Rising Rates of Severe Obesity in Adults Younger Than 50 Correspond to Rise in Hospitalizations for Non-malignant Gastrointestinal Disease

• Published in: Digestive diseases and sciences Vol. 68; no. 2; pp. 554 - 563
• Main Authors: Patel, Arsheya, Krishna, Somashekar G., Patel, Kishan, Gray, Darrell M., Mumtaz, Khalid, Stanich, Peter P., Hinton, Alice, Hussan, Hisham
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2023; Springer; Springer Nature B.V
• Subjects: Acute Disease; Adult; Adults; Biochemistry; Colorectal Neoplasms - epidemiology; Comparative analysis; Disease prevention; Diverticulitis; Gastroenterology; Gastrointestinal diseases; Hepatology; Hospitalization; Humans; Incidence; Liver; Liver diseases; Medicine; Medicine & Public Health; Middle Aged; Nutrition Surveys; Obesity; Obesity - epidemiology; Obesity, Morbid; Oncology; Original Article; Pancreatitis; Statistics; Surveys; Transplant Surgery; Trends; Young Adult; Young adults; Obesity; Young; Colorectal; Trends; Gastrointestinal; Outcomes
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-022-07589-3

Background Colorectal cancer incidence is rising in adults < 50 years old, possibly due to obesity. Non-malignant colorectal conditions are understudied in this population. We hypothesize that developing severe obesity in young adulthood also corresponds with increased hospitalization rates for non-malignant colorectal conditions. Methods We examined annual percent change (APC) in the prevalence of obesity in adults < 50 using the 2009–2014 National Health and Nutrition Examination Survey. Using the 2010–2014 Nationwide Readmission Database, we then compared yearly hospitalization trends for various gastrointestinal conditions and their outcomes in adults < 50 with severe obesity vs. no obesity. Results The prevalence of obesity increased in adults < 50 years in 2009–2014. This increase was most pronounced for severe obesity (APC of + 12.8%). The rate of patients with severe obesity < 50 who were admitted for gastrointestinal diseases has increased by 7.76% per year in 2010–2014 ( p  < 0.001). This increase was > 10% per year for colorectal conditions such Clostridium difficile infections (APC + 17.3%, p  = 0.002), inflammatory bowel disease (APC + 13.1%, p  = 0.001), and diverticulitis (APC + 12.7%, p  = 0.002). The hospitalization rate for chronic liver diseases and acute pancreatitis also increased by 12.2% and 10.0% per year, respectively ( p  < 0.01). In contrast, young adults without obesity had lower hospitalization rate for most gastrointestinal diseases. Furthermore, adults with no obesity had lower mortality rates for appendicitis, diverticulitis, pancreatitis and chronic liver diseases than adults with severe obesity. Conclusion Our data suggest that increased adiposity in young adults is associated with more hospitalization and worse outcomes for infectious/inflammatory gastrointestinal conditions. Future prevention strategies are warranted to ameliorate these trends.