The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health 9:88

Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, BC, Canada.
BMC Public Health (Impact Factor: 2.26). 04/2009; 9(1):88. DOI: 10.1186/1471-2458-9-88
Source: PubMed


Overweight and obese persons are at risk of a number of medical conditions which can lead to further morbidity and mortality. The primary objective of this study is to provide an estimate of the incidence of each co-morbidity related to obesity and overweight using a meta-analysis.
A literature search for the twenty co-morbidities identified in a preliminary search was conducted in Medline and Embase (Jan 2007). Studies meeting the inclusion criteria (prospective cohort studies of sufficient size reporting risk estimate based on the incidence of disease) were extracted. Study-specific unadjusted relative risks (RRs) on the log scale comparing overweight with normal and obese with normal were weighted by the inverse of their corresponding variances to obtain a pooled RR with 95% confidence intervals (CI).
A total of 89 relevant studies were identified. The review found evidence for 18 co-morbidities which met the inclusion criteria. The meta-analysis determined statistically significant associations for overweight with the incidence of type II diabetes, all cancers except esophageal (female), pancreatic and prostate cancer, all cardiovascular diseases (except congestive heart failure), asthma, gallbladder disease, osteoarthritis and chronic back pain. We noted the strongest association between overweight defined by body mass index (BMI) and the incidence of type II diabetes in females (RR = 3.92 (95% CI: 3.10-4.97)). Statistically significant associations with obesity were found with the incidence of type II diabetes, all cancers except esophageal and prostate cancer, all cardiovascular diseases, asthma, gallbladder disease, osteoarthritis and chronic back pain. Obesity defined by BMI was also most strongly associated with the incidence of type II diabetes in females (12.41 (9.03-17.06)).
Both overweight and obesity are associated with the incidence of multiple co-morbidities including type II diabetes, cancer and cardiovascular diseases. Maintenance of a healthy weight could be important in the prevention of the large disease burden in the future. Further studies are needed to explore the biological mechanisms that link overweight and obesity with these co-morbidities.

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    • "Many of the reported studies are limited to unadjusted/poorly adjusted associations or fail to account for underlying chronic diseases345 9]. Controlling for underlying physical health may be important as common chronic conditions such as arthritis and cardio-metabolic conditions are associated with both obesity [17, 18] and mental health192021. Moreover, many existing studies rely on BMI (measured or self-report) and most of them are limited in their assessment of alternative measures of adiposity [3,8910 15]. "
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    • "An increasing number of people are facing the burden of obesity, which is defined as an excess amount of body fat and it is determined by a Body Mass Index (BMI) of ≥ 30 kg/m2 (Haslam & James, 2005). Obesity is an important risk factor for other morbidities, such as type II diabetes, hypertension, coronary artery disease, and reduces life expectancy (see for a review: Guh et al., 2009). The causes of obesity are as varied as the people it affects. "
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