Houston Methodist Study Finds Sustained Weight Loss Lowers Risk of Chronic Rhinosinusitis

Sustained weight loss significantly reduces the risk, symptoms and treatment burden of chronic rhinosinusitis (CRS), according to a Houston Methodist-led study about the persistent inflammatory condition of the sinuses that affects millions of Americans.

The study, believed to be the first of its kind, found that significantly overweight patients who achieved and maintained a 5-point reduction in body mass index (BMI) over a two-year period experienced a 47% lower risk of developing chronic rhinosinusitis and required 46% fewer follow-up visits related to the condition compared to those patients who did not lose weight.

"This is the first longitudinal study to show that sustained weight loss can meaningfully decrease the incidence and severity of chronic sinus disease," said Dr. Mas Takashima, chair of Otolaryngology – Head and Neck Surgery at Houston Methodist and a co-primary investigator on the study. "It highlights the immunologic connection between adiposity and upper airway inflammation, and it points to weight loss as a potentially modifiable intervention for preventing CRS."

Dr. Zain Mehdi, a Houston Methodist resident and study author, presented data from the study at the Combined Otolaryngology Spring Meetings in May. The full study is expected to be published this summer.

To conduct the retrospective study, the research team used advanced data modeling and artificial intelligence to evaluate more than 3,500 obese patients in the NIH's "All of Us" national database.

The team focused on a 5-point BMI reduction — about 33 pounds for an average-height individual — as the benchmark for meaningful and safe weight loss. According to Dr. Takashima, extreme or rapid weight loss has been associated with pro-inflammatory states, so the researchers aimed for a "sweet spot" that would yield clinical benefits without triggering counterproductive immune responses.

The study utilized propensity score matching and predictive modeling to compare patients with sustained weight loss to matched "clones" in the database — individuals with similar demographics, health conditions and lifestyle factors who did not lose weight. This allowed the team to isolate the effect of weight loss on sinus health while controlling for comorbidities like obstructive sleep apnea, hypertension and diabetes.

"We verified through statistical analysis that the weight loss itself, not just the resolution of associated conditions, was responsible for the reduction in sinus symptoms and antibiotic use," Dr. Takashima explained.

Antibiotic usage was also significantly lower in the sustained weight loss group; the odds of needing antibiotics in this group was 57% lower. This indicates a protective association between sustained weight loss and antibiotic use. Dr. Takashima noted that this finding could have broader implications for public health by helping reduce antimicrobial resistance.

The link between obesity and inflammation is well established, but few studies have looked specifically at upper airway conditions like CRS.

Dr. Takashima believes the chronic low-grade inflammation driven by excess adipose tissue disrupts immune regulation in the nasal and sinus cavities, possibly through cytokines produced by T-helper 1 and T-helper 2, which are known to play roles in sinus disease.

The study did not track the specific method of weight loss, whether through GLP-1 agonists, surgery or less invasive lifestyle interventions, but future research could explore the effects of these individual strategies.

"This reinforces the need for a multidisciplinary approach to obesity management," explained Dr. Takashima. "Endocrinologists, internists, bariatric surgeons, dietitians and otolaryngologists all have a role to play. And we hope to see more studies investigating how GLP-1 medications might directly improve otolaryngologic outcomes like chronic sinusitis."

Dr. Omar Ahmed, a rhinology and skull base surgeon at Houston Methodist and the study's co-primary investigator, said he looks forward to further investigations into the potential mechanisms at work, the types of inflammation involved and exactly how weight loss decreases symptoms.

The study, conducted in partnership with Cedars-Sinai, the University of Houston and UT Health Houston, highlights the power of collaborative, data-driven research.

"Sifting through massive national health data to extract meaningful clinical insights required a team that included data engineers, AI specialists and statisticians," Dr. Takashima said. "It's a great example of how modern data science can help us improve patient outcomes in otolaryngology and beyond."