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Int. J. Environ. Res. Public Health 2017, 14(2), 183;

Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis

First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
Samuel Curtis Johnson Graduate School of Management, Cornell University, Ithaca, NY 14853, USA
Department of Health Policy and Management, University of Georgia, Athens, GA 30609, USA
Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA
Author to whom correspondence should be addressed.
Academic Editor: Paul A. Scuffham
Received: 7 November 2016 / Revised: 3 January 2017 / Accepted: 19 January 2017 / Published: 13 February 2017
(This article belongs to the Section Health Services and Health Economics Research)
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Background: The link between body weight status and spinal diseases has been suggested by a number of cross-sectional and cohort studies with a limited range of patient populations. No population-representative samples have been used to examine the link between obesity and spinal diseases. The present study is based on a nationally representative sample drawn from the Medical Expenditure Panel Survey. Methods: Using the cross-sectional sample of the 2014 Medical Expenditure Panel Study, we built four weighted logistic regression analyses of the associations between body weight status and the following four spinal diseases: low back pain, spondylosis, other cervical disorders and intervertebral disc disorder (IDD). Each respondent’s body weight status was used as the key independent variable with three categories: normal/underweight, overweight, and obese. We controlled for marital status, gender, age, smoking status, household income, health insurance coverage, educational attainment and the use of health services for other major categories of diseases. Results: A total sample of 23,048 respondents was used in our analysis. Overweight and obese respondents, as compared to normal/underweight respondents, were more likely to develop lower back problems (Overweight: logged odds = 0.218, p < 0.01; Obese: logged odds = 0.395, p < 0.001) and IDD (Overweight: logged odds = 0.441, p < 0.05; Obese: logged odds = 0.528, p < 0.001). The associations between bodyweight status and spondylitis were statistically insignificant (Overweight: logged odds = 0.281, p = 0.442; Obese: logged odds = 0.680, p = 0.104). The associations between body weight status and other cervical disorders (Overweight: logged odds = −0.116, p = 0.304; Obese: logged odds = −0.160, p = 0.865) were statistically insignificant. Conclusions: As the first study using a national sample to study bodyweight and spinal diseases, our paper supports the hypothesis that obesity adds to the burden of low back pain and IDD. Longitudinal and interventional studies are needed to understand the specific mechanisms behind these positive associations. View Full-Text
Keywords: obesity; low back pain; disc degeneration; spondylosis; cervical diseases; spinal disease obesity; low back pain; disc degeneration; spondylosis; cervical diseases; spinal disease
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Sheng, B.; Feng, C.; Zhang, D.; Spitler, H.; Shi, L. Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis. Int. J. Environ. Res. Public Health 2017, 14, 183.

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