Take a load off

Every month, orthopedic surgeons in Alberta refer young, obese patients to clinics designed to help them reach and maintain a healthy weight.

Obesity not only causes hypertension and Type 2 diabetes in children, it’s also hard on their bones and joints.

“Several bone diseases can be associated with childhood obesity, one of which is in the hip,” says Dr. Elaine Joughin, a pediatric orthopedic surgeon with Alberta Health Services. 

“Obese children can have a particular type of stress fracture within the hip and that can lead to early arthritis in the joint.”

She says while there’s no evidence to suggest obesity leads to a decrease in bone density in children, obesity is often associated with poor diets and subsequent, long-term vitamin D and calcium deficiencies. These can lead to osteoporosis—a bone disease that increases the risk of fracture. 

Joughin says excess weight in a child also can cause sore feet and knock knees, a condition in which the knees touch and the ankles are separated.

“We see that very frequently in obese children and knock knees can lead to not only deformity but premature arthritis in the knee,” she says.

“In some cases, if you’ve got knee deformity, this can predispose to patella dislocation—the knee cap coming out of joint.” 

Statistics Canada’s 2004 Canadian Community Health Survey: Nutrition found eight per cent of Albertans two to 17 years old were obese. Another 14 per cent were overweight.

“We see lots of obese children,” says Joughin. “And (they) usually have obese parents. It’s very familial and it’s eating habits.”

Special clinics throughout the province are addressing the problem of child obesity, including the Pediatric Centre for Weight and Health at the Stollery Children's Hospital in Edmonton.

"There is no magic bullet when it comes to weight loss,” says Dr. Geoff Ball, director Pediatric Centre and assistant professor of pediatrics at the University of Alberta. “But when we work with motivated families who are supportive of one another, we’re most likely to help them to make healthy changes.” 

Such clinics educate kids and their families on healthy eating and active living and provide individual counselling, group-based education and long-term support.

The work at these weight-management clinics today could decrease the demand for orthopedic services tomorrow.

People who are obese nine times more likely to develop osteoarthritis, which often degenerates bone to point of needing joint-replacement surgery, says Dr. Jason Werle, an orthopedic surgeon in Calgary.

“Strategies directed at improving childhood obesity should improve the chances that we’re going to reduce the risk of osteoarthritis later on,” says Werle.