Improvement of Social Isolation and Loneliness and Excess Mortality Risk in People with Obesity

Abstract

Importance: Individuals with obesity experience markedly higher levels of social isolation and loneliness than those without obesity, but little is known about whether improvement of social isolation or loneliness might attenuate obesity-related excess risk of mortality. Objective: To investigate whether improvement of social isolation or loneliness is associated with lower obesity-related excess risk of mortality. Design, Setting, and Participants: This cohort study included individuals without cancer or cardiovascular disease (CVD) at baseline from the UK Biobank with follow-up beginning in March 2006 and ending in November 2021. Main Outcomes and Measures: All-cause, cancer-related, and CVD-related mortality were estimated. Results: A total of 398972 participants were included in this study (mean [SD] age, 55.85 [8.08] years; 220469 [55.26%] women; 13734 [3.44%] Asian, 14179 [3.55%] multiracial, and 363685 [91.16%] White participants). Overall, 93357 (23.40%) had obesity, and 305615 (76.60%) did not. During a median (IQR) follow-up of 12.73 (12.01-13.43) years, a total of 22872 incident deaths were recorded. Compared with participants with obesity with an index of 2 or greater for social isolation, the multivariable adjusted hazard ratios (HRs) for all-cause mortality were 0.85 (95% CI, 0.79-0.91) and 0.74 (95% CI, 0.69-0.80) for participants with obesity and a social isolation index of 1 and 0, respectively (P for trend