TOPLINE

Obesity contributes substantially to polypharmacy among older adults, accounting for about 1 in 7 cases when defined by BMI and about 1 in 4 cases when defined by waist circumference, according to a cross-sectional analysis of a US cohort.

METHODOLOGY

• Obesity contributes to chronic conditions — such as cardiovascular disease, diabetes, depression, and hypertension — that drive polypharmacy, but its contribution to medication burden in older adults has not been well quantified.
• Researchers conducted a cross-sectional analysis of National Health and Nutrition Examination Survey data (2021-2023) to estimate the proportion of polypharmacy attributable to obesity among older adults aged at least 65 years.
• Obesity was defined by BMI (≥ 30) or waist circumference (≥ 102 cm in men and ≥ 88 cm in women), with BMI-defined obesity categorized as class 1 (30 to < 35) or class 2-4 (BMI ≥ 35).
• Polypharmacy was defined as self-reported use of five or more prescription medications.
• Researchers calculated the population attributable fraction of polypharmacy due to obesity using adjusted relative risk estimates and obesity prevalence among older adults with polypharmacy.

TAKEAWAY

• The analysis included 1944 adults (weighted mean age, 72.7 years; 55% female), representing an estimated 53.2 million older US adults.
• Polypharmacy affected 41.8% of older adults, representing approximately 22 million people, and was significantly more common among those with BMI-defined obesity than among those without (51.1% vs 35.9%; P < .001).
• BMI-defined obesity accounted for an estimated 14.8% of polypharmacy cases, representing approximately 3.3 million older adults.
• The population attributable fraction of polypharmacy was 4.9% for class 1 obesity and 9.7% for class 2-4 obesity and 24.8% for waist circumference-defined obesity.

IN PRACTICE

“Obesity medications, which provide significant weight loss, can improve many obesity-related complications (eg, diabetes, sleep apnea) and may potentially reduce obesity-related polypharmacy,” the authors of the study wrote.

SOURCE

The study was led by Alissa S. Chen, MD, MPH, MHS, Yale School of Medicine, New Haven, Connecticut. It was published online in the Journal of General Internal Medicine.

LIMITATIONS

The study relied on self-reported medication use. Older adults living in long-term care settings were not included, limiting generalizability. Unmeasured confounding factors may have affected the observed association between obesity and polypharmacy.

DISCLOSURES

One author reported receiving funding from the Claude D. Pepper Older Americans Independence Center at Yale School of Medicine, a Yale Physician Scientist Development Award, and a grant from the National Center for Advancing Translational Sciences. Three additional authors reported receiving funding or support, consulting fees, or personal fees from various organizations.

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