Reducing Social Isolation in Obesity Might Yield Longer Lives

A new study of social isolation in people living with obesity tells us that this might be among the most important complications of obesity. In fact, it points to the possibility that reducing isolation could yield longer lives for people living with obesity.

These results are nothing more than the observation of an association. But they are quite striking. The authors write:

“Social isolation was ranked higher than loneliness, depression, anxiety, and lifestyle-related risk factors including alcohol, physical activity, and healthy diet for estimating the risks of all-cause mortality, cancer-related mortality, and CVD-related mortality.

“Improvement of social isolation and loneliness attenuated obesity-related excess risk of all-cause mortality.”

Jian Zhou and colleagues published their study yesterday in JAMA Network Open.

The Big Question: How To?

This study raises more questions than it answers, which is actually quite a good thing – if smart people will dig into those questions.

Of course the biggest question is whether an intervention actually can reduce social isolation for people with obesity and by doing so, help people live better, longer lives. Answering that question requires the identification of interventions that will effectively reduce social isolation.

One possibility is that effective obesity treatments might yield reductions in isolation as a benefit that accompanies reductions in obesity. Certainly clinical trials tell us that weight-related quality of life improves with highly effective obesity treatment. Social isolation is an important aspect of the effects this disease has on a person’s quality of life. But the fact is that we do not have a rigorous study of the effects that obesity treatment specifically has upon social isolation.

Care That Aims to Reduce Social Isolation

Of course, another important question is whether it is possible to provide support and care that will reduce social isolation as a primary therapeutic endpoint. Again, the fact is that we have little data on this. In a systematic review, Ruimin Ma and colleagues tell us there are promising options for reducing social isolation. But, they explain, “The evidence is not yet strong enough to make specific recommendations for practice.”

We have a long way to go. By inadvertently promoting weight bias and stigma, it is possible that health providers and public health professionals have added to the social isolation that people experience with obesity.

The first step in solving a problem is to recognize it.

Click here for the study by Zhou et al and here for a systematic review and meta-analysis of social isolation, loneliness, and mortality.

Girl at a Window, painting by Walter Sickert / WikiArt

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January 23, 2024