Obesity-associated morbidity
Obesity-associated morbidity | |
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Obesity has a number of medical complications which negatively impact peoples' quality of life. | |
Specialty | Endocrinology(other specialties) |
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Human body weight |
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Obesity is an important risk factor for many chronic physical and mental illnesses. The generally accepted view is that being overweight causes similar health problems to obesity, but to a lesser degree.[1]
Cardiological[]
![](http://upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Blausen_0463_HeartAttack.png/220px-Blausen_0463_HeartAttack.png)
Ischemic heart disease[]
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[]
Having obesity is associated to about 11% of heart failure cases in men and 14% in women.[5]
High blood pressure[]
More than 85% of those with hypertension have a BMI greater than 25.[5] 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.[6] The association between hypertension and obesity has been also well described in children.[7]
Abnormal cholesterol levels[]
Obesity is associated with increased LDL cholesterol (bad cholesterol) and lowered HDL cholesterol (good cholesterol).[5][8]
Deep vein thrombosis and pulmonary embolism[]
Obesity increases one's risk of venous thromboembolism by 2.3 fold.[9][10]
Dermatological[]
Obesity is associated with the incidence of stretch marks, acanthosis nigricans, lymphedema, cellulitis, hirsutism, and intertrigo.[11][12]
Endocrine[]
![](http://upload.wikimedia.org/wikipedia/commons/thumb/2/2e/Gynecomastia_001.jpg/220px-Gynecomastia_001.jpg)
Diabetes mellitus[]
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".[5] Excess weight is behind 64% of cases of diabetes in men and 77% of cases in women.[13]
Gynecomastia[]
Obesity, according to a 2009 review, can be associated with elevated peripheral conversion of androgens into estrogens in some individuals.[14]
Gastrointestinal[]
Gastroesophageal reflux disease[]
Several studies have shown that the frequency and severity of GERD symptoms are higher in those who are obese.[15][16]
Cholelithiasis (gallstones)[]
According to NIH, obesity causes the amount of cholesterol in bile to rise, in turn the formation of stone can occur [5][17]
Reproductive system (or genital system)[]
Polycystic ovarian syndrome (PCOS)[]
Due to its association with insulin resistance, the risk of obesity increases with polycystic ovarian syndrome (PCOS). In the US approximately 60% of patients with PCOS have a BMI greater than 30. It remains uncertain whether PCOS contributes to obesity, or the reverse.[18]
Infertility[]
Obesity leads to infertility in both men and women. This is primarily due to excess estrogen interfering with normal ovulation in women[5] and altering spermatogenesis in men.[19] It is believed to cause 6% of primary infertility.[5][20] 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.[21] Being morbidly obese increases the odds ratio to 2.0.[21]
Complications of pregnancy[]
Obesity is related to many complications in pregnancy including: haemorrhage, infection, increased hospital stays for the mother, and increased NICU requirements for the infant.[22] Obese women have more than twice the rate of C-sections compared to women of normal weight.[23] Obese women also have increased risk of preterm births and low birth weight infants.[24]
Birth defects[]
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.[25]
Intrauterine fetal death[]
Maternal obesity is associated with an increased risk of intrauterine fetal death.[20]
Neurological[]
![](http://upload.wikimedia.org/wikipedia/commons/thumb/4/49/MCA_Territory_Infarct.svg/220px-MCA_Territory_Infarct.svg.png)
Stroke[]
Ischemic stroke is increased in both men and women who are obese.[5]
Meralgia paresthetica[]
Meralgia paresthetica is a neuropathic pain or numbness of the thighs, sometimes associated with obesity.[26]
Migraines[]
Migraine and obesity are comorbid. The risk of migraine rises 50% by BMI of 30 kg/m2 and 100% by BMI of 35 kg/m2.[27] The causal connection remains unclear.[28]
Carpal tunnel syndrome[]
The risk of carpal tunnel syndrome rises 7.4% for each 1 kg/m2 increase of body mass index.[29]
Dementia[]
Those who are obese have a rate of dementia 1.4 times greater than those of normal weight.[30]
Idiopathic intracranial hypertension[]
Idiopathic intracranial hypertension, or unexplained high pressure in the cranium, is a rare condition that can cause visual impairment, frequent severe headache, and tinnitus. It is most commonly seen in obese women.[31][32]
Multiple sclerosis[]
Women that are obese at age 18 have a greater than twofold increased risk of MS.[33]
Cancer (or oncological)[]
![](http://upload.wikimedia.org/wikipedia/commons/thumb/2/24/Hepatocellular_carcinoma_1.jpg/220px-Hepatocellular_carcinoma_1.jpg)
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.[34] These cancers include: [35]
