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Health Risks Associated with Obesity
(Co -Morbidities)
Being obese (BMI of 30 or more) is hazardous to your health. The following describe medical conditions closely associated with obesity.

They are often referred to as co-morbidities, meaning that the symptoms typically worsen as the degree of obesity increases and improve as the obesity is successfully treated.

Diabetes Mellitus - This disease is a leading cause of death in the United States causing a twofold to fourfold increase in risk for cardiovascular disease and stroke, as well as being the leading cause of blindness in adults and renal failure requiring dialysis. These risks are even greater in minorities in the United States. Recent studies have indicated that tight control of the blood glucose is the best way to reduce the associated risks of the deadly disease. Work by Porries and others show the best treatment for DM is Surgery (Gastric Bypass). A recent study of 100 Gastric Bypass patients included 24 Diabetics pre-operatively. After three months and for as long as 30 months (the length of the study), all but two of the diabetics had no sign of their glucose intolerance and the other two were markedly improved. All were off medications for Diabetes. A recent study by MacDonald followed obese diabetic patients who underwent Gastric Bypass and a similar group who did not undergo surgery. The group who did not have surgery had a significantly increased mortality rate. Clearly, the best treatment to avoid the complications of DM is to maintain close glucose control and the best way to accomplish that task is through the performance of a Gastric Bypass or Laparoscopic Adjustable Band.

High Blood Pressure (Hypertension/Stroke) - The associated problems with hypertension are well known. It is a major factor of cardiovascular disease, including stroke, coronary infection and peripheral vascular disease. Hypertension and sleep apnea have also been linked to obesity.

Heart Disease - Excess body weight forces the heart to work harder to meet the body's needs. This strain can cause significant heart and kidney damage and, if accompanied by high blood pressure, hyperlipidemia and diabetes mellitus can lead to heart attack or stroke.

Cancer - Studies have shown that obese men are more likely than non-obese men to die from cancer of the colon, rectum or prostate. Obese women are more likely than non-obese women to die from cancer of the gallbladder, breast, uterus, cervix or ovaries.

Osteoarthritis - This a disease in which the joints deteriorate. This is possibly the result of excess weight on the joints. Excess weight causes strain and inflammation of the joints, especially the hips, knees and ankles, causing pain and decreased mobility.

Chronic Low Back Pain - Obesity and the lack of mobility related to obesity are directly associated with chronic back pain.

Psychological disorders - Emotional suffering may be one of the most painful aspects of obesity. Obese people often face prejudice or discrimination in the job market or in social situations, resulting in depression, eating disorders, distorted body image and low self esteem.

Dyslipidemia (lipid metabolism abnormalities) - Both hypercholesterolemia and Hypertriglyceridemia are associated with obesity.

Hypercholesterolemia - This is an additional risk factor for cardiovascular and cerebrovascular disease.

Hypertriglyceridemia - This is an additional risk factor for cardiovascular and cerebrovascular disease.

Gastroesophageal reflux disease/heartburn - The disease of Gastroesophageal Reflux not only causes a major alteration in one's lifestyle but can also lead to stricture, dysphagia, aspiration and asthma. In certain instances it leads to the development of cancer. The medication used for the treatment of this disease is quite costly and may not protect the patient from the side effects even though the symptoms are controlled. Bariatric surgery is quite effective in controlling the symptoms and recent studies indicate may reverse the pre-malignant changes of the esophagus. Healthcare plans have realized it is more cost effective to perform an anti-reflux operation than to pay for the years of expensive medications and the cost of repeated endoscopies and the treatment of the associated complications. Data shows essentially complete resolution of the process with a laparoscopic procedure. As the patient has indications for a surgical procedure for reflux, it would be much better to perform a Gastric Bypass or Laparscopic Band and treat so much more than the reflux.

Skin Disorders - These are mostly related to diabetes and difficulty with hygiene.

Liver disease - The liver parenchyma/tissue in a morbidly obese patient can be paralyzed and/or partially replaced with fat. This can lead to decreased liver function, elevated laboratory tests and sometimes liver failure.

Gallbladder disease and gallstones - Obesity and rapid weight-loss can both be risk factors for the development of gallstones.

Gout - This is a disease affecting the joints and is more common in obese patients.

Pulmonary (breathing) problems - This includes asthma and sleep apnea in which a person can stop breathing for a short time during sleep. Sleep apnea is directly related to obesity. Associated problems include hypertension, cardiac problems, pulmonary problems, nighttime regurgitation, difficulty sleeping and inability to stay awake and function performing daily activities.

Reproductive problems in women - This may include menstrual irregularities, infertility and irregular ovulation.

Bladder Control/Stress Urinary Incontinence - Although not life threatening, Stress Urinary Incontinence is a process which causes the patient to alter their lifestyle significantly. The individual needs to be aware of how full their bladder is and where the nearest restroom is at all times. There is a surgical procedure (bladder suspension) to alleviate these symptoms. A bladder suspension is not as effective in the morbidly obese patient and therefore the best option is through surgical weight reduction.
Diabetes Complications - A Health Risk of Obesity
"Co-morbidities are medical conditions whose symptoms typically worsen as the degree of obesity increases and improve as the obesity is successfully treated."

Sources:
www.walkfromobesity.com

www.niddk.nih.gov/health/nutrit/pubs/unders.htm

Stunkard AJ, Wadden TA. (Editors) Obesity: theory and therapy, Second Edition. New York: Raven Press, 1993.

National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, Maryland: Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, 1998.
 
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