Implications of a New Obesity Definition Among the All of Us Cohort
Authors' conclusion
In this cohort study, adoption of the new definition of obesity significantly increased obesity prevalence with major implications for clinical practice and public policy. The new framework effectively stratified individuals at high risk of organ dysfunction and long-term complications while introducing anthropometric-only obesity and preclinical obesity as distinct entities warranting further study.
Study context
- Population
- All of Us participants with complete anthropometric data, enrolled May 31, 2017–September 30, 2023; 61.0% female; median age 54 (IQR 38–65) years
- Participants
- 301,026 participants
- Exposure
- Obesity by new definition vs traditional BMI definition
- Clinical obesityn = 108,650
- Outcome
- Obesity prevalence by new vs traditional definition; clinical vs preclinical obesity
Main finding
As reported in the abstract
Obesity by new definition
206 361
68.6%
Obesity by traditional definition
128 992
42.9%
Clinical obesity by new definition
108 650
36.1%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Organ dysfunctionBMI-plus-anthropometric obesityvs No obesity | OR 3.31 (95% CI 3.24–3.37) | |
| Organ dysfunctionAnthropometric-only obesityvs No obesity | OR 1.76 (95% CI 1.73–1.80) | |
| Incident diabetes · median follow-up 4.0 (IQR 1.7-4.7) yearsClinical obesityvs No obesityReference: no obesity or organ dysfunction | aHR 6.11 (95% CI 5.67–6.60) | |
| Incident diabetes · median follow-up 4.0 (IQR 1.7-4.7) yearsPreclinical obesityvs No obesity | aHR 3.32 (95% CI 3.08–3.58) | |
| Cardiovascular events · median follow-up 4.0 (IQR 1.7-4.7) yearsClinical obesityvs No obesityReference: no obesity or organ dysfunction | aHR 5.88 (95% CI 5.38–6.43) | |
| Cardiovascular events · median follow-up 4.0 (IQR 1.7-4.7) yearsPreclinical obesityvs No obesity | aHR 1.40 (95% CI 1.27–1.55) | |
| All-cause mortality · median follow-up 4.0 (IQR 1.7-4.7) yearsClinical obesityvs No obesityReference: no obesity or organ dysfunction | aHR 2.71 (95% CI 2.41–3.05) | |
| 0.10.31310Ratio (log scale) |
Clinical obesity in individuals aged ≥70 years
- Clinical obesity, aged ≥70 years
- 24 498 of 45 018 (54.4%)
- Prevalence increased with age
Original publication
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