Associations between Class I, II, or III Obesity and Health Outcomes
Authors' conclusion
Obesity, particularly severe obesity, was strongly associated with the incidence of 16 common health outcomes.
Study context
- Population
- All of Us research program participants with linked EHR and BMI ≥18.5; 62.0% women, 22.0% Black
- Participants
- 270,657 participants
- Exposure
- Class I, II and III obesity vs normal weight
- Outcome
- Prevalence and incidence of 16 a priori-identified outcomes (cardiovascular-kidney-metabolic syndrome and others)
Methodological detailselectronic health record-linked
- Electronic health record-linked
Main finding
As reported in the abstract
Incident outcomes, class III obesity vs normal weight
Each group vs normal weightEstimate (95% CI)
Class III obesity
aHR, obstructive sleep apnea 10.94(9.97–12.00)
Class III obesity
aHR, T2D 7.74(7.03–8.53)
Class III obesity
aHR, MASLD 6.72(6.01–7.50)
Class III obesity
aHR, asthma 2.14(1.95–2.35)
Class III obesity
aHR, osteoarthritis 2.06(1.94–2.19)
Class III obesity
aHR, atherosclerotic CVD 1.96(1.70–2.25)
Observational data: associations, not effects.
Further findings
| Outcome | Class I obesity | Class II obesity | Class III obesity |
|---|---|---|---|
| Prevalence of obesity classes | 21.2% | 11.3% | 9.8% |
Obesity-related population-attributable fraction
- Lowest: osteoarthritis
- 14.0%
- Highest: obstructive sleep apnea
- 51.5%
Subgroups by sex and race
- Associations consistent across sex and race
Original publication
Associations between Class I, II, or III Obesity and Health Outcomes. NEJM Evid. Published 25 March 2025. doi:10.
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