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There are more than 30 obesity-related health risks. Obesity is a known factor for osteoarthritis, heart disease, high blood pressure, gallbladder disease, liver disease, sleep apnea, stroke and diabetes. Cancer of the breast, uterus, ovaries, prostate and colon are twice as likely to occur in an obese person. A BMI greater than 35 increases the risk for diabetes 93-fold in women and 42-fold in men. Obesity is one of the most common causes of preventable deaths in the U.S. An estimated 280,000 annual deaths are attributed to obesity.
Obesity is one of America's most serious epidemics. Over two-thirds of U.S. citizens are overweight; a frightening statistic that continues to increase. Of even greater concern, over 23 million Americans are morbidly obese, which means that they have a Body Mass Index (BMI) greater than 40, exceeding their ideal body weight by at least 100 pounds. One-third of these, a population equal to that of North Carolina, attain BMI's greater than 40, a level often considered superobese. Those afflicted by these severe forms of obesity are not only burdened by their bulk, they are also confronted with life-threatening co-morbidities including diabetes, hypertension and severe pulmonary compromise.
Surgery is the only effective therapy for morbid obesity and its complications. A variety of surgical procedures can now offer not only durable and safe control of weight but also provide previously unimaginable full remission of many of the co-morbidities, including diabetes, asthma, cardiopulmonary failure, infertility and stress incontinence. After surgery, patients who were once disabled and wheelchair bound can be returned to full activity. Hypertension can be cut in half. These outcomes are being achieved at the Centers for which we have data, with preliminary data indicating mortality rates of less than one percent and complication rates of about six percent. Bariatric surgery is a complex and challenging undertaking. Many of the patients present sharply increased surgical risks. Psychosocial challenges and the uncontrolled complications of morbid obesity require highly competent and compassionate support. Furniture, hospital equipment, instruments and imaging resources must be suitable to deal with massive patients who often exceed their ideal body weight by 100 pounds. Especially important is a well-trained staff, capable of dealing with the physical and emotional demands of the morbidly obese.
The health problems associated with obesity are numerous. Obesity is not just a cosmetic problem. It's a health hazard. Someone who is 40% overweight is twice as likely to die prematurely as is an average-weight person. This is because obesity has been linked to several serious medical conditions, including:
- Heart disease and stroke
- High blood pressure
- Diabetes
- Cancer
- Gallbladder disease and gallstones
- Osteoarthritis
- Gout
Breathing problems, such as sleep apnea (when a person stops breathing for a short time during sleep) and asthma. Doctors generally agree that the more obese a person is the more likely he or she is to have health problems. People who are 20% or more overweight can gain significant health benefits from losing weight. Many obesity experts believe that people who are less than 20% above their healthy weight should still try to lose weight if they have any of the following risk factors. Family history of certain chronic diseases. People with close relatives who have had heart disease or diabetes are more likely to develop these problems if they are obese. Pre-existing medical conditions. High blood pressure, high cholesterol levels, or high blood sugar levels are all warning signs of some obesity-associated diseases. "Apple" shape. People whose weight is concentrated around their stomachs may be at greater risk of developing heart disease, diabetes or cancer than people of the same weight who are "pear-shaped" (they carry their weight in their hips and buttocks). Fortunately, even a modest weight loss of 10 to 20 pounds can bring significant health improvements, such as lowering one's blood pressure and cholesterol levels.
How Is Obesity Linked to Heart Disease and Stroke?
Heart disease and stroke are the leading causes of death and disability for people in the U.S. Overweight people are twice as likely to have high blood pressure, a major risk factor for heart disease and stroke, than people who are not overweight. Very high blood levels of cholesterol can also lead to heart disease and often are linked to being overweight. Being overweight also contributes to angina (chest pain caused by decreased oxygen to the heart) and sudden death from heart disease or stroke without any signs or symptoms. The good news is that losing a small amount of weight can reduce your chances of developing heart disease or a stroke. Reducing your weight by 10% can decrease your chance of developing heart disease.
Type 2 diabetes reduces your body's ability to control blood sugar. It is a major cause of early death, heart disease, stroke, and blindness. Overweight people are more than twice as likely to develop type 2 diabetes compared to normal weight people. More than 80% of cases of type 2 diabetes can be attributed to being overweight or obese. You can reduce your risk of developing type 2 diabetes by losing weight and exercising more. If you have type 2 diabetes, losing weight and becoming more physically active can help control your blood sugar levels. Increasing your physical activity may also allow you to reduce the amount of diabetes medication you need.
Several types of cancer are associated with being overweight. Being obese also increases the risk of dying from cancer. In women, these include cancer of the uterus, gallbladder, cervix, ovary, breast, and colon. Overweight men are at higher risk for developing colorectal cancer and prostate cancer. For some types of cancer, such as colon or breast, it is not clear whether the increased risk is due to the extra weight or to a high-fat, high-calorie diet.
Gallbladder disease and gallstones are more common if you are overweight. Your risk of disease increases as your weight increases. It is not clear how being overweight may cause gallbladder disease. Ironically, weight loss itself, particularly rapid weight loss or loss of a large amount of weight, can actually increase your chances of developing gallstones. Modest, slow weight loss of about 1 pound a week is less likely to cause gallstones.
Osteoarthritis is a common joint condition that most often affects the knee, hip, and lower back joints. Carrying extra pounds places extra pressure on these joints and wear away the cartilage (tissue that cushions the joints) that normally protects them. Weight loss can decrease stress on the knees, hips, and lower back and may improve the symptoms of osteoarthritis.
Gout is a disease that affects the joints that is caused by high levels of a substance called uric acid in the blood. The large amount of uric acid can form into solid or crystal-like masses that deposit in the joints. Gout is more common in overweight people and the risk of developing the disorder increases with higher body weights. Over the short term, certain dietary changes may lead to an attack of gout in people who have high levels of uric acid or who have had gout before. If you have a history of gout, check with your doctor before trying to lose weight.
Sleep apnea is a serious breathing condition that is associated with being overweight. Sleep apnea can cause a person to snore heavily and to stop breathing for short periods during sleep. Sleep apnea may cause daytime sleepiness and even heart failure. The risk for sleep apnea increases as body weight increases. Weight loss usually improves sleep apnea.
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