Prevalence and Comorbidity Network Analysis of Obesity and Related Complications: A Real-World Study Based on 233,004 Individuals

Purpose: To determine the prevalence of overweight/obesity and their major complications, and to map comorbidity relationships by means of large-scale, real-world data. Patients and Methods: This cross-sectional study included individuals undergoing routine health examinations from January 2021 to April 2024. Clinical and demographic data were systematically collected. Obesity-related complications were diagnosed using standardized criteria. Descriptive statistics assessed prevalence; correlation and network analyses characterized comorbidity relationships. Results: A total of 233,004 participants (57.5% male; mean age 43.51 ± 13.28 years) were enrolled. Among these, 41.1% were overweight and 6.1% had obesity. The most prevalent complications were dyslipidemia (30.9%), fatty liver disease (26.4%), and hyperuricemia (20.0%). Over 60% of participants had at least one obesity-related comorbidity. Network analysis indicated a central disease cluster comprising overweight/obesity, fatty liver disease, hypertension, diabetes, and carotid plaque, with diabetes playing a key role linking metabolic abnormalities to cardiovascular risks. Conclusion: Overweight prevalence was high in this large-scale examined population and frequently coexisted with multiple metabolic and cardiovascular conditions. Network analysis highlighted diabetes as a central condition, supporting early targeted interventions for overweight individuals to reduce obesity-related chronic disease burden. Keywords: obesity, overweight, obesity-related complications, comorbidity network, epidemiology