Severe obesity linked to rising burden of cardiometabolic and kidney disease, study finds
A major new study has revealed that the severity of obesity is closely tied to an escalating burden of cardiometabolic and renal disease across the United States. Researchers at the Pennington Biomedical Research Center report that higher levels of obesity are associated with significantly greater odds of developing conditions such as diabetes, hypertension, hyperlipidaemia, kidney disease, myocardial infarction, stroke and coronary artery disease.
The findings, published in the journal Obesity, draw on a cross-sectional analysis of data from the US Behavioral Risk Factor Surveillance System survey. The dataset included information from more than five million adults collected between 2011 and 2023. Researchers calculated the likelihood of receiving diagnoses for a range of metabolic and cardiovascular conditions across four classes of obesity: Class I (body mass index, or BMI, of 30.0 to 34.9), Class II (35.0 to 39.9), Class III (40.0 to 49.9) and Class IV (50.0 or above).
Across all conditions studied, a higher BMI was linked to increased odds of disease. Individuals in Class IV obesity showed particularly elevated likelihoods of diabetes, hypertension and kidney disease, according to the analysis.
“The data show an increased likelihood of a wide array of common metabolic diseases that rises with obesity severity. A clear, gradual increase in disease risk is associated with higher BMI, starting as early as Class I obesity,” said Dr Florina Corpodean, a Postdoctoral Research Fellow at Pennington Biomedical’s Metamor Institute and one of eight contributors to the study. “Our work points to an urgent need for early intervention for people in all classes of obesity if we are to reduce the occurrence of these metabolic diseases.”
Dr Corpodean presented the findings at ObesityWeek 2025 in Atlanta, the annual meeting for obesity and metabolic health researchers.
Senior author Dr Vance Albaugh, Assistant Professor at Pennington Biomedical, said the study’s strength lies in its examination of numerous cardiometabolic conditions within a single, nationally representative population. “While individual associations between obesity and disease have long been suggested, most studies lump all cases together and rarely distinguish beyond a BMI of more than 40. This approach misses the unique risks faced by those with more severe obesity,” he said. “Adults with a BMI of 50 or higher face dramatically raised odds of disease, underlining the need for greater clinical and research focus on treatment for this group.”
Pennington Biomedical’s Executive Director, Dr John Kirwan, said the findings highlight the pace at which health risks rise alongside obesity severity. “What is striking is how dramatically the risk of cardiometabolic and renal diseases escalates with each increment in obesity,” he said. “It is a clear, stepwise progression. Our team at Pennington Biomedical and the Metamor Institute is bringing essential attention to individuals in higher BMI categories who have been overlooked in clinical research. Understanding these distinctions is vital for developing more targeted and personalised treatment and prevention strategies.”