A recent study found that obesity was linked to a higher risk for infection-related hospitalizations and death: “Adult obesity is a risk factor for infection-related hospitalisations [sic] and mortality across diverse pathogen types, populations, and baseline clinical profiles, with evidence suggesting that approximately one in ten infection-related deaths worldwide might be attributable to obesity.”
An analysis of ten widely studied infectious diseases, obesity showed the strongest association with skin and soft tissue infections and the weakest association with acute pharyngitis or tonsillitis. No associations were observed for HIV (which accounted for 8.8% of all persistent non-herpes viral infections or tuberculosis (which accounted for 71.5% of all mycobacterial infections)).
In 2023, 0.6 million infectious deaths were attributable to adult obesity, out of 5.4 million total infectious deaths. During the COVID-19 pandemic in 2021, there were 2.0 million obesity-attributable infectious deaths and 13.6 million total infectious deaths. Before 2018 (that is, prior to the COVID-19 pandemic), there were 0.4 million obesity-attributable infectious deaths and 4.9 million total infectious deaths.
The study reported “robust associations between adult obesity and an increased risk of severe infections across diverse pathogen types, populations, and baseline clinical profiles, independent of sociodemographic, behavioural, and clinical risk factors. Compared with individuals with healthy weight, the risk of any severe infection was 1·7-times higher for individuals with any obesity (BMI ≥30 kg/m2), 1·5-times higher for individuals with class I obesity, and 2·0-times higher for individuals with class II obesity. Class III obesity (BMI ≥40 kg/m2) was associated with nearly a 3-times higher risk of non-fatal and fatal infections, with consistent findings across all three adiposity measures: BMI, waist circumference, and waist-to-height ratio. In repeat-measure analyses, weight gain from healthy weight or overweight was associated with a modest increase in infection risk, whereas weight loss from obesity was linked to a modest reduction in risk. Elevated risks were observed for most infection types and selected infections (particularly viral, bacterial, and skin and soft tissue infections) and across subgroups, including individuals with and without diabetes or metabolic syndrome, supporting the robustness of our findings. When applied to GBD statistics, these findings suggest that approximately one in ten infection-related deaths worldwide might be attributable to adult obesity, highlighting its substantial contribution to the global communicable disease burden.”
“The finding that obesity is associated with a wide range of infections suggests that, in addition to pathogen-specific factors, broader biological mechanisms are likely to be involved. Obesity is characterised by immune dysregulation, chronic systemic inflammation, and metabolic disturbances, all of which can impair host defence against diverse pathogens. These mechanisms are particularly plausible given that our analyses focused on severe, hospital-treated infections, which reflect not only susceptibility to infection acquisition but also progression and prognosis once infection occurs.”
“[W]e estimated that 9% to 11% of infection-related deaths worldwide could potentially be prevented by eliminating obesity (rising to 15% during the COVID-19 pandemic).”
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