Obesity and the risk of developing chronic diseases in middle-aged and older adults: Findings from an Australian longitudinal population survey, 2009-2017

PLoS One. 2021 Nov 16;16(11):e0260158. doi: 10.1371/journal.pone.0260158. eCollection 2021.


Background: Overweight and obesity impose a significant health burden in Australia, predominantly the middle-aged and older adults. Studies of the association between obesity and chronic diseases are primarily based on cross-sectional data, which is insufficient to deduce a temporal relationship. Using nationally representative panel data, this study aims to investigate whether obesity is a significant risk factor for type 2 diabetes, heart diseases, asthma, arthritis, and depression in Australian middle-aged and older adults.

Methods: Longitudinal data comprising three waves (waves 9, 13 and 17) of the Household, Income and Labour Dynamics in Australia (HILDA) survey were used in this study. This study fitted longitudinal random-effect logistic regression models to estimate the between-person differences in the association between obesity and chronic diseases.

Results: The findings indicated that obesity was associated with a higher prevalence of chronic diseases among Australian middle-aged and older adults. Obese adults (Body Mass Index [BMI] ≥ 30) were at 12.76, 2.05, 1.97, 2.25, and 1.96, times of higher risks of having type 2 diabetes (OR: 12.76, CI 95%: 8.88-18.36), heart disease (OR: 2.05, CI 95%: 1.54-2.74), asthma (OR: 1.97, CI 95%: 1.49-2.62), arthritis (OR: 2.25, 95% CI: 1.90-2.68) and depression (OR: 1.96, CI 95%: 1.56-2.48), respectively, compared with healthy weight counterparts. However, the study did not find any evidence of a statistically significant association between obesity and cancer. Besides, gender stratified regression results showed that obesity is associated with a higher likelihood of asthma (OR: 2.64, 95% CI: 1.84-3.80) among female adults, but not in the case of male adults.

Conclusion: Excessive weight is strongly associated with a higher incidence of chronic disease in Australian middle-aged and older adults. This finding has clear public health implications. Health promotion programs and strategies would be helpful to meet the challenge of excessive weight gain and thus contribute to the prevention of chronic diseases.

MeSH terms

  • Asthma / etiology
  • Australia / epidemiology
  • Body Mass Index
  • Chronic Disease / epidemiology*
  • Cross-Sectional Studies
  • Depression / etiology
  • Diabetes Mellitus, Type 2 / etiology
  • Female
  • Heart Diseases / etiology
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity / complications*
  • Overweight / complications
  • Surveys and Questionnaires
  • Weight Gain / physiology

Grants and funding

The authors received no specific funding for this work.