Ryu S, et al. - In this retrospective cohort study, researchers assessed the link between BMI and endoscopic intestinal metaplasia (IM) development. Participants included 142,832 Korean adults free of endoscopic IM and atrophic gastritis (AG) who had upper endoscopy at baseline and subsequent visits and were followed for up to 5 years. They estimated the adjusted hazard ratio with 95% CI for incident IM by using a parametric proportional hazards model. The development of endoscopic IM was reported in 2,281 participants over 444,719.1 person-years of follow-up. They found that increased BMI categories were linked to increased risk of new-onset IM in a dose-response manner. Overall, they noted an independent association of obesity with increased incidence of endoscopic AG and IM in a large cohort of Korean men and women.