A comprehensive descriptive assessment of obesity related chronic morbidity and estimated annual cost burden from a population-based electronic health record database

Reges, Orna; Leibowitz, Morton; Hirsch, Avital; Dicker, Dror; Finer, Nick; Haase, Christiane L; Satylganova, Altynai; Leventer‐Roberts, Maya; Feldman, Becca

doi:10.1186/s13584-020-00378-1

Cited by 6 publications

(10 citation statements)

References 18 publications

(25 reference statements)

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“…39 Overall, these results demonstrate the challenges of discerning the large and comprehensive data source that has been used in previous observational studies [40][41][42] showing that approximately 27% of members have obesity. 11 This is similar to reported obesity rates of approximately 23% across Europe 43 ; therefore, this study population was broadly representative of Western obesity rates. Another strength of this analysis was the length of the study period.…”

Section: Discussionsupporting

confidence: 84%

“…Whereas previous studies have been conducted in relatively small cohorts based on general populations, this study included over 350,000 adults with obesity. The Clalit Health Services database is a large and comprehensive data source that has been used in previous observational studies 40–42 showing that approximately 27% of members have obesity 11 . This is similar to reported obesity rates of approximately 23% across Europe 43 ; therefore, this study population was broadly representative of Western obesity rates.…”

Section: Discussionsupporting

confidence: 67%

“…8 Obesity-related complications are also linked to increased mortality, 9 and high direct and indirect healthcare costs. 10,11 According to international guidelines, BMI level and the presence of comorbidities are key criteria in treatment decisions for the management of obesity. 12 However, much of the available evidence on obesityrelated complications is based on BMI measurements calculated at one time point, whereas the relationship between weight change over time and obesity-related complications is less well characterized.…”

Section: Introductionmentioning

confidence: 99%

“…Obesity‐related complications are also linked to increased mortality, 9 and high direct and indirect healthcare costs 10,11 . According to international guidelines, BMI level and the presence of comorbidities are key criteria in treatment decisions for the management of obesity 12 .…”

Section: Introductionmentioning

confidence: 99%

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Body mass index trajectories among people with obesity and association with mortality: Evidence from a large Israeli database

Reges

Dicker

Haase

et al. 2020

Obesity Science & Practice

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Objective: Previous studies using longitudinal weight data to characterize obesity are based on populations of limited size and mostly include individuals of all body mass index (BMI) levels, without focusing on weight changes among people with obesity. This study aimed to identify BMI trajectories over 5 years in a large population with obesity, and to determine the trajectories' association with mortality. Methods: For inclusion, individuals aged 30-74 years at index date (1 January 2013) with continuous membership in Clalit Health Services from 2008 to 2012were required to have ≥1 BMI measurement per year in ≥3 calendar years during this period, of which at least one was ≥30 kg/m 2 . Latent class analysis was used to generate BMI trajectories over 5 years (2008)(2009)(2010)(2011)(2012). Cox proportional hazards models were used to assess the association between BMI trajectories and all-cause mortality during follow-up (2013-2017).Results: In total, 367,141 individuals met all inclusion criteria. Mean age was 57.2 years; 41% were men. The optimal model was a quadratic model with four classes of BMI clusters. Most individuals (90.0%) had stable high BMI over time. Individuals in this cluster had significantly lower mortality than individuals in the other trajectory clusters (p < 0.01), including clusters of people with dynamic weight trajectories. Conclusions:The results of the current study show that people with stable high weight had the lowest mortality of all four BMI trajectories identified. These findings help to expand the scientific understanding of the impact that weight trajectories have on health outcomes, while demonstrating the challenges of discerning the cumulative effects of obesity and weight change, and suggest that dynamic historical measures of BMI should be considered when assessing patients' future risk of obesity-related morbidity and mortality, and when choosing a treatment strategy. K E Y W O R D Sbody mass index, databases, mortality, obesity, population studies, weight changeThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body mass index trajectories among people with obesity and association with mortality: Evidence from a large Israeli database

Reges

Dicker

Haase

et al. 2020

Obesity Science & Practice

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“…With class II/III obesity increasing in the US paediatric population, there is surprisingly little documentation of the quantitative association of these comorbidities across obesity classes, especially for children who are seen for routine care in large US‐based paediatric healthcare systems. A study using electronic health record (EHR) data from a large population‐based sample in Israel found significant associations between BMI groups and number of existing comorbidities 20 . However, this study only focused on older ages in a Middle Eastern population.…”

Section: Introductionmentioning

confidence: 99%

Distribution of comorbidities as primary diagnoses by obesity class among patients in a large US paediatric healthcare system

et al. 2021

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Summary There is little documentation of the distribution of specific health conditions across obesity classes (I, II, III), especially for paediatric populations who are seen for routine care in large United States US healthcare systems. The aim of this study was to assess the odds of presenting ≥2 obesity‐related comorbidities as well as assess the overall distribution of these co‐morbidities in children by class I/II/III obesity status controlling for key sociodemographic characteristics. This retrospective (2015–2019) electronic health record review analysed 49 276 patients from the Children's Health System of Texas diagnosed with obesity‐related health conditions by obesity status (no obesity, class I, II, III). Crude and adjusted logistic regression models examined the association between obesity class and the likelihood of ≥2 comorbidities as primary diagnoses. Patients with class I obesity were 22% more likely (OR 1.22, 95% CI, 1.16, 1.27), patients with class II obesity were almost 50% more likely (OR 1.44, 95% CI, 1.35, 1.53) and those with class III obesity twice as likely (OR 2.04, 95% CI 1.91, 2.18) to be diagnosed with ≥2 comorbidities as primary diagnoses, compared with patients classified with no obesity. Children with obesity, particularly severe obesity, should be monitored closely by paediatricians for possible diagnoses of risk factors that could lead to adult chronic disease.

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Time-restricted feeding promotes muscle function through purine cycle and AMPK signaling in Drosophila obesity models

et al. 2023

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Obesity caused by genetic and environmental factors can lead to compromised skeletal muscle function. Time-restricted feeding (TRF) has been shown to prevent muscle function decline from obesogenic challenges; however, its mechanism remains unclear. Here we demonstrate that TRF upregulates genes involved in glycine production (Sardh and CG5955) and utilization (Gnmt), while Dgat2, involved in triglyceride synthesis is downregulated in Drosophila models of diet- and genetic-induced obesity. Muscle-specific knockdown of Gnmt, Sardh, and CG5955 lead to muscle dysfunction, ectopic lipid accumulation, and loss of TRF-mediated benefits, while knockdown of Dgat2 retains muscle function during aging and reduces ectopic lipid accumulation. Further analyses demonstrate that TRF upregulates the purine cycle in a diet-induced obesity model and AMPK signaling-associated pathways in a genetic-induced obesity model. Overall, our data suggest that TRF improves muscle function through modulations of common and distinct pathways under different obesogenic challenges and provides potential targets for obesity treatments.

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A comprehensive descriptive assessment of obesity related chronic morbidity and estimated annual cost burden from a population-based electronic health record database

Cited by 6 publications

References 18 publications

Body mass index trajectories among people with obesity and association with mortality: Evidence from a large Israeli database

Body mass index trajectories among people with obesity and association with mortality: Evidence from a large Israeli database

Distribution of comorbidities as primary diagnoses by obesity class among patients in a large US paediatric healthcare system

Time-restricted feeding promotes muscle function through purine cycle and AMPK signaling in Drosophila obesity models

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