Obesity Linked to 16 Health Conditions In New Study

Given the increasing prevalence of obesity and its significant impact on health, this study aimed to comprehensively assess the association between different classes of obesity—Class I, II, and III—and the incidence of multiple common health conditions. Recognizing the limitations of previous research, which often lacked sufficient power to evaluate severe obesity, focused on a narrow range of outcomes, or had limited population diversity, Zhiqi Yao, Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, and colleagues sought to provide a more robust and inclusive analysis.

By examining a broad spectrum of diseases, including cardiovascular, metabolic, respiratory, and musculoskeletal conditions, the researchers aimed to enhance understanding of the long-term health risks associated with varying levels of obesity.

For this purpose, they analyzed data from 270,657 participants in the All of Us research program with a BMI of 18.5 or higher. They assessed the prevalence and incidence of 16 health conditions spanning cardiovascular, metabolic, respiratory, and musculoskeletal disorders. These included hypertension, type 2 diabetes, dyslipidemia, heart failure, atrial fibrillation, atherosclerotic cardiovascular disease, chronic kidney disease, pulmonary embolism, deep vein thrombosis, gout, liver disease, biliary calculus, sleep apnea, asthma, GERD, and osteoarthritis. Adjusted hazard ratios were calculated for each BMI category relative to normal weight, and the population-attributable fraction was analyzed for different obesity classifications.

Key Findings:

• The study population consisted of 62% women and 22% Black participants.

• Class I obesity was present in 21.2% of participants, Class II in 11.3%, and Class III in 9.8%.

• Obesity was linked to an increased risk of all studied health conditions, with stronger associations in higher obesity classes.

• Class III obesity showed the highest association with:

• Obstructive sleep apnea (HR: 10.94)

• Type 2 diabetes (HR: 7.74)

• Liver disease (HR: 6.72)

• Weaker associations were found for:

• Asthma (HR: 2.14)

• Osteoarthritis (HR: 2.06)

• Cardiovascular disease (HR: 1.96)

• The associations were consistent across sex and race.

• The proportion of cases attributed to obesity ranged from 14% for osteoarthritis to 51.5% for obstructive sleep apnea.

The findings highlight the significant impact of obesity, particularly severe obesity, on the risk of multiple health conditions. Higher obesity classes were strongly linked to an increased incidence of cardiovascular, metabolic, respiratory, and musculoskeletal disorders, with the strongest associations observed for obstructive sleep apnea, type 2 diabetes, and liver disease. The graded relationship across obesity classes emphasizes the need for targeted prevention and management strategies to mitigate obesity-related health risks.

"These results emphasize the importance of early intervention, lifestyle modifications, and clinical management to reduce the burden of obesity-related diseases and improve long-term health outcomes," the authors concluded.

Reference: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2400229