Differences in body composition and physical activity in youth with obesity who report pain.

Background: Pain is a common comorbidity in youth with obesity and may reduce participation in physical activity (PA), a cornerstone of obesity treatment. However, the relationship between pain severity, body composition, and physical activity participation remains poorly understood. Methods: Anthropometrics and body composition were assessed in youth (8-20 years) with obesity at a healthy lifestyle clinic. PA was reported as the number of days/week the youth engaged in ≥60 min of activity (0-1, 2-4, 5-7 days). Youth were grouped by caregiver-reported pain level (no pain, mild, or moderate-to-extreme pain). Statistical analyses examined differences in body composition and PA level based on pain grouping. Results: The sample included 687 youth (12.4 ± 3.4 years; 67.8% African American/Black; 62.6% female); 76.5% reported no pain, 11.9% mild pain, and 11.6% moderate-to-extreme pain while walking on a flat surface. Higher pain severity was associated with greater body fat percentage (p = 0.002) and fat mass (p = 0.04) compared with mild or no pain, Differences in PA were evident between the 3 groups based on their reported pain (p = 0.009). Conclusion: Pain severity was associated with higher body fat mass and percentage, and less PA. Findings highlight the need to better characterize pain in youth with obesity and develop exercise interventions to support PA and body composition.