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What are the health risks associated with obesity?

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Obesity is not just a cosmetic consideration;

it is a dire health dilemma directly harmful to
one's health. In the United States, roughly
300,000 deaths per year are directly related
to obesity, and more than 80% of these
deaths are in patients with a BMI (body
mass index, which will be discussed later in
this article) over 30. For patients with a BMI
over 40, life expectancy is reduces
significantly (as much as 20 years for men
and 5 years for women ). Obesity also
increases the risk of developing a number of
chronic diseases including:
Insulin Resistance. Insulin is
necessary for the transport of blood
glucose (sugar) into the cells of muscle
and fat (which is then used for energy).
By transporting glucose into cells,
insulin keeps the blood glucose levels
in the normal range. Insulin resistance
(IR) is the condition whereby the
effectiveness of insulin in transporting
glucose (sugar) into cells is diminished.
Fat cells are more insulin resistant than
muscle cells; therefore, one important
cause of insulin resistance is
obesity. The pancreas initially
responds to insulin resistance by
producing more insulin. As long as the
pancreas can produce enough insulin to
overcome this resistance, blood
glucose levels remain normal. This
insulin resistance state (characterized
by normal blood glucose levels and high
insulin levels) can last for years. Once

http://www.medicinenet.com/obesity_weight_loss/page2.htm

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What are the health risks
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Obesity (Weight Loss)

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Obesity (Weight Loss) Glossary
with producing high levels of insulin,
Obesity (Weight Loss) Index
blood glucose levels begin to rise,
Find a local Internist in your
resulting in type 2 diabetes, thus
town
insulin resistance is a pre-diabetes
condition. In fact scientists now believe that the atherosclerosis
(hardening of the arteries) associated with diabetes likely develops
during this insulin resistance period.
Type 2 (adult-onset) diabetes. The risk of type 2 diabetes increases
with the degree and duration of obesity. Type 2 diabetes is associated
with central obesity; a person with central obesity has excess fat around
his/her waist, so that the body is shaped like an apple.

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High blood pressure (hypertension). Hypertension is common among

obese adults. A Norwegian study showed that weight gain tended to
increase blood pressure in women more significantly than in men. The
risk of developing high blood pressure is also higher in obese people
who are apple shaped (central obesity) than in people who are pear
shaped (fat distribution mainly in hips and thighs).
High cholesterol (hypercholesterolemia)
Stroke (cerebrovascular accident or CVA)
Heart attack. A prospective study found that the risk of developing
coronary artery disease increased three to four times in women who had
a BMI greater than 29. A Finnish study showed that for every one
kilogram (2.2 pounds) increase in body weight, the risk of death from
coronary artery disease increased by one percent. In patients who have
already had a heart attack, obesity is associated with an increased
likelihood of a second heart attack.
Congestive heart failure
Cancer. While not conclusively proven, some observational studies
have linked obesity to cancer of the colon in men and women, cancer of
the rectum and prostate in men, and cancer of the gallbladder and uterus
in women. Obesity may also be associated with breast cancer,

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http://www.medicinenet.com/obesity_weight_loss/page2.htm

particularly in postmenopausal women. Fat tissue is important in the

production of estrogen, and prolonged exposure to high levels of
estrogen increases the risk of breast cancer.
Gallstones
Gout and gouty arthritis
Osteoarthritis (degenerative arthritis) of the knees, hips, and the lower
back
Sleep apnea

What Causes Obesity?

The balance between calorie intake and energy expenditure determines a
person's weight. If a person eats more calories than he or she burns
(metabolizes), the person gains weight (the body will store the excess energy
as fat). If a person eats fewer calories than he or she metabolizes, he or she
will lose weight. Therefore the most common causes of obesity are
overeating and physical inactivity. At present, we know that there are many
factors that contribute to obesity, some of which have a genetic component:
Genetics. A person is more likely to develop obesity if one or both
parents are obese. Genetics also affect hormones involved in fat
regulation. For example, one genetic cause of obesity is leptin
deficiency. Leptin is a hormone produced in fat cells, and also in the
placenta. Leptin controls weight by signaling the brain to eat less when
body fat stores are too high. If, for some reason the body cannot
produce enough leptin, or leptin cannot signal the brain to eat less, this
control is lost, and obesity occurs. The role of leptin replacement as a
treatment for obesity is currently being explored.
Overeating. Overeating leads to weight gain, especially if the diet is
high in fat. Foods high in fat or sugar (for example, fast food, fried food,
and sweets) have high energy density (foods that have a lot of calories
in a small amount of food). Epidemiologic studies have shown that diets
high in fat contribute to weight gain.

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A diet high in simple carbohydrates. The role of carbohydrates in

weight gain is not clear. Carbohydrates increase blood glucose levels,
which in turn stimulate insulin release by the pancreas, and insulin
promotes the growth of fat tissue and can cause weight gain. Some
scientists believe that simple carbohydrates (sugars, fructose, desserts,
soft drinks, beer, wine, etc.) contribute to weight gain because they are
more rapidly absorbed into the blood-stream than complex carbohydrates
(pasta, brown rice, grains, vegetables, raw fruits, etc.) and thus cause a
more pronounced insulin release after meals than complex
carbohydrates. This higher insulin release, some scientists believe,
contributes to weight gain.
Frequency of eating. The relationship between frequency of eating
(how often you eat) and weight is somewhat controversial. There are
many reports of overweight people eating less often than people with
normal weight. Scientists have observed that people who eat small
meals four or five times daily, have lower cholesterol levels and lower
and/or more stable blood sugar levels than people who eat less
frequently (two or three large meals daily). One possible explanation is
that small frequent meals produce stable insulin levels, whereas large
meals cause large spikes of insulin after meals.
Slow metabolism. Women have less muscle than men. Muscle burns
(metabolizes) more calories than other tissue (which includes fat). As a
result, women have a slower metabolism than men, and hence, have a
tendency to put on more weight than men, and weight loss is more
difficult for women. As we age, we tend to lose muscle and our
metabolism slows; therefore, we tend to gain weight as we get older
particularly if we do not reduce our daily caloric intake.
Physical inactivity. Sedentary people burn fewer calories than people
who are active. The National Health and Nutrition Examination Survey
(NHANES) showed that physical inactivity was strongly correlated with
weight gain in both sexes.
Medications. Medications associated with weight gain include certain
antidepressants (medications used in treating depression),

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anti-convulsants [medications used in controlling seizures such as

carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) and
valproate], diabetes medications (medications used in lowering blood
sugar such as insulin, sulfonylureas and thiazolidinediones), certain
hormones such as oral contraceptives and most corticosteroids such as
Prednisone. Weight gain may also be seen with some high blood
pressure medications and antihistamines.
Psychological factors. For some people, emotions influence eating
habits. Many people eat excessively in response to emotions such as
boredom, sadness, stress or anger. While most overweight people have
no more psychological disturbances than normal weight people, about 30
percent of the people who seek treatment for serious weight problems
have difficulties with binge eating.
Diseases such as hypothyroidism, insulin resistance, polycystic ovary
syndrome and Cushing's syndrome, are also contributors to obesity.

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