Intense interest surrounds the healthy obese description, which is defined as obesity in the absence of health risk factors. Obesity is defined as body mass index (BMI), a measurement obtained by dividing a person's weight by the square of the person's height, over 30 kg/m2, with the range 25-30 kg/m2 defined as overweight. Metabolically healthy obesity (hereafter abbreviated to MHO) is a medical condition characterized by obesity which does not associate with or produce concomitant medical problems. Through the use of the CPRD database the intention of this study is to study a group of obese patients who are otherwise fit and healthy and follow them up in the community to understand various long term results. This will also be examined after different interventions such as weight loss surgery when compared to those who have not had weight loss surgery but have other medical illnesses related to their obesity such as diabetes or heart disease. The aim of this study is to identify factors that help justify the risk of surgery in the healthy obese when compared to the obese patients with other illnesses already present. The advantage of using CPRD over other databases is that this will evaluate the surgical results compared with the unhealthy obese in the community leading to a greater understanding of characteristics and circumstances to determine if operative risk is justifiable in the healthy obese when compared to the already available literature for unhealthy obese.
In 2014 62% of adults in England were classified as overweight (a body mass index of >25) or obese, compared to 53% 20 years earlier. Our aim is to investigate the impact of management of metabolically healthy obese patients on the NHS compared to non-Healthy Obese. To investigate through retrospective descriptive statistics, the sustainability of being without comorbidities while being morbidly obese through community follow up. This has not been studied before through CPRD and a novel mean of research for benefit of health impact on various demographic and regional distribution of the obesity population. Obesity surgery has been proven beneficial for the metabolically troubled obese, however it has not been proven that this also benefits the healthy obese and hence this will be very beneficial and cost analytical for the impact both of the NHS and worldwide. Read codes for all diagnoses of obesity as well as Medcodes for BMI (Body Mass Index) and comorbidities. Metabolic comorbidities will be determined in primary and secondary databases and, in parallel, relate through HES (length of stay, readmission, in-hospital morbidity and mortality) with CPRD (number of GP consultations, re-referral, resolution of comorbidities). We aim to determine the effect of obesity surgery on this cohort in term of medical outcomes and survival this is as well as resolution of comorbidities and this will be utilised in multilevel and cox regression modelling to determine the effect on survival. This will be in addition to a simple descriptive analysis for the longevity of 'un-healthiness' and survival with and without exposure to obesity surgery. Our study population criteria are - patients over the age of 18 - that have a diagnosis of obesity at any time since initial registration and - (BMI) of or greater than 30. - Patients who are metabolically healthy (ie NO comorbidity)
We would be looking for primary outcomes of mortality and secondary outcomes of coronary heart disease, stroke, cerebrovascular accident, obstructive sleep apnea, hyperlipidemia as well as depression etc on long term follow up of this cohort.
Paul Ziprin - Chief Investigator - Imperial College London
Osama Moussa - Corresponding Applicant - Imperial College London
Dalton Coker - Collaborator - Imperial College London
Paul Aylin - Collaborator - Imperial College London
Sanjay Purkayastha - Collaborator - Imperial College London
HES Admitted Patient Care;HES Outpatient;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation