Work

Change in body mass index and disease burden among people with obesity and multiple long‐term conditions

Year: 2026

Type: article

Abstract: AIMS: Obesity is a risk factor for multiple long-term conditions (MLTCs/multimorbidity). However, the impact of weight loss in people with MLTCs is unclear. We investigated the association between body mass index (BMI) change and the development of obesity-related complications (ORCs), as well as clinical and economic outcomes in individuals with obesity and MLTCs. MATERIALS AND METHODS: and ≥2 ORCs. BMI was recorded during Years 1 and 4 of the baseline period. BMI change was categorised as increases or decreases of 3%-7%, 7%-15% and 15%-30%. Data were analysed using Cox regression (hazard ratios [HRs] for mental-health conditions, hospitalisation and mortality) and Ghosh-Lin models (risk of ≥1 new ORC and clinical consultations). RESULTS: A total of 618 426 individuals were included. The mean number of ORCs at index (Year 4) was 3.8 (standard deviation 1.5). HRs (95% confidence intervals) for incident ORCs were 0.96 (0.94-0.98), 0.98 (0.96-0.99) and 0.98 (0.97-0.99) for the highest to lowest BMI reductions, respectively; BMI increases were associated with HRs >1.00. Risk ratios for consultations were 0.99 (0.98-1.00), 0.99 (0.98-1.00) and 1.00 (0.99-1.00). BMI reductions were linked to lower polypharmacy rates. Both BMI decrease and increase were associated with higher HRs for mental-health conditions, hospitalisation and mortality versus stable BMI. CONCLUSIONS: Weight loss in individuals with obesity and MLTCs was linked to both favourable and adverse outcomes, highlighting the importance of personalised treatment approaches that consider outcomes beyond weight loss.

Source: Diabetes Obesity and Metabolism

DOI: 10.1111/dom.70446