Children and adolescents with obesity and type 2 diabetes (T2D) could experience a greater risk of fractures and osteoporosis later in life, as both conditions are linked to an interference with bone development. The findings, which were presented at the Endocrine Society’s annual meeting (ENDO 2025) in San Francisco, California, emphasized the importance of building lifelong bone strength during teen years to lessen the risk of bone-related complications.1
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“Obesity and early type 2 diabetes in adolescence don’t just affect weight or blood sugar—they can quietly interfere with bone development during the most critical years for building lifelong bone strength,” Fida Bacha, MD, lead researcher from Baylor College of Medicine in Houston, Texas, said in a news release. “That means teens with these health issues may face a greater risk of fractures and osteoporosis as they get older.”1
Signs and Symptoms of Osteoporosis
Osteoporosis causes bones to become so weak and brittle that small movements and even coughs can lead to a break. Although the condition typically does not show symptoms in its early stages, once the bones become weak, individuals may experience back pain, loss of height over time, a stooped posture, and a bone that breaks much more easily than expected.2
Obesity and Type 2 Diabetes
According to the CDC, around 1 in 5 children and adolescents ages 2 to 9 years that reside in the United States have obesity. For children, obesity is defined as a body mass index (BMI) at or above the 95th percentile for age and sex.3 Additionally, for children aged 5 years and under, overweight is defined as a weight-for-height measurement greater than 2 standard deviations above the WHO Child Growth Standards median. Obesity in this age group is when weight-for-height is greater than 3 standard deviations above the same median. For children and adolescents between 5 and 19 years old, overweight is defined by a BMI-for-age greater than 1 standard deviation above the WHO Growth Reference median, while obesity is greater than 2 standard deviations above this median.4
An increase in children with obesity has led to more cases of T2D in younger individuals. Although it is not widely known why some children develop type 2 diabetes and some do not, common risk factors that increase its development include weight, inactivity, and diet—which are all closely related to overweight and obesity. To aid prevention, health care providers urge guardians to ensure their youth are eating healthy foods and are physically active.5
“While adults with [T2D] are known to have increased risk of fractures, this has not been investigated in youth with type 2 diabetes,” Bacha said in the news release. “We wanted to understand how childhood obesity and early [T2D] affect bone health as children grow.”1
Obesity and Type 2 Diabetes Link With Bone Health
To further understand how obesity and T2D impact bone health in children and adolescents, researchers conducted a study that monitored 48 teenagers with an average age of 15.5 years. Of the total number of teens, 27% had normal weight, 31% were classified as overweight with normal blood sugar, and 42% had overweight and impaired blood sugar control, including 4 teens with prediabetes and 16 teens with T2D. The researchers measured body fat, fitness, blood sugar, and insulin levels for all teens included in the study. Additionally, they used high-resolution imaging to evaluate the teens’ bone structure and strength in the tibia and radius.1
The results demonstrated that the teens with obesity showed less improvement in bone strength and quality over time compared with teens at a normal weight—and similar results were demonstrated among teens with T2D. These results were consistent in both the tibia and radius, as higher insulin levels seemed to contribute to less increase in bone strength.1
The findings suggest teens with obesity and T2D could experience a greater risk of developing osteoporosis as they increase in age, emphasizing the importance of learning and continuing healthy habits and daily preventative steps to decrease their risk.1