- New research has found that those who are socially isolated, lonely, and obese face a higher risk of death.
- The study included data from more than 300,000 participants.
- Those who wrote the study, as well as other experts, are hopeful that research like this will lead to both clinical studies and the development of better interventions for those facing these barriers.
Dr. Lu Qi (MD, PhD), a professor in Tulane’s School of Public Health and Tropical Medicine who was also an author of the article, says that while he and his team were not surprised by the findings.
“The findings are not surprising, because there are prior studies including ours [that] have linked social isolation and loneliness with various diseases which increase the risk of premature death,” Qi said. “The cohort UK Biobank we used in this study is open to international investigators, collaborations between investigators with diverse expertise is helpful to study complex diseases such as obesity.”
The article was published in JAMA Network Open and included 398,972 participants.
Degrees of social isolation and loneliness were identified via self-reported questionnaires. This data, which Qi—director of Tulane’s Obesity Research Center—characterizes as “well collected information”, was initially gathered between 2006 and 2010. Follow up continued until 2021.
The researchers looked at data collected by the UK Biobank project, that those with obesity who also had low levels of social isolation and loneliness saw a 36% decrease in all-cause mortality when compared to those with all three risk factors.
The average age of participants was 55 with the median follow up spanning just over 12 years.
The team also found that people without obesity also had a 9% drop in mortality risk if they had lower levels of social isolation.
Qi and his team also characterized participants according to a number of factors including their level of physical activity; whether they had a history of depression, anxiety, or eating disorders; whether they had reported hypertension or high cholesterol, and whether they had diabetes.
Using a relative importance analysis, the researchers found that social isolation was a bigger risk factor for people with obesity than alcohol, physical activity and healthy diet. It was also identified as a higher all-cause mortality risk than loneliness, depression, and anxiety.
The authors suggest that “social isolation and loneliness control” is one way these findings can be brought into practice. Qi says that he’d like to see clinical trials “to test the effects of improving isolation and loneliness on health.”
Dr. Katherine Kidwell (PhD), an assistant professor in the department of psychology at Syracuse University, said the findings are valuable. She says this connection between physical and mental health is particularly important given that weight is not a protected class under US federal law.
“When you’re pairing loneliness and people who have another risk factor like obesity, it’s understandable that the rates would increase. I think, in our society, obesity is one of the last few things that people can be ostracized for, unfortunately, and it should not happen,” Kidwell said.
Kidwell says that it’s important, when we’re considering this type of information, to understand that obesity is just part of a larger picture. She said that it’s important to think deeply about the connection between physical and mental health rather than just zeroing in on obesity and associated risk factors like hypertension and diabetes.
“Obesity is a risk factor for mortality because it comes along with all these other health comorbidities that can place people at risk… [but] somebody could be at a higher weight status and then lab values come back, and it’s all completely healthy. So I think it’s just an indicator that there might be an overall health status that is placing somebody more at risk.”
The researchers hope to continue their work with a more diverse group of individuals. In this study, the relative lack of diversity in participants is also a potential issue in applying the findings to other populations. More than 91% of the study participants identified as white, while just over 7% were either Asian or multiracial.
Kidwell said there are ways in which this data can further support practical work in the community for people of all ages.
“I think it would be an intervention that is motivating adolescents, youth, and adults as well, to get engaged in an activity and in their community. To feel like they’re a part of something, to feel like they’re a part of a community,” Kidwell said.
She also points to initiatives like the National Institutes of Health’s All of Us Study as an American example of where an increased effort is being paid to identify this historical lack of representation.