Health Risks
of Obesity
The medical importance of morbid obesity is that people who
are very obese have higher rates of medical problems, translating into greater need
for weight loss and the rationale for more extreme measures (such as bariatric surgery)
to control the weight. The medical complications of obesity may occur in moderately
obese people but the frequency of these associated problems increases dramatically
as weight increases. For example, very obese men between the ages of 25 and 35 have
12-fold greater risk of dying prematurely compared to their normal weight counterparts.
Medical conditions that are commonly caused or exacerbated
by obesity are considered “co-morbidities”. Below is a list of these medical conditions
that are expected to resolve or improve after weight-loss surgery.
Pulmonary
The obese have decreased lung volumes and a decreased expiratory reserve
volume causing obstructive sleep apnea, obesity hypoventilation syndrome, cor pulmonale
and Asthma/Reactive Airway Disease.
Cardiac
High blood pressure is 6 times more prevalent in the obese person than in average
weight people. The morbidly obese population has a 55-60% higher prevalence of hypertension.
Increased weight at a young age is a risk factor for later development of hypertension.
The relationship of obesity to the incidence of Coronary Artery Heart Disease (CAHD)
has been documented in a large number of studies. The Framingham Study is a large
general population-based study with a long period of follow-up. Results indicate
an increased risk of CAHD with increasing levels of obesity: for each 10% increase
in body weight there is a 20% increase in the incidence of CAHD.
Gastrointestinal and Abdominal
There is a six times increase in incidence of gallstones (Cholelithiasis) in obese
women between 20-30 years. At the age of 60, 33% of women will have gallbladder
disease. Other problems include recurrent heartburn or GERD (Gastro esophageal Reflux
Disease) and recurrent hernias.
Endocrine
Moderate obesity will increase the risk of Non-insulin dependent diabetes mellitus
(NIDDM) or type II diabetes ten times and as a result, 33% of the morbidly obese
have diabetes. Reducing weight in diabetics will improve glucose control, hypertension,
heart attack, stroke, blindness and amputation.
Genitourinary, Reproductive
There is an increase of irregular menstruation in obese women leading to
irregular periods and infertility. During pregnancy the obese can have an increase
in toxemia and hypertension. Menses occurs earlier in obese girls. Frequent urinary
track infections and stress urinary incontinence are other problems
Musculoskeletal
An increase in weight can cause degeneration or osteoarthritis of the spine, knees,
and hips, and also creates more problems like disc herniation and chronic non-surgical
low back pain. An increase in uric acid levels due to excess weight increases the
prevalence for Gout. The joints are traumatized by increased weight demand but weight
loss can relieve or decrease the chance of osteoarthritis.
Cancer Risk
Studies show a correlation between obesity and certain kinds of cancer. The American
Cancer Society (ACS) Study involving more than 1 million men and women found that
obese males had a higher mortality from cancer of the colon, rectum and prostate.
Men who are 130% above average weight have a 2.5 times higher chance of death from
prostate cancer in a 20-year follow-up study. Obese females had a higher mortality
from cancer of the gallbladder, biliary tract, breast (postmenopausal), uterus (including
both cervix and endometrium) and ovaries. In the case of endometrial cancer, women
with marked obesity showed the highest relative risk (5.4) compared to non-obese.
Psychological Disorders
The obese person has difficulty in daily life, work, recreation, social interaction
and sleep. Because of their limitations in lung capacity and mobility they become
physically impaired and become a target for discrimination. They suffer from an
impairment of their body image, which can lead to depression.
Here is a relative risk of a person with a BMI of 25 compared to a person with a
BMI of 40: