'Obesity Linked to Earlier Disease, Higher Comorbidity Risk'

 Compared with individuals with normal BMI, those with obesity have earlier onset and higher rates of related comorbidities, with musculoskeletal pain as the most common.

METHODOLOGY:

• Obesity is associated with more than 200 comorbidities, yet limited data exist on their timing and sequence of onset.
• Researchers conducted a retrospective cohort study using US electronic health record data to compare the prevalence, incidence, and sequence of obesity-related comorbidities in adults with obesity (BMI ≥ 30) vs those with normal BMI (18.5 to < 25) between January 2011 and December 2014.
• The prevalence of 19 obesity-related comorbidities, including musculoskeletal pain and cardiometabolic and endocrine disorders, was assessed at baseline; the incidence of new-onset cases was analyzed over a median follow-up of 5 years.

TAKEAWAY:

• Researchers included 57,978 adults each (mean age, 52 years; 64.7% women) in the cohorts with obesity and normal BMI.
• At baseline, 61.1% of individuals with obesity and 49.6% of those with normal BMI had at least one obesity-related comorbidity.
• Multimorbidity (at least three comorbidities) was nearly twice as prevalent in the obesity group vs the normal BMI group (31.2% vs 16.6%).
• Individuals with obesity had a significantly higher risk of developing a new obesity-related comorbidity (adjusted hazard ratio, 1.35; P < .0001).
• Musculoskeletal pain was the most prevalent comorbidity at baseline and the most frequent new comorbidity in both cohorts, with a higher incidence among those with obesity (244.6 vs 197.9 per 1000 person-years).
• Those with obesity developed their first comorbidity at a median of 0.67 years earlier than those with normal BMI (P < .0001), with similarly significant accelerations in the onset of second and third comorbidities.

IN PRACTICE:

“Early identification and effective interventions to manage obesity should be the focus for preventing [obesity-related comorbidities], with the overall goal of reducing the burden of disease and simplifying treatment approaches,” the study authors wrote.

SOURCE:

This study was led by Firas Dabbous, Evidera Inc., Wilmington, North Carolina, and published online in Clinical Obesity.

LIMITATIONS:

Most participants were White, women, and from the US Midwest, limiting generalizability. The 5-year follow-up may not capture potential comorbidities with longer latent periods, such as cancer. Inclusion of patients taking antiobesity medications may also complicate interpretation of the results.

DISCLOSURES:

This study received funding from Novo Nordisk Inc. Six authors are employees and shareholders of the funding agency, and one is a consultant. Three authors are employees of Evidera Inc., which received funding from Novo Nordisk Inc.

https://www.medscape.com/viewarticle/obesity-linked-earlier-disease-higher-comorbidity-risk-2025a1000fsx