Obesity-associated morbidity

Obesity has a number of medical complications which negatively impact peoples' quality of life

Obesity is an important risk factor for many chronic physical and mental illnesses that people suffer from. The generally accepted view is that being overweight causes similar health problems to obesity, but to a lesser degree.[1]

Cardiological

HeartAttack (Myocardial infarct)

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

Stretch marks ABD.

Obesity is associated with the incidence of stretch marks, acanthosis nigricans, lymphedema, cellulitis, hirsutism, and intertrigo.[11][12]

Endocrine

Gynecomastia in an obese male.

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)

Obesity, according to NIH,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 polycystic ovarian syndrome (PCOS) increases with adiposity. 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

MCA Territory Infarct (stroke)

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 migrane 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)

Hepatocellular carcinoma 1
Main article: Obesity and cancer

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]

Al 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]

Psychiatric

Risk of suicide decreases with increased body mass index in the United States.[37]

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.[38] Suicide rate however decreases with increased BMI.[37]

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.[39]

Respiratory system

Obstructive sleep apnea

Obesity is a risk factor for obstructive sleep apnea.[5][40]

Obesity hypoventilation syndrome

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.[41]

Chronic lung disease

Obesity is associated with a number of chronic lung diseases, including asthma and COPD.[40] It is believed that a systemic pro-inflammatory state induced by some causes of obesity may contribute to airway inflammation, leading to asthma.[42]

Complications during general anaesthesia

Obesity significantly reduces and stiffens the functional lung volume, requiring specific strategies for respiratory management under general anaesthesia.[43]

Rheumatological and orthopedic

Gout

Gout

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.[44]

Poor mobility

There is a strong association between obesity and musculoskeletal pain and disability[45]

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.[46]

Low back pain

Obese individuals are twice to four times more likely to have lower back pain than their normal weight peers.[47]

Traumatological

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.[48]

Urological and nephrological

Urinary system

Urinary incontinence

Urge, stress, and mixed incontinence all occur at higher rates in the obese.[49] The rates are about double that found in the normal weight population.[50] Urinary incontinence improves with weight lost.[51]

Chronic renal failure

Obesity increases one's risk of renal failure by three to four times.[52]

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.[53]

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.[54][55]

