Prevalence and severity of obesity-related comorbidities in Belgian general practice (PASOC-GP)

Overweight and obesity are common in Belgium and can lead to health problems such as high blood pressure, high cholesterol, type 2 diabetes, and sleep apnea. These issues increase the risk of cardiovascular diseases.

Although there are medical treatments to regulate weight and treat obesity complications, there are challenges in the care for people with overweight and obesity. Often, obesity and related health problems are not well investigated or recorded. Moreover, not all people with overweight and obesity have the same risk of complications. Therefore, it is important to better understand who would benefit from specialized obesity care.

The body-mass index (BMI) alone is not sufficient to determine who needs, for example, bariatric surgery or medications like Semaglutide. The Edmonton Obesity Staging System (EOSS) helps to categorize people based on the severity of their obesity-related health problems. This system can distinguish between people with and without an increased risk of mortality.

This study aims to provide insight into the problems of overweight and obesity in Belgium. Data from general practitioners will be used to look at the health problems in people with overweight and obesity. These people will also be categorized based on the EOSS and a new system that relies less on arbitrary cut-offs for cardiovascular risk factors.

Overweight and obesity affect about half of the Belgian population and increase the risk of conditions such as hypertension, dyslipidemia, type 2 diabetes, and sleep apnea, all of which pose a risk for cardiovascular diseases.

Although there are various medical options to regulate weight and treat obesity complications such as hypertension and dyslipidemia, there are several obstacles in the care for people living with overweight and obesity. The presence of obesity and related comorbidities often goes unexamined or unrecorded. Moreover, not all people living with overweight and obesity have the same risk of complications. Therefore, it is important to better understand the population for whom specialized obesity care would be truly beneficial.

In this context, the body-mass index (BMI) alone is insufficient as a criterion to prescribe, for example, bariatric surgery or medication like Semaglutide. The Edmonton Obesity Staging System (EOSS), which categorizes people based on the severity of obesity-related complications, has the added value of distinguishing between individuals with and without an increased mortality risk within populations with obesity.

This study aims to provide insight into the issues of overweight and obesity within the Belgian context. Data from a general practitioners' platform will be used to look at the prevalence of comorbidities in people living with overweight and/or obesity. Additionally, this population will be categorized based on the EOSS and a newly developed variant for obesity staging that relies less on arbitrary cut-offs for cardiovascular risk factors.

The primary objective of this study is to examine the prevalence of obesity-related comorbidities in general practice care.

The secondary objective of this study is to examine the severity of obesity-related comorbidities in general practice care.

The associated outcomes of the study are the prevalence of individual obesity-related comorbidities (such as hypertension, dyslipidemia, type 2 diabetes, prediabetes, and sleep apnea), the overlap of different comorbidities, and scores from obesity staging systems (Edmonton Staging System and a new variant of it).

New diagnoses in Intego are recorded with thesaurus codes, which are linked to the International Classification of Primary Care (ICPC-2) and the International Statistical Classification of Diseases and Related Health Problems (ICD-10). For these studies, the following ICPC/ICD-10 codes will be used for diagnosing comorbidities: hypertension (K86, K87), dyslipidemia (T93), prediabetes (R73.0), type 2 diabetes (E11), and sleep apnea (G47.3).

For diagnosing obesity comorbidities and determining scores for the obesity staging systems, data will be used from recorded diagnoses, lab results, and medication use for specific conditions. Detailed information about the criteria for the obesity staging systems is included in the appendices.