{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:58:56Z","timestamp":1780635536101,"version":"3.54.1"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Recent estimates of chronic conditions (CCs) among adults with obesity are lacking. This study analysed state\u2010representative data to assess the prevalence of CCs that co\u2010occur with obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      We used 2021\u20132022 Behavioural Risk Factor Surveillance System data to assess the age\u2010standardised prevalence of nine CCs among adults with obesity (body mass index \u226530\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) based on self\u2010reported weight and height. We examined prevalence overall and by key sociodemographic factors, obesity class, and states and territories, using\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests for subgroup comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The most prevalent CCs with obesity were hypertension (42.2%), high cholesterol (37.4%), arthritis (30.2%), and depression (26.4%), followed by diabetes (16.7%), asthma (13.4%), heart disease\/stroke (9.2%), cancer (6.9%), and kidney disease (3.9%). Prevalence generally increased with age except for depression and asthma, which were lower among those 65 and older compared to those aged 18\u201344 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). There was an inverse relationship between CCs prevalence and household income. Significant differences were observed across sex, race\/ethnicity, education, employment status, healthcare access, and obesity class. Across states and territories, hypertension was the most prevalent CC, ranging from 31.8% in the Virgin Islands (VI) to 51.6% in Alabama, followed by high cholesterol (28.1% in VI to 44.9% in Guam). Other CCs also showed significant variation by state and territory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among US adults with obesity, the age\u2010standardised prevalence of CCs varies significantly across population subgroups and states. Awareness of these differences can help clinicians, public health officials, and decision\u2010makers address chronic disease prevention and obesity management for populations at higher risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70024","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T10:05:57Z","timestamp":1755684357000},"page":"6333-6340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["State\u2010level prevalence of chronic conditions co\u2010occurring with obesity among US adults"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9217-5398","authenticated-orcid":false,"given":"Lixia","family":"Zhao","sequence":"first","affiliation":[{"name":"Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyson B.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"US Public Health Service Commissioned Corps  Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Tong","sequence":"additional","affiliation":[{"name":"Division for Heart Disease and Stroke Prevention Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Onufrak","sequence":"additional","affiliation":[{"name":"Division of Diabetes Translation Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha L.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reena B.","family":"Oza\u2010Frank","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlen","family":"Stadnik","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brook","family":"Belay","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi M.","family":"Blanck","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Local Foods Research Center Appalachian Sustainable Agriculture Project  Asheville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP161365.GL"},{"issue":"360","key":"e_1_2_10_3_1","first-page":"1","article-title":"Prevalence of obesity and severe obesity among adults: United States, 2017\u20102018","author":"Hales CM","year":"2020","journal-title":"NCHS Data Brief"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2017.03.107"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc\/159281"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.00379.2020"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2013.11.006"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S275898"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.2"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(02)00849\u20105"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000973"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001184"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(25)00355\u20101"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1909301"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)01548\u20104"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2017.75"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2022.100568"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdi025"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0247307"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14897"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2020.106225"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19084726"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2018.04.180008"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7130a3"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6529a3"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232346"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd17.200130"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd21.240109"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd22.240539"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpae040"},{"key":"e_1_2_10_31_1","unstructured":"Center for Disease Control and Prevention.The Behavioral Risk Factor Surveillance System. May 17 2024. Accessed June 11 2024.https:\/\/www.cdc.gov\/brfss\/"},{"key":"e_1_2_10_32_1","unstructured":"Centers for Disease Control and Prevention.Adult BMI Categories. March 19 2024. Accessed August 15 2024.https:\/\/www.cdc.gov\/healthyweight\/assessing\/bmi\/adult_bmi\/index.html"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199001000-00010"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.124.24123"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0803715"},{"issue":"427","key":"e_1_2_10_36_1","first-page":"1","article-title":"Mortality in the United States, 2020","author":"Murphy SL","year":"2021","journal-title":"NCHS Data Brief"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2023.08.005"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2005.49"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.19897"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679\u2010017\u20100262\u2010y"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437739.71477.ee"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)01210\u20108"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2023.07.002"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494818761971"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107525\u201012\u201058"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14\u20102391"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.70024","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/full-xml\/10.1111\/dom.70024","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.70024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T06:24:09Z","timestamp":1771309449000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/10.1111\/dom.70024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":45,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/dom.70024"],"URL":"https:\/\/doi.org\/10.1111\/dom.70024","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.70024\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70024\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70024\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70024\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70024\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70024\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70024\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70024\/v1\/decision1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,20]]},"assertion":[{"value":"2025-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}