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TOPLINE:

Obesity-related conditions were prevalent among older adults regardless of obesity status, but some conditions, including congestive heart failure and diabetes, were highly attributable to obesity.

METHODOLOGY:

• Researchers conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey from 2017 to 2020 and from 2021 to 2023 to assess the burden of obesity-related conditions attributable to obesity in older adults.
• The analysis included a total of 4029 adults aged 65 years or older with a BMI of 18.5 or higher, representing 50,755,846 older adults (weighted mean age, 73 years; 55.3% women).
• Obesity-related conditions included congestive heart failure, diabetes, asthma, metabolic dysfunction-associated steatotic liver disease (MASLD), obesity-associated cancer, coronary artery disease, chronic kidney disease, hypertension, probable obstructive sleep apnea, dyslipidemia, and stroke. They were defined using self-reported data, laboratory tests, imaging, and vital signs.
• Relative risks for and prevalences of obesity-related conditions were compared between older adults with and without obesity, and population attributable fractions were calculated.

TAKEAWAY:

• The weighted prevalence of obesity, defined as a BMI ≥ 30, in the overall cohort was 40.2%. All obesity-related conditions were more prevalent in older adults with obesity than in those without it except stroke, coronary artery disease, and chronic kidney disease; hypertension was the most prevalent condition, seen in 74.5% of those with obesity and 59.7% of those without obesity.
• Population attributable fractions due to obesity were significant for congestive heart failure (33.3%; 95% CI, 24.7%-39.7%), diabetes (25.3%; 95% CI, 20.4%-29.5%), asthma (19.4%; 95% CI, 6.0%-29.0%), and MASLD (17.9%; 95% CI, 14.3%-21.2%).
• Statistically significant population attributable fractions were also noted for obesity-associated cancer (12.3%), urinary incontinence (10.6%), arthritis (10.9%), coronary artery disease (10.3%), chronic kidney disease (9.2%), hypertension (9.3%), probable obstructive sleep apnea (8.7%), and dyslipidemia (5.8%).
• The population attributable fraction for stroke was not significant.

IN PRACTICE:

“These results highlight that a substantial number, but not all, of the most common and burdensome chronic conditions in older adults are attributable to obesity, but ORCs [obesity-related conditions] are still common even without preexisting obesity in older adults,” the authors wrote. “These insights can facilitate the design of targeted population-level interventions to reduce the burden of ORCs and enhance overall health outcomes in older adults,” they added.

SOURCE:

The study was led by Alissa S. Chen, MD, MPH, MHS, of the Section of General Internal Medicine, in the Department of Internal Medicine at Yale School of Medicine in New Haven, Connecticut. It was published online on May 17, 2026, in the American Journal of Preventive Medicine.

LIMITATIONS:

The cross-sectional study design made it hard to determine if one factor causes another. There could be multiple reasons for the development of obesity-related conditions, such as obesity itself and other factors that lead to hypertension, which was not considered in this analysis. Some participants might have had an obesity-related condition before having obesity. Many conditions were reported by the participants themselves and may not reflect actual disease prevalence.

DISCLOSURES:

This study received support from the National Institutes of Health and the National Center for Advancing Translational Science. One author reported being a Pepper Scholar with support from the Claude D. Pepper Older Americans Independence Center at Yale School of Medicine. Some authors disclosed receiving financial support from various sources and having a consulting or advisory relationship for various companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.