Decrease in breastfeeding.

• Medical conditions like Prader-Willi syndrome, Cushing's syndrome, and Klinefelter's syndrome.

• Increased advertisements of unhealthy food.

• Limited accessibility of healthy foods.

What Is the Relation Between Childhood Obesity and Musculoskeletal Deformities?

Some of the health conditions that occur due to childhood and adolescent obesity are:

• Type 2 diabetes (a clinical condition occurring due to increased blood sugar levels due to resistance of the insulin-producing cells).

• Heart diseases.

• Lung infections.

• Difficulty sleeping.

• Syndromes associated with defective metabolism, like obesity and increased blood cholesterol content.

• Difficulty sleeping.

• Depression.

But apart from the major systemic complications, other factors lead to major musculoskeletal complications, including vitamin deficiencies, stress, hormonal imbalance, tension, etc., which overall impact musculoskeletal health. These complications lead to complications like:

• Pain.

• Bone deformity.

• Efficacy of the person to perform well.

• Compromised mobility.

• Compromised to life quality.

Childhood is when children exhibit an increase in bone growth, determining the growth, development, and strengthening of an individual's bones. And here, as the body weight increases, it hinders the growth of the muscles, bones, and joints. A growth plate in a bone helps regulate and determine the shape and length of the bone, leading to its complete growth and maturity. However, an increase in weight creates internal stress within the growth plates of the bones, leading to more chances of bone fracture, an early indication of arthritis, and other major complications like Blount’s disease or slipped capital femoral epiphysis (SCFE).

What Are the Musculoskeletal Deformities Seen in Obese Children?

• Blount’s Disease: Blount’s disease is also called bowed legs, where the legs appear severely bowed. The main reason for this condition is due to a hormonal imbalance resulting from weight gain, leading to increased stress in the growth plates of the bone. This disease further progresses to form a permanent deformity, leading to discomfort in the knee and pain. However, this condition can be corrected in children and younger adults at an earlier age than in adults. The treatment can be either surgical or nonsurgical.

• Slipped Capital Femoral Epiphysis: Slipped capital femoral epiphysis is a clinical condition occurring as a bone disorder commonly seen in children. The condition occurs due to weakness in the hip or knee, leading to pain and limping. Severe cases can lead to the inability to bear weight in the affected leg. One of the main reasons for this condition is a hormonal dysfunction occurring due to obesity. Although the condition is very common, it is mostly seen to accelerate after puberty. The extra weight in the bones leads to a slip In the growth plate of the femur. However, with childhood obesity, it is quite challenging to secure the position of the joints; hence, proper care should be given.

How Can Musculoskeletal Problems in Obese Children Be Managed?

• Non-Surgical Management: Surgical management includes physiotherapy, ortho shoes, braces to hold the knee, and knee bands (orthotics).

• Surgical Management: The surgical management of these conditions includes two methods, and they are:

  • Altering the Growth Pattern of the Bone: In this procedure, the surgeon places a mental plate near and around the growth plate and screws it up, aiming to correct the bowing over the given period.

  • Osteotomy of the Tibial Bone: This procedure removes a part of the shin bone from the leg that appears deformed. However, the leg is assembled straight, and the removed area is strengthened during closure.

Conclusion:

Hence, weight management is necessary to maintain the well-being of the child. The normal BMI range of a child ranges within a BMI of 18 to 25. In children above the BMI of 40, surgeries aiding in weight loss are also recommended. This shows that physical activities and guided nutrition are essential for children to maintain their weight, growth, and development. Allowing the children to play for 30 to 60 minutes ensures that the child is active and strong both physically and mentally. Also, the inclusion of proteins from childhood helps in better development of the muscles.