Obesity associated morbidity
Encyclopedia
Whether obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...

 should be considered a disease on its own, it is also an important risk factor
Risk factor
In epidemiology, a risk factor is a variable associated with an increased risk of disease or infection. Sometimes, determinant is also used, being a variable associated with either increased or decreased risk.-Correlation vs causation:...

 for many chronic physical and mental illnesses.

Ischemic heart disease

Obesity is associated with cardiovascular diseases including angina and myocardial infarction
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...

. A 2002 report concluded that 21% of ischemic heart disease is due to obesity while a 2008 European consensus puts the number at 35%.

Congestive heart failure
Congestive heart failure
Heart failure often called congestive heart failure is generally defined as the inability of the heart to supply sufficient blood flow to meet the needs of the body. Heart failure can cause a number of symptoms including shortness of breath, leg swelling, and exercise intolerance. The condition...

Having a BMI of greater than 30 increases ones risk of heart failure by two.

High blood pressure

More than 85% of hypertension occurs in people with a BMI of greater than 25. 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, from these it has been realized that many mechanisms are potential causes of obesity induced hypertension. These mechanisms include the activation of the sympathetic nervous system as well as the activation of the renin–angiotensin-aldosterone system.

Abnormal cholesterol levels
Dyslipidemia
Dyslipidemia or dyslipidaemia is an abnormal amount of lipids in the blood. In developed countries, most dyslipidemias are hyperlipidemias; that is, an elevation of lipids in the blood, often due to diet and lifestyle. The prolonged elevation of insulin levels can lead to dyslipidemia...

Obesity is associated with an increased LDL cholesterol and a lowered HDL cholesterol.

Deep vein thrombosis
Deep vein thrombosis
Deep vein thrombosis is the formation of a blood clot in a deep vein. Deep vein thrombosis commonly affects the leg veins or the deep veins of the pelvis. Occasionally the veins of the arm are affected...

 and Pulmonary embolism
Pulmonary embolism
Pulmonary embolism is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream . Usually this is due to embolism of a thrombus from the deep veins in the legs, a process termed venous thromboembolism...

Obesity increases one's risk of venous thromboembolism by 2.3 fold.

Dermatology
Dermatology
Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....

  • stretch marks
  • acanthosis nigricans
    Acanthosis nigricans
    Acanthosis nigricans is a brown to black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds, such as the posterior and lateral folds of the neck, the axilla, groin, umbilicus, forehead, and other areas.-Causes:...

  • lymphedema
    Lymphedema
    Lymphedema , also known as lymphatic obstruction, is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system....

  • cellulitis
    Cellulitis
    Cellulitis is a diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin. Cellulitis can be caused by normal skin flora or by exogenous bacteria, and often occurs where the skin has previously been broken: cracks in the skin, cuts, blisters,...

  • hirsutism
    Hirsutism
    Hirsutism or frazonism is the excessive hairiness on women in those parts of the body where terminal hair does not normally occur or is minimal - for example, a beard or chest hair. It refers to a male pattern of body hair and it is therefore primarily of cosmetic and psychological concern...

  • intertrigo
    Intertrigo
    An intertrigo is an inflammation of the body folds .An intertrigo sometimes refers to a bacterial, fungal, or viral infection that has developed at the site of broken skin due to such inflammation...


Diabetes mellitus
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...

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

Polycystic ovarian syndrome (PCOS)

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 of greater than 30.

Infertility
Infertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...

Obesity leads to infertility in both men and women. This is primarily due to excess estrogen interfering with normal ovulation
Ovulation
Ovulation is the process in a female's menstrual cycle by which a mature ovarian follicle ruptures and discharges an ovum . Ovulation also occurs in the estrous cycle of other female mammals, which differs in many fundamental ways from the menstrual cycle...

 in women and altering spermatogenesis
Spermatogenesis
Spermatogenesis is the process by which male primary germ cells undergo division, and produce a number of cells termed spermatogonia, from which the primary spermatocytes are derived. Each primary spermatocyte divides into two secondary spermatocytes, and each secondary spermatocyte into two...

 in men. It is believed to cause 6% of primary infertility.

Complications of pregnancy
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...

Obesity is related to many complications in preganacy including: haemorrhage, infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

, increased hospital stays for the mother, and increased NICU requirements for the infant. Obese women have more than twice the rate of C-sections compared to women of normal weight. Obese women also have increased risk of preterm births and low birth weight infants.

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
Neural tube defects
Neural tube defects are one of the most common birth defects, occurring in approximately one in 1,000 live births in the United States. An NTD is an opening in the spinal cord or brain that occurs very early in human development. In the 2nd week of pregnancy called gastrulation, specialized cells...

 such as anencephaly
Anencephaly
Anencephaly is a cephalic disorder that results from a neural tube defect that occurs when the cephalic end of the neural tube fails to close, usually between the 23rd and 26th day of pregnancy, resulting in the absence of a major portion of the brain, skull, and scalp...

 and spina bifida
Spina bifida
Spina bifida is a developmental congenital disorder caused by the incomplete closing of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to protrude through...

, cardiovascular anomalies, including septal anomalies, cleft lip and palate, anorectal malformation, limb reduction anomalies, and hydrocephaly.

Gastroesophageal reflux disease
Gastroesophageal reflux disease
Gastroesophageal reflux disease , gastro-oesophageal reflux disease , gastric reflux disease, or acid reflux disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus...

