Obesity in the U.S.: Temporal Shifts and Emerging Gastrointestinal and Hepatologic Consequences

Abstract

Introduction

Obesity is a chronic complex disease that can be defined as excessive fat deposits which impairs health. It is noted by measuring weight and height to ensure calculation of the BMI. Although BMI has been utilized in with management or predicting good health, studies have shown that it is not an accurate predictor of health status in African Americans.

Obesity is an important driver in a lot of gastrointestinal pathology which can influence the prevalence and the severity of several GI conditions. This study highlights the trend of obesity by region and in African Americans from 2011- 2023 in correlation the clinical impact on GI disorders.

Methods

Data was obtained from NHANES. The obesity analysis was then contextualized with peer reviewed literature to further portray the impacts of obesity on GI disorders such as GERD, MAFLD, and colorectal cancer.

Results

Our study found that obesity has a high prevalence in the South and Midwest areas with females having slightly higher median values of obesity 40.4% vs. 29.5% compared to men. From about 2018 onward, females consistently show a slightly higher obesity rate than males. Results showed no significant difference in between males (M = 30.63, SD = 4.00) and females (M = 30.84, SD = 4.92), t (1336.05) = -0.90, p = .37, 95% CI [-0.69, 0.25]. This gap widens around 2020–2021 and then stabilizes. This change takes into consideration the biological, behavioral and sociocultural factors.

Together with showing the regions affected, non-Hispanic black individuals generally have the highest rates of obesity with Hawaiian/Pacific Islanders recording also an elevated rate of obesity in the region. Non-Hispanic blacks in the South have been found to have higher prevalence of obesity. This is attributed to systemic issues such as structural inequalities, limited access to healthcare, cultural dietary contribution, and lower educational attainment.

Discussion

Obesity has a lot of clinical implications, It is associated with GERD and Barrett’s esophagus especially in younger adults that are African Americans. Obesity increases the risk of MAFLD with a growing indication for liver transplant across the country. However, there is lesser indication for liver transplant in AA (HR 0.56, 95% CI 0.50-0.62). Obesity is an independent factor that increases the risk of pancreatitis and colorectal neoplasia in the African American population.

Conclusions

With the ongoing rise of obesity prevalence, it is important to redefine GI screening, management, and prevention strategies. Such strategies will include weight reduction interventions such as pharmacologic, dietary counseling that should be incorporated into workflow of physicians. Providers particularly those serving the high-risk minority populations like the African Americans must adopt these practices in order to improve their patient outcome.