Young Adults at Greatest Risk of Becoming Overweight, Developing Obesity

Harry Hemingway, MBBS

With the obesity epidemic projected to grow moving forward, new research from a team of investigators from institutions in Europe is sounding the alarm on the risk of becoming overweight or developing obesity among different age groups over the next decade.

An analysis of electronic health record (EHR) data from more than 2 million individuals from 400 primary care practices in England from 1998-2016, results indicate the greatest risks for becoming overweight or developing obesity were seen among patients aged 18-24 years and investigators purport these findings should serve as a call for immediate policy changes to address the growing burden of obesity on society.

“Our results show clearly that age is the most important sociodemographic factor for BMI change. Young people aged 18 to 24 have the highest risk of BMI gain, compared to older people. We also found that among individuals with obesity, those aged between 35 and 54 had the highest risk of not losing weight compared to other adults,” said Michail Katsoulis, MSc, a senior research fellow at the University College London (UCL) Institute of Health Informatics, in a statement.

With obesity placing an increasing burden on health systems and society as a whole, the current study was conducted with the aim of identifying patient groups at an elevated risk of weight and BMI change through analysis of data from EHRs. To do so, investigators designed their study as a longitudinal, population-based cohort study of patients aged 18-74 years, with BMI and weight measurements recorded from January 1, 1998, and June 30, 2016, and with at least 1 year of follow-up identified from the CALIBER program. A collaborative data-sharing platform, use of the CALIBER program allowed access to EHR data related to 2,092,260 individuals from 400 primary care practices in England meeting eligibility criteria.

With more than 9 million BMI measurements from this patient cohort. Investigators planned to assess longitudinal changes in BMI over 1, 5, and 10 years and calculate absolute risk and odds ratio for transition between BMI groups, which were defined using WHO criteria. Associations with demographics factors were assessed using logistic regression, adjusted for baseline BMI, family history of cardiovascular disease, use of diuretics, and comorbidities.

Results of the investigators' analysis suggested young age adult age was the strongest risk factor for weight gain at 1, 5, and 10 years of follow-up. Specifically, results suggested adults aged 18-24 years had the highest odds (OR, 4.22; 95% 3.86-4.62) and greatest absolute risk (37% vs 24% of transitioning from normal weight to overweight or obesity at 10 years when compared to those aged 65-74 years.

Similarly, adults in the youngest age group with overweight or obesity at baseline were at the greatest risk of transition to a higher BMI category. Specific results highlighted by investigators included the increased OR (4.60; 95% CI, 4.06-5.22) and absolute risk (42% vs 18%) of transition from overweight to class 1 and 2 obesity and increased OR (5.87; 95% CI, 5.23-6.50) and absolute risk (22% vs 5%) of transition from class 1 and 2 obesity to class 3 obesity.

Investigators also noted associations with transitions were consistently, but less strongly observed for other demographics factors. Specifically, increased ORs were observed for transition from normal weight o overweight or obesity at 10 years for men compared to women (OR, 1.12; 95% CI, 1.08-1.16), Black individuals compared to White individuals (OR, 1.13; 95% CI, 1.04-1.24), and those livings in the most socially deprived areas compared to the least deprived areas (OR, 1.23; 95% CI, 1.18-1.27).

“Health systems, like the NHS, need to identify new ways to prevent obesity and its consequences. This study demonstrates that NHS data collected over time in primary care holds an important key to unlocking new insights for public health action,” said Harry Hemingway, MBBS, professor of Clinical Epidemiology at the UCL Institute of Health Informatics, in a statement.

This study, “Identifying adults at high-risk for change in weight and BMI in England: a longitudinal, large-scale, population-based cohort study using electronic health records,” was published in The Lancet Diabetes & Endocrinology.