Body Mass Index Progression, Development of Complications and Healthcare Costs Over 8 Years in UK Individuals Living With Overweight/Obesity

Introduction: A detailed understanding of the risk factors for and impacts of body mass index (BMI) progression in people living with obesity is vitally needed. In this retrospective observational study, we examined the relationships between BMI progression, obesity-related complications (ORCs) and healthcare costs in individuals living with overweight or obesity in the UK. Methods: Data were from the Discover database of linked primary and secondary care records from 2.7 million individuals in North West London, UK. Included individuals were ≥ 18 years old, had a BMI of ≥ 25.0 kg/m2 at index (date of first eligible BMI measurement during the study period: 1 January 2007 to 31 December 2019) and had no evidence of intentional weight loss. We examined BMI progression (increase) of ≥ 5% and ≥ 10% over 8 years in demographic and ORC subgroups, and compared ORCs and costs between groups with and without BMI progression. Results: In total, 290,051 individuals were included, of whom 31.4% experienced BMI progression of ≥ 5% during follow-up, with most progression occurring from year 1 to year 3. Proportions of individuals with ≥ 5% BMI progression were highest in the following subgroups: 18-29 years (45.8%), 30-39 years (39.2%), polycystic ovary syndrome (41.4%), asthma (34.5%), depression (33.9%) and women (33.9%). Total annual healthcare costs per person per year were £1000 for those with no BMI progression, £1143 for those with 5 to < 10% progression and £1251 for those with ≥ 10% progression. Groups with progression were more likely to develop ≥ 3 ORCs than those without. Conclusion: Younger adults, women and people with specific ORCs were most likely to experience BMI progression, which was associated with increased health and economic burden. Targeting high-risk subgroups with interventions to prevent weight gain could limit the clinical and economic impacts of obesity.