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05 for men, p  0.01 for women). For both sexes, TBLH, LS and hip BMC and BMD positively correlated with weight, BMI, LM and FM. TBS negatively correlated with BMI-percentile in both sexes, with a negative correlation with FM for males alone. Hip BMC and BMD, BMD, ACT and CSA at the three hip sites positively correlated with BMI-percentile in males. Extreme obesity impacts bone health depending on anatomical sites, altering lumbar trabecular bone in both males and females adolescents. Extreme obesity impacts bone health depending on