Adverse effects of obesity on overall health, quality of life, and related physical health metrics: A cross-sectional and longitudinal study from the All of Us Research Program

IF 9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of Internal Medicine Pub Date : 2025-05-05 DOI:10.1111/joim.20083

Zhiqi Yao, Beverly G. Tchang, Kacey Chae, Michael Albert, Jeanne M. Clark, Michael J. Blaha

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引用次数: 0

Abstract

Background

Population-level adverse effects of obesity beyond commonly considered chronic conditions need to be characterized to understand its overall burden.

Objective

To assess the cross-sectional associations between obesity and self-reported status of overall health, quality of life, pain, fatigue, ability of physical activity, and the risks of developing chronic pain syndrome, chronic fatigue syndrome, fibromyalgia, and insomnia.

Methods

Using data from the All of Us Research Program (the United States), we included participants with a body mass index (BMI) ≥18.5 kg/m² and available Overall Health Survey or electronic health records. Cross-sectional analyses of self-reported variables were conducted using multivariable logistic and linear regression models. Cox proportional-hazard models were used to assess risks for incident outcomes.

Results

Among 323,640 participants (60.3% were female, mean age: 51.3 years), 20.7%, 11.0%, and 9.5% were with Classes I, II, and III obesity, respectively. Higher BMI categories were correlated with worse health metrics, with Class III obesity exhibiting the greatest disparities. Among those with Class III obesity, 9.6% (vs. 3.2% for normal weight) reported poor overall health, 28.3% (vs. 13.2%) reported severe pain, and 11.8% (vs. 8.4%) had prevalent insomnia. Graded associations were observed across high BMI categories, with Class III obesity showing the strongest effects. Compared with normal weight, in Class III obesity, the odds ratio (95% CI) was 3.82 (3.69–3.96) for fair/poor overall health, 3.93 (3.71–4.17) for severe pain, and 3.13 (2.98–3.29) for severely limited physical activity; the hazard ratio (95% CI) was 2.83 (2.36–3.40) for fibromyalgia and 1.53 (1.41–1.65) for insomnia.

Conclusion

Obesity imposes a substantial burden on broad aspects of well-being in the US population.

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肥胖对整体健康、生活质量和相关身体健康指标的不利影响：来自我们所有人研究项目的横断面和纵向研究。

背景：肥胖在人群水平上的不良影响超出了通常认为的慢性疾病，需要对其进行表征，以了解其总体负担。目的：评估肥胖与自我报告的整体健康状况、生活质量、疼痛、疲劳、体力活动能力以及发生慢性疼痛综合征、慢性疲劳综合征、纤维肌痛和失眠的风险之间的横断面关联。方法：使用来自美国“我们所有人研究计划”的数据，我们纳入了身体质量指数(BMI)≥18.5 kg/m2和现有整体健康调查或电子健康记录的参与者。采用多变量logistic和线性回归模型对自述变量进行横断面分析。Cox比例风险模型用于评估事件结果的风险。结果：在323,640名参与者中（60.3%为女性，平均年龄：51.3岁），分别有20.7%、11.0%和9.5%为I类、II类和III类肥胖。较高的BMI类别与较差的健康指标相关，其中III类肥胖表现出最大的差异。在III级肥胖患者中，9.6%（正常体重组3.2%）报告整体健康状况不佳，28.3%（正常体重组13.2%）报告严重疼痛，11.8%（正常体重组8.4%）报告普遍失眠。在高BMI类别中观察到分级关联，其中III级肥胖表现出最强的影响。与正常体重相比，III类肥胖患者总体健康状况一般/较差的比值比（95% CI）为3.82(3.69-3.96)，严重疼痛的比值比为3.93(3.71-4.17)，严重体力活动受限的比值比为3.13 (2.98-3.29)；纤维肌痛的风险比（95% CI）为2.83(2.36-3.40)，失眠症的风险比为1.53（1.41-1.65）。结论：肥胖给美国人的健康带来了巨大的负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Internal Medicine 医学-医学：内科

CiteScore

22.00

自引率

0.90%

发文量

176

审稿时长

4-8 weeks

期刊介绍： JIM – The Journal of Internal Medicine, in continuous publication since 1863, is an international, peer-reviewed scientific journal. It publishes original work in clinical science, spanning from bench to bedside, encompassing a wide range of internal medicine and its subspecialties. JIM showcases original articles, reviews, brief reports, and research letters in the field of internal medicine.