Estimating the association and timing of occurrence between obesity and related comorbidity outcomes in a real-world setting: A cohort study in the United States.

To understand the prevalence, incidence and sequence of obesity-related comorbidities (ORCs) among people with obesity compared with those with a normal body mass index (BMI). People with obesity (BMI ≥30 kg/m²) and normal BMI (BMI 18.5 to <25 kg/m²) were matched 1:1 using a large United States claims-linked electronic health record database. The index date was the date of the first qualifying BMI. Prevalence was assessed at baseline (12 months pre-index date); incidence and sequence of new ORCs were assessed during follow-up. Each cohort included 57 978 people. At least 1 ORC was present at baseline in 61.1% and 49.6% of the obesity and normal BMI cohorts, respectively. During follow-up (median 61 months) event rates per 1000 person-years of new ORCs were higher in the obesity cohort than the normal BMI cohort (572 vs. 378, respectively). In both cohorts, musculoskeletal pain was the most frequent new ORC, followed by dyslipidemia and hypertension. Median times to the first, second and third new ORC were shorter in the obesity cohort compared with the normal BMI cohort by 0.67, 0.81 and 0.66 years, respectively. People with obesity had a higher prevalence and incidence, and accelerated onset of ORCs compared with those with normal BMI.