Obesity is common but often underdiagnosed in Swedish healthcare and is associated with a high cardiovascular burden and a markedly increased risk of future cardiovascular disease and premature death. This is shown in a new study by researchers from Karolinska Institutet published in the journal Diabetes, Obesity and Metabolism. The findings point to a need for improved detection and treatment.
In a large registry-based observational study, researchers analysed data from approximately 40 percent of the population between 2013 and 2023. and identified more than 320,000 adults in Sweden with obesity. The results were compared with a matched control group from the general population.
Obesity often underdiagnosed
About 14 percent of individuals had obesity based on height and weight, but the condition was seldom documented in medical records, only 29 percent had received a formal diagnosis and after five years, this proportion had increased to 48 percent.
Importantly, a majority of the participants also had other recorded health problems. Nearly 68 percent had at least one cardiometabolic disease, and 44 percent had two or more, such as hypertension, dyslipidemia, or type 2 diabetes.
Researchers also found that individuals with obesity had an increased risk of future cardiovascular events and mortality compared with the population. The risk of hospitalisation due to heart failure was more than doubled.
- We see that many patients with obesity do not receive a diagnosis despite having contact with healthcare. This may affect their ability to receive appropriate treatment, says Viveca Ritsinger , researcher at the Department of Medicine, Solna , Karolinska Institutet.
Few receive medical treatment for obesity
Despite the increased disease risk, medical treatment for obesity was limited. Five years after the first BMI registration, 7.8 percent had received medication and 4.2 percent had undergone bariatric surgery.
- Today there are evidence that novel weight reductive medications can prevent cardiovascular complications. Our study demonstrates that more patients could benefit from earlier identification and treatment, says Anna Norhammar , professor at the same department.
The researchers highlight that the results are based on medical record data, why some diagnoses may be underestimated. Furthermore, lifestyle interventions and behavior treatment were not analysed in the study. However, the study still confirms the importance of obesity as a cardiovascular risk factor and the challenges with neglecting this.
