Association of Body Mass Index with Chronic Conditions and Procedures in General Medicine Clinics at an Academic Health Center

Objectives: Determine the prevalence of obesity in an adult patient population at an academic health center, and determine the association between body mass index (BMI) with type 2 diabetes, hypertension, coronary stent placement, joint replacement, and spinal fusion procedures stratified by age and sex. Methods: Patient age, sex, BMI, and disease conditions/procedures for 51,435 adult patients seen since 2015 at either the family medicine clinic or general internal medicine clinic were obtained from the electronic health record using ICD-10 codes. A logistic regression analysis was performed with and without adjusting for the impact of age and sex. Odds ratios were calculated using both the adjusted and unadjusted models. Results: The percentage of patients with a BMI in the healthy weight range, overweight range, and obesity categories was 28.5%, 31.3%, and 40.2%, respectively. The percent of adult patients with obesity steadily increased with age and peaked in the 49-54 age group at 49.5% for women and 46.9% for men, and then decreased with age. The odds ratios (both adjusted and unadjusted) indicated that individuals with greater BMI measurements are at significantly greater risk of type 2 diabetes (odds ratio 1.096), hypertension (odds ratio 1.097), coronary stent (odds ratio 1.051), and joint replacement (odds ratio 1.051), while no statistically significant relationship between spinal fusion and BMI was identified (odds ratio 1.014). Conclusions: Our findings support the increasingly high prevalence of obesity in American society, the significant associations of obesity with chronic conditions and surgical/medical procedures, and the need for effective prevention and treatment interventions.