Body mass index trends over four years in persons with multiple sclerosis

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• Obesity's impact on multiple sclerosis (MS) disease course is not fully understood.
• Obesity is linked to a pro-inflammatory state and cardiovascular issues, potentially worsening MS.
• Understanding weight trends in people with MS (PwMS) is crucial for managing overweight and obese individuals.

Purpose of the Study:

• To analyze body mass index (BMI) trends in newly diagnosed PwMS.
• To identify characteristics linked to weight gain post-diagnosis.
• To assess how physical disability affects BMI changes in PwMS.

Main Methods:

• Two longitudinal retrospective cohort analyses were performed using the MS PATHS database.
• Multivariable regression models analyzed baseline BMI and annualized BMI changes (≥0.5 kg/m² or ≥2.0 kg/m²).
• Consolidated Patient Determined Disease Steps (PDDS) categories measured disability's impact on BMI changes.

Main Results:

• Over 70% of newly diagnosed PwMS were overweight or obese.
• Higher education correlated with lower baseline BMI and reduced odds of rapid weight gain (≥2.0 kg/m²/year).
• Female sex was associated with increased odds of rapid weight gain (≥0.5 and ≥2.0 kg/m²/year).
• Higher baseline BMI was linked to moderate and severe disability, but disability level did not significantly predict annualized BMI changes.

Conclusions:

• Overweight and obesity are prevalent at MS diagnosis.
• Women with MS are particularly prone to rapid weight gain throughout the disease.
• Higher education appears protective against rapid weight gain in newly diagnosed MS patients.
• While baseline disability is linked to higher BMI, its impact on BMI change varies, suggesting weight management is a key aspect of MS care.