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

Fatty liver disease
Non-alcoholic fatty liver disease
Non-alcoholic fatty liver disease is one cause of a fatty liver, occurring when fat is deposited in the liver not due to excessive alcohol use. It is related to insulin resistance and the metabolic syndrome and may respond to treatments originally developed for other insulin-resistant states...

Stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...

Ischemic stroke in increased in both men and women who are obese. For women with BMI of greater than 30 their risk of ischemic stroke was 1.7 times greater. While men with a BMI of greater than 30 had a risk of stroke 2.0 times greater.

Dementia
Dementia
Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging...

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

Multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...

 

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

Oncology
Oncology
Oncology is a branch of medicine that deals with 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. These cancers include:
  • breast
    Breast cancer
    Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

    , ovarian
    Ovarian cancer
    Ovarian cancer is a cancerous growth arising from the ovary. Symptoms are frequently very subtle early on and may include: bloating, pelvic pain, difficulty eating and frequent urination, and are easily confused with other illnesses....

  • esophageal
    Esophageal cancer
    Esophageal cancer is malignancy of the esophagus. There are various subtypes, primarily squamous cell cancer and adenocarcinoma . Squamous cell cancer arises from the cells that line the upper part of the esophagus...

    , colorectal
    Colorectal cancer
    Colorectal cancer, commonly known as bowel cancer, is a cancer caused by uncontrolled cell growth , in the colon, rectum, or vermiform appendix. Colorectal cancer is clinically distinct from anal cancer, which affects the anus....

  • liver
    Hepatocellular carcinoma
    Hepatocellular carcinoma is the most common type of liver cancer. Most cases of HCC are secondary to either a viral hepatitide infection or cirrhosis .Compared to other cancers, HCC is quite a rare tumor in the United States...

    , pancreatic
    Pancreatic cancer
    Pancreatic cancer refers to a malignant neoplasm of the pancreas. The most common type of pancreatic cancer, accounting for 95% of these tumors is adenocarcinoma, which arises within the exocrine component of the pancreas. A minority arises from the islet cells and is classified as a...

  • gallbladder
    Gallbladder cancer
    Gallbladder cancer is a relatively uncommon cancer. It has peculiar geographical distribution being common in central and South America, central and eastern Europe, Japan and northern India; it is also common in certain ethnic groups e.g. Native American Indians and Hispanics. If it is diagnosed...

    , stomach
    Stomach cancer
    Gastric cancer, commonly referred to as stomach cancer, can develop in any part of the stomach and may spread throughout the stomach and to other organs; particularly the esophagus, lungs, lymph nodes, and the liver...

  • endometrial
    Endometrial cancer
    Endometrial cancer refers to several types of malignancies that arise from the endometrium, or lining, of the uterus. Endometrial cancers are the most common gynecologic cancers in the United States, with over 35,000 women diagnosed each year. The incidence is on a slow rise secondary to the...

    , cervical
    Cervical cancer
    Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. One of the most common symptoms is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer is in its advanced stages...

  • prostate
    Prostate cancer
    Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize from the prostate to other parts of the body, particularly...

    , kidney
    Renal cell carcinoma
    Renal cell carcinoma is a kidney cancer that originates in the lining of the proximal convoluted tubule, the very small tubes in the kidney that filter the blood and remove waste products. RCC is the most common type of kidney cancer in adults, responsible for approximately 80% of cases...

  • non-Hodgkin's lymphoma, multiple myeloma
    Multiple myeloma
    Multiple myeloma , also known as plasma cell myeloma or Kahler's disease , is a cancer of plasma cells, a type of white blood cell normally responsible for the production of antibodies...


Depression

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

Social stigmatization

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.

Obesity hypoventilation syndrome

Obesity hypoventilation syndrome is defined as the combination of obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...

, hypoxia
Hypoxia (medical)
Hypoxia, or hypoxiation, is a pathological condition in which the body as a whole or a region of the body is deprived of adequate oxygen supply. Variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise...

 during sleep, and hypercapnia
Hypercapnia
Hypercapnia or hypercapnea , also known as hypercarbia, is a condition where there is too much carbon dioxide in the blood...

 during the day, resulting from hypoventilation
Hypoventilation
In medicine, hypoventilation occurs when ventilation is inadequate to perform needed gas exchange...

. Based on its definition it occurs only in the obese.

Chronic lung disease

Obesity is associated with a number of chronic lung diseases including: Asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...

 and COPD
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...

. It is believed that a systemic pro-inflammatory state induced by some causes of obesity may be contributing to airway inflammation and thus leading to asthma.

Gout
Gout
Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected . However, it may also present as tophi, kidney stones, or urate...

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.

Poor mobility

There is a strong association between obesity and musculoskeletal pain and disability

Osteoarthritis
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...

Increased rates of arthritis are seen in both weight bearing and non weight bearing joint. 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.

Low back pain
Low back pain
Low back pain or lumbago is a common musculoskeletal disorder affecting 80% of people at some point in their lives. In the United States it is the most common cause of job-related disability, a leading contributor to missed work, and the second most common neurological ailment — only headache is...

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

Erectile dysfunction
Erectile dysfunction
Erectile dysfunction is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance....

One third of obese men with erectile dysfunction who lose weight have improvement in their sexual functioning.

Urinary incontinence
Urinary incontinence
Urinary incontinence is any involuntary leakage of urine. It is a common and distressing problem, which may have a profound impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but is under-reported to medical practitioners...

Urge, stress, and mixed incontinence all occur at higher rates in the obese. The rates are about double that found in the normal weight population. Urinary incontinence improves with weight lose.
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