BackgroundObesity is a growing public health problem worldwide. Over the past few decades, the prevalence of obesity has increased significantly in Saudi Arabia, putting population health at an increased risk of mortality and morbidity. Because of the wide variation in previous local estimates, this study used electronic records of a population-based sample to estimate the prevalence of obesity and its association with diabetes and hypertension.MethodsThis study used records from five hospitals in the National Guard Health Affairs, which provides medical service to about a million beneficiaries. We included individuals aged 17 years or older who visited any outpatient clinic in the past four years (2016-2019). Body mass index (BMI) was measured before the doctor’s encounter. Patients were classified as diabetic or hypertensive if they had any visit during the four years, where the primary diagnosis was one of those conditions or if the patient was taking medications. The associations between obesity (BMI>30) and diabetes and hypertension were evaluated using a multiple logistic regression model adjusting for age, gender, nationality, and region.ResultsA total of 616,092 individuals were included. Of them, 55.0% were females, and the majority were Saudi nationals (93.1%). Approximately 68% of the population were either obese (38.9%) or overweight (29.30%). Obesity was more prevalent among Saudi nationals (39.8% vs. 26.7%, p<0.01) and females (45.3% vs. 31. 2%, p<0.01). Compared to those younger than 26 years of age, those older than 65 years were over 27 times more likely to have diabetes (OR= 27.3, p<0.01). In addition, obesity was independently associated with diabetes mellitus (OR= 2.24, p<0.01) and hypertension (OR= 2.15, p<0.01).ConclusionsThe prevalence of obesity in the study population was high, and more pronounced among women. Our findings call for efforts to intensify preventive measures to reduce obesity and associated conditions. Using electronic records to examine the impact of interventions to reduce obesity and chronic conditions may help monitor and improve population health.