Abstract
Background: The prevalence of obesity is high in individuals with spinal cord injury (SCI) due to the alterations in body composition that occur as a direct result of injury. Body mass index (BMI) is used to classify body habitus. In 2009, an adjusted BMI classification, with lower thresholds for obesity, was recommended for individuals with SCI. Objective: Determine obesity prevalence before and after SCI to examine the trajectory of obesity development. Furthermore, we discuss the challenges of applying a modified BMI classification system in this population. Methods: We conducted a retrospective medical record review. Adults with traumatic SCI were selected. Height and body weight measurements were used to calculate BMI two years before injury through two years after injury. Results: Obesity prevalence is high in SCI participants. However, we report no significant difference in BMI between motor complete and incomplete injuries, or between tetraplegic or paraplegic injuries. We report a decrease in BMI from one year before injury to one- and two-years after injury for all groups. With moderate obesity before injury, the transition to a new BMI classification system creates a challenge in reducing obesity prevalence. Conclusion: Obesity prevalence encompassed nearly all participants by the second year following SCI. The adjusted BMI classification system dictates the high obesity prevalence in this population and is best used as a screening tool to track the risk of developing obesity. Exceptions should be considered when using the SCI-adjusted BMI classification system, and tissue composition analysis is preferred.
Keywords
Spinal cord injury, Obesity, Body mass index