title: Obesity and symptom burden in family medicine patients.
abstract: BACKGROUND
  Medical visits are initiated by patients in search of symptom relief. The extent to which obesity independently increases the risk of common symptoms is unknown.
  
  
  OBJECTIVE
  To assess how obesity affects symptom burden among family medicine patients, after adjustment for severity of illness, via retrospective analysis of electronic medical records pertaining to 1738 adult family medicine patients treated in a large family medicine department in Rochester, Minnesota, USA.
  
  
  METHODS
  A symptom index was used to measure symptom burden. Body mass index (BMI; kg/m) was measured during clinic visits. Multiple logistic regression analysis was used to test for an independent relationship between BMI category and the presence of three or more common symptoms.
  
  
  RESULTS
  Adjusting for co-morbidity and other confounders using multiple logistic regression analysis revealed that having a BMI ≥35 kg/m was independently related to symptom burden (adjusted odds ratio [OR] = 1.80; 95% CI 1.24, 2.63). Patients with low and moderate co-morbidities (as measured by the Charlson Co-morbidity Index) also had higher odds of reporting more symptoms (OR = 1.60; 95% CI 1.17, 2.17 and OR = 1.87; 95% CI 1.36, 2.56, respectively). Symptom burden increased with age. Odds of having three or more symptoms were lower for married patients (OR 0.63; 95% CI 0.47, 0.83).
  
  
  CONCLUSIONS
  In our sample of family medicine patients, increased symptom burden may be associated with a BMI ≥35 kg/m. Lower levels of obesity do not appear to be related to symptom burden.
authors.affiliation: 1 Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA 2 Departments of Psychiatry, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Rohrer
authors.forename: Norman H
authors.initials: NH
authors.lastname: Rasmussen
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Houston
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Angstman