In a recent study published in JAMA network open, Researchers are investigating the association between social isolation and loneliness and mortality risk in obese and normal-weight individuals.
study: Improving social isolation, loneliness, and excess mortality risk among obese people. Image credit: KieferPix / Shutterstock.com
The relationship between obesity, social isolation, and loneliness
Obesity causes a variety of metabolic disorders, from type 2 diabetes (T2D) and chronic inflammation to cardiovascular disease (CVD) and cancer. The prevalence of obesity is increasing, with approximately 30% of the population in high-income countries (HICs) thought to be obese.
Similarly, loneliness is becoming a global public health crisis. Along with social isolation, loneliness is an important social determinant of health. However, these two factors have different correlations with mortality.
Social isolation generally reflects a lack of contact with others, and loneliness describes feelings of isolation that are potentially associated with emotional states such as depression. Therefore, even if you live with others, you may feel lonely.
Without support, these two factors can lead to poorer health behaviors in obese individuals. For example, obese people often experience greater levels of social isolation and loneliness than non-obese people.
About research
In this study, researchers screened the UK Biobank to identify obese and non-obese people based on body mass index (BMI). BMI values above 30 and below 30 reflect obese and non-obese individuals, respectively. The study cohort consisted of an equal number of obese and nonobese subjects randomly matched based on age, sex, and assessment center.
The primary outcomes were all-cause mortality and cancer and CVD mortality according to International Statistical Classification of Diseases and Related Health Problems (ICD) codes C00-C97 and I00-I99. The study end date was the date of death or November 27, 2021, whichever was earlier.
Social isolation and loneliness were defined based on the UK Biobank self-report questionnaire. The researchers also investigated whether improving social isolation and loneliness indices could eliminate or attenuate the excess mortality risk associated with obesity.
Data on several variables were collected from the UK Biobank, including age, gender, race/ethnicity, education, smoking status, alcohol intake, and glycated hemoglobin (HbA1c) levels. Study participants were then categorized based on whether their weekly physical activity level was less than or greater than 150 minutes.
Each participant’s metformin and glucocorticoid use and self-reported history of depression, anxiety, eating disorders, hypertension, high cholesterol, and diabetes were also recorded.
Fisher’s exact test or Wilcoxon rank sum test was used to examine participant characteristics based on obesity status. Additionally, Cox regression models revealed an association between social isolation and loneliness and all-cause, cancer, and CVD-related mortality among obese people.
Another statistical model was developed by researchers to determine the contribution of social isolation and loneliness to obese people’s relative risk for lifestyle-related mortality risk factors such as depression, anxiety, and the Townsend Deprivation Index. It was helpful. Two sensitivity analyzes were also performed to ensure the stability of the results.
research result
The study included 398,972 participants, of whom 55.3% were female and the mean age was 55.9 years. Of the study cohort, 93,357 (23.4%) were obese, while 305,615 (76.6%) were non-obese.
Among obese participants, 48.9%, 40.6%, and 10.5% had social isolation indices of zero, 1, and 2 or higher, reflecting no social isolation, mild, and moderate to severe social isolation, respectively. . Loneliness indices of 0, 1, and 2 were also applicable to 63.6%, 28.5%, and 7.9% of obese participants, respectively.
Compared to controls, obese people had a significantly higher prevalence of social isolation and loneliness. Furthermore, over a median follow-up of 12.7 years, there were 22,872 incident deaths, including 11,442 cancer deaths, 4372 CVD-related deaths, and 7058 other deaths.
Of all mortality risk factors, social isolation was ranked 4th in terms of intensity, and loneliness was ranked 14th.
conclusion
The current UK Biobank cohort study found that social isolation was more strongly associated with mortality than loneliness. Therefore, preventing social isolation and reducing its effects may be more beneficial in reducing the risk of all-cause and CVD-related mortality than loneliness, lifestyle factors, depression, and anxiety in obese patients. There is sex.
Importantly, more intensive interventions are needed to improve social isolation in people with obesity than in people without obesity to reduce mortality risk.
Reference magazines:
- Zhou, J., Tang, R., Wang, X. other. (2024). Improving social isolation, loneliness, and excess mortality risk in obese people. JAMA network open. doi:10.1001/jamanetworkopen.2023.52824