Obesity Independently Associated With Higher Rates of Tinnitus in US Adults, Large Population Study Suggests

Key Takeaways: 

• Adults living with obesity were significantly more likely to report tinnitus than those without obesity, even after accounting for demographic, behavioural and psychological factors.
  
• Around one in five adults with obesity reported tinnitus, compared with approximately one in seven adults without obesity.
  
• The findings highlight metabolic health and body weight as potentially relevant, modifiable factors in the broader management of tinnitus.
  
  
  

A growing public health question

Obesity appears to be independently associated with a higher prevalence of tinnitus, according to a large, nationally representative study of adults in the United States published online on 2 November in Cureus. 

The research was led by Ashir Ahtsham of Lahore General Hospital in Pakistan and examined whether obesity contributes to tinnitus prevalence beyond the influence of age, sex, mental health and other known risk factors. The analysis drew on data from the National Health and Nutrition Examination Survey (NHANES), a long-running survey designed to reflect the health of the US population.

Tinnitus, commonly described as ringing, buzzing or other sounds perceived in the absence of an external auditory stimulus, affects a substantial proportion of adults worldwide. While its causes are multifactorial and not fully understood, increasing attention has been given to the role of systemic and metabolic health in its development and persistence.

How the study was conducted

The researchers performed a cross-sectional analysis using de-identified data from the NHANES 2015–2016 and 2017–2018 survey cycles. These two cycles were combined in line with established analytic guidance to improve statistical power.

After excluding individuals under the age of 20 and those with missing data on body mass index or tinnitus, the final analytic sample included 5,452 adults aged 20 years and older. Obesity was defined using standard criteria, with a body mass index of 30 kg/m² or higher.

Tinnitus was assessed through self-report. Participants were classified as having tinnitus if they reported experiencing ringing, buzzing or other noises in their ears lasting five minutes or more in the absence of an external sound.

To isolate the association between obesity and tinnitus, the researchers adjusted their analyses for a range of potential confounders, including age, sex, race and ethnicity, smoking status, sleep duration and symptoms of depression, assessed using the Patient Health Questionnaire-9. Hearing loss data were not included, as this would have substantially reduced the available sample across both survey cycles. Readers interested in the detailed methodology can refer directly to the journal article.

Tinnitus was common, particularly among people with obesity

Across the full sample, 863 participants reported tinnitus, corresponding to a weighted prevalence of 17.2 percent. Tinnitus was more frequently reported by older adults, men and individuals living with obesity or depression.

Notably, the prevalence of tinnitus differed markedly by obesity status. Around 20.3 percent of adults with obesity reported tinnitus, compared with 15.0 percent of adults without obesity. This difference remained statistically significant at the population level.

Age was also a strong factor. Tinnitus prevalence increased steadily with age, rising from just over 10 percent in adults aged 20–39 years to nearly one quarter of those aged 60 years and older. Differences were also observed across racial and ethnic groups, with non-Hispanic White adults reporting the highest prevalence.

Obesity remained a significant predictor after adjustment

In unadjusted analyses, obesity was associated with a 44 percent higher likelihood of reporting tinnitus. Importantly, this association persisted even after accounting for demographic characteristics, lifestyle factors and depression.

After full adjustment, adults living with obesity still had approximately 41 percent higher odds of reporting tinnitus than adults without obesity. The strength and consistency of this association suggest that obesity may contribute to tinnitus prevalence independently, rather than simply reflecting shared risk factors such as age or mental health.

As the authors note, “These findings underscore the potential role of body weight and metabolic health in the development or progression of tinnitus.” They add that, “The substantial burden of obesity in recent years and its association with tinnitus highlight the importance of considering modifiable metabolic risk factors as part of comprehensive tinnitus management.”

Why might obesity and tinnitus be linked?

Although the study was not designed to explore biological mechanisms directly, the authors outline several plausible pathways supported by existing research.

Obesity is characterised by chronic low-grade inflammation, metabolic dysregulation and vascular dysfunction. These processes may impair microcirculation within the cochlea and disrupt normal auditory signalling. Excess adipose tissue is also known to produce pro-inflammatory cytokines, which may contribute to oxidative stress and neural inflammation affecting auditory pathways.

In addition, obesity is frequently associated with metabolic syndrome, insulin resistance and sleep disorders, all of which have been independently linked to tinnitus severity and distress. Together, these factors may help explain why people living with obesity experience tinnitus more frequently, even in the absence of measured hearing loss.

Strengths and limitations

A key strength of this study is its use of a large, nationally representative dataset with appropriate weighting to reflect the US population. The analysis also accounted for a wide range of demographic, behavioural and psychological variables.

However, the authors emphasise that the cross-sectional design means causality cannot be inferred. Tinnitus was self-reported, which may introduce recall or reporting bias. Important factors such as occupational noise exposure, medication use and audiometric hearing thresholds were not included, and these may partially mediate the observed association.

For readers seeking detailed statistical outputs or subgroup analyses, the original journal article provides comprehensive tables and supplementary information.

Implications for clinical practice and future research

The findings suggest that obesity is independently associated with tinnitus among US adults, reinforcing the view that tinnitus should be considered within a broader framework of systemic and metabolic health.

While weight reduction cannot currently be recommended as a specific treatment for tinnitus, the results support the inclusion of metabolic risk assessment as part of holistic tinnitus care. Further longitudinal studies, particularly those incorporating objective hearing measures, are needed to clarify causal pathways and to determine whether improvements in metabolic health could reduce tinnitus risk or severity.

As the burden of both obesity and tinnitus continues to rise globally, understanding how these conditions intersect may help inform more comprehensive and person-centred approaches to prevention and management.