- breast, ovarian
- esophageal, colorectal
- liver, pancreatic
- gallbladder, stomach
- endometrial, cervical
- prostate, kidney
- non-Hodgkin's lymphoma, multiple myeloma
A high body mass index (BMI) is associated with a higher risk of developing ten common cancers including 41% of uterine cancers and at least 10% of gallbladder, kidney, liver and colon cancers in the UK.[36] For those undergoing surgery for cancer, obesity is also associated with an increased risk of major postoperative complications compared with those of normal weight.[37]
Psychiatric[]
![](http://upload.wikimedia.org/wikipedia/commons/thumb/4/41/Relationship_between_bmi_and_suicide.png/220px-Relationship_between_bmi_and_suicide.png)
Depression[]
Obesity has been associated with depression.[5] The relationship is strongest in those who are more severely obese, those who are younger, and in women.[39] Suicide rate however decreases with increased BMI.[38]
Social stigmatization[]
A 2011 systematic review indicated that obese people draw negative reactions, furthermore people are less willing to help the affected individual in any situation.[40]
Respiratory system[]
Obstructive sleep apnea[]
Obesity is a risk factor for obstructive sleep apnea.[5][41]
Obesity hypoventilation syndrome[]
![](http://upload.wikimedia.org/wikipedia/commons/thumb/c/cb/Cpap-example.jpg/220px-Cpap-example.jpg)
Obesity hypoventilation syndrome is defined as the combination of obesity, hypoxia during sleep, and hypercapnia during the day, resulting from hypoventilation.[42]
Chronic lung disease[]
Obesity is associated with a number of chronic lung diseases, including asthma and COPD.[41] It is believed that a systemic pro-inflammatory state induced by some causes of obesity may contribute to airway inflammation, leading to asthma.[43]
Complications during general anaesthesia[]
Obesity significantly reduces and stiffens the functional lung volume, requiring specific strategies for respiratory management under general anesthesia.[44]
Obesity and asthma[]
The low grade systemic inflammation of obesity has been show to worsen lung function in asthma and increase the risk of developing an asthma exacerbation.[45]
Rheumatological and orthopedic[]
Gout[]
Compared to men with a BMI of 21–22.9, men with a BMI of 30–34.9 have 2.33 times more gout, and men with a BMI ≥ 35 have 2.97 times more gout. Weight loss decreases these risks.[46]
Poor mobility[]
There is a strong association between obesity and musculoskeletal pain and disability.[47]
Osteoarthritis[]
Increased rates of arthritis are seen in both weight-bearing and non-weight-bearing joints.[5] Weight loss and exercise act to reduce the risk of osteoarthritis.[48]
Low back pain[]
Obese individuals are twice to four times more likely to have lower back pain than their normal weight peers.[49]
Traumatic injury[]
In women, class II obesity (i.e. BMI = 35) is a risk factor for osteoporotic fractures in general, as well as for upper arm fractures.[50]
Urological and nephrological[]
![](http://upload.wikimedia.org/wikipedia/commons/thumb/b/ba/Urinary_system_00000.gif/100px-Urinary_system_00000.gif)
Urinary incontinence[]
Urge, stress, and mixed incontinence all occur at higher rates in the obese.[51] The rates are about double that found in the normal weight population.[52] Urinary incontinence improves with weight lost.[53]
Chronic kidney disease[]
Obesity increases one's risk of chronic kidney disease by three to four times.[54]
Hypogonadism[]
In men, obesity and metabolic syndrome both increase estrogen and adipokine production. This reduces gonadotropin-releasing hormone, in turn reducing both luteinizing hormone and follicle stimulating hormone. The result is reduction of the testis' production of testosterone and a further increase in adipokine levels. This then feeds back to cause further weight gain.[55]
Erectile dysfunction[]
Obese men can experience erectile dysfunction, (as well as, in association with diabetes), however weight loss causes an improvement in their sexual functioning.[56][57]
See also[]
- Obesity hypoventilation syndrome
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Further reading[]
- King, Lauren K.; March, Lyn; Anandacoomarasamy, Ananthila (2013-08-01). "Obesity & osteoarthritis". The Indian Journal of Medical Research. 138 (2): 185–193. ISSN 0971-5916. PMC 3788203. PMID 24056594.Review
- Zhao, Lan-Juan; Jiang, Hui; Papasian, Christopher J; Maulik, Dev; Drees, Betty; Hamilton, James; Deng, Hong-Wen (2008-01-01). "Correlation of Obesity and Osteoporosis: Effect of Fat Mass on the Determination of Osteoporosis". Journal of Bone and Mineral Research. 23 (1): 17–29. doi:10.1359/jbmr.070813. ISSN 1523-4681. PMC 2663586. PMID 17784844.
- Guh, Daphne P; Zhang, Wei; Bansback, Nick; Amarsi, Zubin; Birmingham, C Laird; Anis, Aslam H (25 March 2009). "The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis". BMC Public Health. 9 (1): 88. doi:10.1186/1471-2458-9-88. ISSN 1471-2458. PMC 2667420. PMID 19320986.
- Obesity
- Medical conditions related to obesity