Obesity in adults with epilepsy

Sixty-eight percent of the US adult population is overweight, and 35% is obese. The rate of obesity in patients with epilepsy is unknown. Its determination was the goal of the present study. Weight and height were measured, and body mass index (BMI) was calculated in all newly evaluated patients with epilepsy at a single epilepsy center between 2003 and 2009. Five hundred fifty-four patients aged ≥ 16-87 years were included (62.7% were women, 12.6% with primary generalized epilepsy, and 86.4% with localization-related epilepsy). Three hundred six (55.2%) patients were overweight or obese (BMI > 25 kg/m2) (95% confidence interval [CI]: 51.1%-59.3%), 173 (31.2%) were obese (BMI > 30 kg/m2) (95% CI: 27.5%-35.2%), and 24 (4.3%) were morbidly obese (BMI > 40 kg/m2). Overweight/obesity combined was more common in men (65.4% [95% CI: 58.8%-71.5%]) than in women (49% women [95% CI: 43.3%-54.3%]) (p ≤ 0.001). The rate of overweight/obesity combined trended to be greater in blacks (67.9%) than in whites (51.9%). Obesity alone was more common in blacks (46.4%) than in whites (29.4%), with too few Hispanics and Asians to allow a comparison. Overweight/obesity and obesity rates were higher in patients with refractory than nonrefractory epilepsy (60.4% vs. 49.2% overweight, 36.9% vs.24.6% obesity). Obesity was more common in patients treated with polytherapy than those treated with monotherapy (37.7% vs. 25%). There were no associations between obesity and other disease characteristics such as epilepsy type, duration, or etiology. Obesity is common in patients with epilepsy, similar to the general population.