Obesity-associated morbidity

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Obesity has a number of medical complications which negatively impact peoples' quality of life and are costly to treat.
Gynecomastia as seen in an obese male.

Whether or not obesity should be considered a disease on its own, it is also an important risk factor for many chronic physical and mental illnesses.[1] The generally accepted view is that being overweight causes similar health problems to obesity, but to a lesser degree.

Cardiological[edit]

Ischemic heart disease[edit]

Obesity is associated with cardiovascular diseases including angina and myocardial infarction.[2][3] A 2002 report concluded that 21% of ischemic heart disease is due to obesity[1] while a 2008 European consensus puts the number at 35%.[4]

Congestive heart failure[edit]

Having a BMI greater than 30 doubles one's risk of congestive heart failure.[5][6]

High blood pressure[edit]

More than 85% of those with hypertension have a BMI greater than 25.[6] The risk of hypertension is 5 times higher in the obese as compared to those of normal weight. A definitive link between obesity and hypertension has been found using animal and clinical studies, which have suggested that there are multiple potential mechanisms for obesity-induced hypertension. These mechanisms include the activation of the sympathetic nervous system as well as the activation of the renin–angiotensin-aldosterone system.[7] The association between hypertension and obesity has been also well described in children.[8]

Abnormal cholesterol levels[edit]

Obesity is associated with increased LDL cholesterol (bad cholesterol) and lowered HDL cholesterol (good cholesterol).[6][9]

Deep vein thrombosis and pulmonary embolism[edit]

Obesity increases one's risk of venous thromboembolism by 2.3 fold.[10][11]

Dermatological[edit]

Stretch marks on the abdomen.

Obesity is associated with the incidence of stretch marks, acanthosis nigricans, lymphedema, cellulitis, hirsutism, and intertrigo.[12][13]

Endocrine[edit]

Diabetes mellitus[edit]

One of the strongest links between obesity and disease is that with type 2 diabetes. These two conditions are so strongly linked that researchers in the 1970s started calling it “diabesity”.[6] Excess weight is behind 64% of cases of diabetes in men and 77% of cases in women.[14]

Reproductive system[edit]

Polycystic ovarian syndrome (PCOS)[edit]

Due to its association with insulin resistance, the risk of PCOS increases with adiposity. In the US approximately 60% of patients with PCOS have a BMI greater than 30.[15]

Infertility[edit]

Obesity leads to infertility in both men and women. This is primarily due to excess estrogen interfering with normal ovulation in women[6] and altering spermatogenesis in men.[16] It is believed to cause 6% of primary infertility.[6][17] A review in 2013 came to the result that obesity increases the risk of oligospermia and azoospermia in men, with an of odds ratio 1.3.[18] Being morbidly obese increases the odds ratio to 2.0.[18]

Complications of pregnancy[edit]

Obesity is related to many complications in pregnancy including: haemorrhage, infection, increased hospital stays for the mother, and increased NICU requirements for the infant.[19] Obese women have more than twice the rate of C-sections compared to women of normal weight.[20] Obese women also have increased risk of preterm births and low birth weight infants.[21]

Birth defects[edit]

Those who are obese during pregnancy have a greater risk of have a child with a number of congenital malformations including: neural tube defects such as anencephaly and spina bifida, cardiovascular anomalies, including septal anomalies, cleft lip and palate, anorectal malformation, limb reduction anomalies, and hydrocephaly.[22]

Intrauterine fetal death[edit]

[clarification needed][17]

Gastrointestinal[edit]

Gastroesophageal reflux disease[edit]

Several studies have show that the frequency and severity of GERD symptoms are higher in those who are obese.[23][24]

Fatty liver disease[edit]

[clarification needed][6]

Non-alcoholic fatty liver disease

Cholelithiasis (gallstones)[edit]

[clarification needed][6]

Neurological[edit]

Stroke[edit]

Ischemic stroke is increased in both men and women who are obese.[6] For women with a BMI greater than 30, the risk of ischemic stroke increases by 1.7 fold,[25] while men with a BMI greater than 30 had a risk of stroke 2.0 times greater.[26]

Meralgia paresthetica[edit]

[clarification needed][27]

Migraines[edit]

[clarification needed][28]

Carpal tunnel syndrome[edit]

[clarification needed][29]

Dementia[edit]

Those who are obese have a rate of dementia 1.4 times greater than those of normal weight.[30]

Idiopathic intracranial hypertension[edit]

[clarification needed][31]

Multiple sclerosis[edit]

Women that are obese at age 18 have a greater than twofold increased risk of MS.[32]

Oncological[edit]

Many cancers occur at increased frequency in those who are overweight or obese. A study from the United Kingdom found that approximately 5% of cancer is due to excess weight.[33] These cancers include: [34]

Psychiatric[edit]

Depression[edit]

Risk of suicide decreases with increased body mass index in the United States.[35]

Obesity has been associated with depression.[6] The relationship is strongest in those who are more severely obese, those who are younger, and in women.[36] Suicide rate however decreases with increased BMI.[35]

Social stigmatization[edit]

In the United States, young women who are overweight complete 0.3 year less school, are 20% less likely to get married, and make $6,710 less than their normal weight counterparts.[6][37]

Respirological[edit]

Obstructive sleep apnea[edit]

[clarification needed][6][38]

Obesity hypoventilation syndrome[edit]

CPAP machine commonly used in OHS

Obesity hypoventilation syndrome is defined as the combination of obesity, hypoxia during sleep, and hypercapnia during the day, resulting from hypoventilation.[39] Based on its definition it occurs only in the obese.

Chronic lung disease[edit]

Obesity is associated with a number of chronic lung diseases, including asthma and COPD.[38] It is believed that a systemic pro-inflammatory state induced by some causes of obesity may contribute to airway inflammation, leading to asthma.[40]

Complications during general anaesthesia[edit]

[clarification needed][6][41]

Rheumatological and orthopedic[edit]

Gout[edit]

Compared to men with a BMI of 21 - 23, men with a BMI of 30 - 35 have 2.3 times more gout, and men with a BMI of greater than 35 have 3.0 times more gout. Weight loss decreases these risks.[42]

Poor mobility[edit]

There is a strong association between obesity and musculoskeletal pain and disability[43]

Osteoarthritis[edit]

Increased rates of arthritis are seen in both weight-bearing and non-weight-bearing joints.[6] Those with a BMI greater than 26.4 had rate of osteoarthritis of the knees 6 times greater than those with a BMI of less than 23.4, well rates of osteoarthritis in the hand was about 1.5 times greater.[44]

Low back pain[edit]

Obese individuals are twice to four times more likely to have lower back pain than their normal weight peers.[45]

Urological and nephrological[edit]

Erectile dysfunction[edit]

One third of obese men with erectile dysfunction who lose weight experience an improvement in their sexual functioning.[46]

Urinary incontinence[edit]

Urge, stress, and mixed incontinence all occur at higher rates in the obese.[47] The rates are about double that found in the normal weight population.[48] Urinary incontinence improves with weight lost.[49]

Chronic renal failure[edit]

Obesity increases one's risk of renal failure by three to four times.[50]

Hypogonadism[edit]

[clarification needed][51]

References[edit]

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