Yao Zhiqi, Tchang Beverly G, Chae Kacey, Albert Michael, Clark Jeanne M, Blaha Michael J
Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland, USA.
Division of Endocrinology, Department of Internal Medicine, Weill Cornell Medical College, New York, New York, USA.
J Intern Med. 2025 Jun;297(6):657-671. doi: 10.1111/joim.20083. Epub 2025 May 5.
Population-level adverse effects of obesity beyond commonly considered chronic conditions need to be characterized to understand its overall burden.
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.
Using data from the All of Us Research Program (the United States), we included participants with a body mass index (BMI) ≥18.5 kg/m 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.
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.
Obesity imposes a substantial burden on broad aspects of well-being in the US population.
肥胖对人群的不良影响，除了常见的慢性病之外，还需要进行特征描述，以了解其总体负担。
评估肥胖与自我报告的总体健康状况、生活质量、疼痛、疲劳、身体活动能力以及患慢性疼痛综合征、慢性疲劳综合征、纤维肌痛和失眠风险之间的横断面关联。
利用美国“我们所有人”研究计划的数据，纳入体重指数（BMI）≥18.5kg/m²且有可用的总体健康调查或电子健康记录的参与者。使用多变量逻辑回归和线性回归模型对自我报告变量进行横断面分析。采用Cox比例风险模型评估事件结局的风险。
在323640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%的人患有I、II和III级肥胖。较高的BMI类别与较差的健康指标相关，III级肥胖表现出最大的差异。在III级肥胖者中，9.6%（正常体重者为3.2%）报告总体健康状况不佳，28.3%（正常体重者为13.2%）报告有严重疼痛，11.8%（正常体重者为8.4%）患有失眠症。在高BMI类别中观察到分级关联，III级肥胖的影响最强。与正常体重相比，在III级肥胖中，总体健康状况为一般/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），身体活动严重受限的比值比为3.13（2.98-3.29）；纤维肌痛的风险比（95%CI）为2.83（2.36-3.40），失眠的风险比为1.53（1.41-1.65）。
肥胖给美国人群的广泛幸福方面带来了沉重负担。