See also

References

  1. 1 2 "Obesity and overweight". World Health Organization. Retrieved 2016-05-17.
  2. ↑ Poirier P, Giles TD, Bray GA, et al. (May 2006). "Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss". Arteriosclerosis, Thrombosis, and Vascular Biology. 26 (5): 968–76. doi:10.1161/01.ATV.0000216787.85457.f3. PMID 16627822.
  3. ↑ Yusuf S, Hawken S, Ounpuu S, et al. (2004). "Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study". The Lancet. 364 (9438): 937–52. doi:10.1016/S0140-6736(04)17018-9. PMID 15364185.
  4. ↑ Tsigos C, Hainer V, Basdevant A, et al. (2008). "Management of obesity in adults: European clinical practice guidelines". Obes Facts. 1 (2): 106–16. doi:10.1159/000126822. PMID 20054170. as PDF
  5. 1 2 3 4 5 6 7 8 9 10 11 Haslam DW, James WP (October 2005). "Obesity". Lancet. 366 (9492): 1197–209. doi:10.1016/S0140-6736(05)67483-1. PMID 16198769. – via ScienceDirect (Subscription may be required or content may be available in libraries.)
  6. ↑ Rahmouni K, Correia ML, Haynes WG, Mark AL (January 2005). "Obesity-associated hypertension: new insights into mechanisms". Hypertension. 45 (1): 9–14. doi:10.1161/01.HYP.0000151325.83008.b4. PMID 15583075.
  7. ↑ Chiolero A, Bovet P, Paradis G, Paccaud F (March 2007). "Has blood pressure increased in children in response to the obesity epidemic?". Pediatrics. 119 (3): 544–53. doi:10.1542/peds.2006-2136. PMID 17332208.
  8. ↑ Malnick, S. D. H.; Knobler, H. (2006-09-01). "The medical complications of obesity". QJM. 99 (9): 565–579. doi:10.1093/qjmed/hcl085. ISSN 1460-2725. PMID 16916862.
  9. ↑ Ageno W, Becattini C, Brighton T, Selby R, Kamphuisen PW (January 2008). "Cardiovascular risk factors and venous thromboembolism: a meta-analysis". Circulation. 117 (1): 93–102. doi:10.1161/CIRCULATIONAHA.107.709204. PMID 18086925.
  10. ↑ Darvall KA, Sam RC, Silverman SH, Bradbury AW, Adam DJ (February 2007). "Obesity and thrombosis". Eur J Vasc Endovasc Surg. 33 (2): 223–33. doi:10.1016/j.ejvs.2006.10.006. PMID 17185009.
  11. ↑ Yosipovitch G, DeVore A, Dawn A (June 2007). "Obesity and the skin: skin physiology and skin manifestations of obesity". J. Am. Acad. Dermatol. 56 (6): 901–16; quiz 917–20. doi:10.1016/j.jaad.2006.12.004. PMID 17504714.
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  13. ↑ Peter G. Kopelman; Ian D. Caterson; Michael J. Stock; William H. Dietz (2005). Clinical obesity in adults and children: In Adults and Children. Blackwell. p. 493. ISBN 1-4051-1672-2.
  14. ↑ Johnson, Ruth E.; Murad, M. Hassan (2009-11-01). "Gynecomastia: Pathophysiology, Evaluation, and Management". Mayo Clinic Proceedings. 84 (11): 1010–1015. doi:10.4065/84.11.1010. ISSN 0025-6196. PMC 2770912Freely accessible. PMID 19880691.
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  17. ↑ "Gallstones". www.niddk.nih.gov. Retrieved 13 May 2016.
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  19. ↑ Hammoud AO, Gibson M, Peterson CM, Meikle AW, Carrell DT (October 2008). "Impact of male obesity on infertility: a critical review of the current literature". Fertil. Steril. 90 (4): 897–904. doi:10.1016/j.fertnstert.2008.08.026. PMID 18929048.
  20. 1 2 Arendas K, Qiu Q, Gruslin A (June 2008). "Obesity in pregnancy: pre-conceptional to postpartum consequences". J Obstet Gynaecol Can. 30 (6): 477–88. PMID 18611299.
  21. 1 2 Sermondade, N.; Faure, C.; Fezeu, L.; et al. (2012). "BMI in relation to sperm count: An updated systematic review and collaborative meta-analysis". Human Reproduction Update. 19 (3): 221–231. doi:10.1093/humupd/dms050. PMC 3621293Freely accessible. PMID 23242914.
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  39. ↑ Sikorski, Claudia; Luppa, Melanie; Kaiser, Marie; Glaesmer, Heide; Schomerus, Georg; König, Hans-Helmut; Riedel-Heller, Steffi G (2011-08-23). "The stigma of obesity in the general public and its implications for public health - a systematic review". BMC Public Health. 11: 661. doi:10.1186/1471-2458-11-661. ISSN 1471-2458. PMC 3175190Freely accessible. PMID 21859493.
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  41. ↑ Olson, Amy L.; Zwillich, Clifford (2005-09-01). "The obesity hypoventilation syndrome". The American Journal of Medicine. 118 (9): 948–956. doi:10.1016/j.amjmed.2005.03.042. ISSN 0002-9343. PMID 16164877. – via ScienceDirect (Subscription may be required or content may be available in libraries.)
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  46. ↑ Yu SP, Hunter DJ (August 2015). "Managing osteoarthritis". Australian Prescriber. 38 (4): 115–9. doi:10.18773/austprescr.2015.039. PMC 4653978Freely accessible. PMID 26648637.
  47. ↑ Molenaar EA, Numans ME, van Ameijden EJ, Grobbee DE (November 2008). "[Considerable comorbidity in overweight adults: results from the Utrecht Health Project]". Ned Tijdschr Geneeskd (in Dutch and Flemish). 152 (45): 2457–63. PMID 19051798.
  48. ↑ Johansson, Helena; Kanis, John A; Odén, Anders; McCloskey, Eugene; Chapurlat, Roland D; Christiansen, Claus; Cummings, Steve R; Diez-Perez, Adolfo; Eisman, John A; Fujiwara, Saeko; Glüer, Claus-C; Goltzman, David; Hans, Didier; Khaw, Kay-Tee; Krieg, Marc-Antoine; Kröger, Heikki; LaCroix, Andrea Z; Lau, Edith; Leslie, William D; Mellström, Dan; Melton, L Joseph; O'Neill, Terence W; Pasco, Julie A; Prior, Jerilynn C; Reid, David M; Rivadeneira, Fernando; van Staa, Tjerd; Yoshimura, Noriko; Zillikens, M Carola (January 2014). "A Meta-Analysis of the Association of Fracture Risk and Body Mass Index in Women". Journal of Bone and Mineral Research. 29 (1): 223–233. doi:10.1002/jbmr.2017.
  49. ↑ Hunskaar S (2008). "A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women". Neurourol. Urodyn. 27 (8): 749–57. doi:10.1002/nau.20635. PMID 18951445.
  50. ↑ Bart S, Ciangura C, Thibault F, et al. (September 2008). "[Stress urinary incontinence and obesity]". Prog. Urol. (in French). 18 (8): 493–8. doi:10.1016/j.purol.2008.04.015. PMID 18760738.
  51. ↑ Subak LL, Wing R, West DS, et al. (January 2009). "Weight loss to treat urinary incontinence in overweight and obese women". N. Engl. J. Med. 360 (5): 481–90. doi:10.1056/NEJMoa0806375. PMC 2877497Freely accessible. PMID 19179316.
  52. ↑ Ejerblad E, Fored CM, Lindblad P, Fryzek J, McLaughlin JK, Nyrén O (2006). "Obesity and risk for chronic renal failure". J. Am. Soc. Nephrol. 17 (6): 1695–702. doi:10.1681/ASN.2005060638. PMID 16641153.
  53. ↑ Corona G, Bianchini S, Sforza A, Vignozzi L, Maggi M (October 2015). "Hypogonadism as a possible link between metabolic diseases and erectile dysfunction in aging men". Hormones (Athens). 14 (4): 569–78. doi:10.14310/horm.2002.1635. PMID 26732155.
  54. ↑ Corona, Giovanni; Rastrelli, Giulia; Filippi, Sandra; Vignozzi, Linda; Mannucci, Edoardo; Maggi, Mario (2014-01-01). "Erectile dysfunction and central obesity: an Italian perspective". Asian Journal of Andrology. 16 (4): 581–591. doi:10.4103/1008-682X.126386. ISSN 1008-682X. PMC 4104087Freely accessible. PMID 24713832.
  55. ↑ Chitaley, Kanchan; Kupelian, Varant; Subak, Leslee; Wessells, Hunter (2009-12-01). "Diabetes, Obesity and Erectile Dysfunction: Field Overview and Research Priorities". The Journal of urology. 182 (6 Suppl): S45–S50. doi:10.1016/j.juro.2009.07.089. ISSN 0022-5347. PMC 2864637Freely accessible. PMID 19846136.

Further reading

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