OBJECTIVE: To examine the clinical characteristics and influencing factors among epilepsy patients with varying Body Mass Index (BMI), and to propose new approaches for the prevention and treatment of epilepsy. METHODS: A total of 250 adult patients, newly diagnosed with epilepsy and not yet treated with antiepileptic drugs at the First Affiliated Hospital of Dali University between January 2017 and December 2022, were randomly selected as the experimental group. Additionally, 250 healthy individuals from the same period served as the control group to investigate the relationship between BMI and epilepsy. Univariate analysis and ordered multiple logistic regression were used to further identify factors influencing BMI in patients with epilepsy. RESULTS: A significant difference in BMI was found between adults newly diagnosed with epilepsy who had not yet used antiepileptic drugs, and healthy individuals (P = 0.001). The obesity rate was higher in epilepsy patients (20.4 %) compared to healthy adults (9.6 %).The ordered multiple logistic regression analysis revealed that gender(P = 0.003), age(P = 0.029), nation(P = 0.008), occupation(P <
0.001), etiology(P = 0.001), NLR(P = 0.022), and SIRI(P = 0.008) were all significant factors influencing BMI in epilepsy patients. CONCLUSION: People with epilepsy are more likely to also be obese and is associated with factors such as gender, age, nation, occupation, etiology, and inflammatory markers. In clinical practice, it is essential to monitor and manage BMI in epilepsy patients, identify preventable risk factors, and ultimately enhance treatment outcomes and quality of life.