| Health
Hazards of Morbid Obesity |
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Health
Hazards of Morbid Obesity |
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| Severe obesity damages the
body by its mechanical, metabolic and physiological adverse
effects on normal bodily function. These "co-morbidities"
affect nearly every organ in the body in some way, and produce
serious secondary illnesses, which may also be
life-threatening. The cumulative effect of these
co-morbidities can interfere with a normal and productive life
and can seriously shorten life, as well. The risk of
developing these medical problems is proportional to the
degree of obesity. |
| Years
of life lost |
| People who are obese do not live
as long as those who are not obese and the earlier a person
become obese; the more years of life are lost. A recent study in
the Annals of Internal Medicine (Jan 2003) concluded that
obesity and overweight are associated with large decreases in
life expectancy and increases in early death. |
- Forty year old female nonsmokers lost 7.1 years of life because of obesity
- Forty year old male nonsmokers lost 5.8 years because of obesity
- Obese female smokers lost 13.3 years & obese male smokers lost 13.7 years compared with normal weight nonsmokers |
| People who are obese are at greater risk of
death from cancer. In the United States, compared to people of a
healthy weight, people who are Obese (BMI of 30-34.9) have a 9%
(men) or 23% (women) increased risk of death from cancer. Very
obese (BMI of 35-39.9) have a 20% (men) or 32% (women) increased
risk of death from cancer. |
| Dysmetabolic
Syndrome X |
| This recently recognized syndrome
involving abdominal obesity, abnormal blood fat levels, changes
in insulin sensitivity and inflammation of the arteries is
associated with a markedly increased risk of heart and blood
vessel disease. It is also a precursor to the onset of Diabetes
in adults. |
| Heart Disease |
| Severely
obese persons are approximately 6 times as likely to develop
heart disease as those who are normal-weighted. Heart disease is
the leading cause of death today and obese persons tend to
develop it earlier in life and it shortens their lives. Coronary
disease is pre-disposed by increased levels of blood fats and
the metabolic effects of obesity. Increased load on the heart
leads to early development of congestive heart failure. Severely
obese persons are 40 times as likely to suffer sudden death, in
many cases due to cardiac rhythm disturbances. |
| High
Blood Pressure |
| Essential hypertension, the
progressive elevation of blood pressure, is much more common in
obese persons and leads to development of heart disease, and
damage to the blood vessels throughout the body, causing
susceptibility to strokes, kidney damage, and hardening of the
arteries. If your doctor finds you have high blood pressure, the
first thing he or she will recommend to you is weight loss (but
doctors have never been able to tell : How? |
| High
Blood Cholesterol |
| Cholesterol levels are commonly
elevated in the severely obese -- another factor predisposing to
development of heart and blood vessel disease. This abnormality
is not just related to diet, but is an effect of the massive
imbalance in body chemistry which obesity causes. |
| Diabetes
Mellitus |
| Overweight persons are 40 times as likely
to develop Type-2, Adult-Onset, diabetes (earlier called non
insulin dependent). Elevation of the blood sugar, the essential
feature of diabetes, leads to damage to tissues throughout the
body: Diabetes is the leading cause of adult-onset blindness, a
major cause of kidney failure and the cause of over one half of
all amputations. Diabetics suffer severely from their disease
and once Diabetes occurs, it becomes even harder to lose weight,
because of hormone changes which cause the body to store fat
even more than before. |
| Sleep Apnea Syndrome |
| Sleep apnea - the stoppage of breathing during
sleep -- is commonly caused in the obese, by compression of the
neck, closing the air passage to the lungs. It leads to loud
snoring, interspersed with periods of complete obstruction
during which no air gets in at all. The sleeping person sounds
to an observer like he is holding his breath, but the sleeper
is, himself, usually unaware that the problem is occurring at
all, or only notices that he sleeps poorly and awakens
repeatedly during the night. The health effects of this
condition may be severe, high blood pressure, cardiac rhythm
disturbances and sudden death. Affected persons awaken exhausted
and often fall asleep during the day, sometimes even at the
wheel of their car, and complain of being tired all the time.
This condition really has a high mortality rate, and is a
life-threatening problem. |
| Obesity
Hypoventilation Syndrome |
| This condition occurs
primarily in the very severely obese -- over 350 lbs. It is
characterized by episodes of drowsiness, or narcosis, occurring
during awake hours and is caused by abnormalities of breathing
and accumulation of toxic levels of carbon dioxide in the blood.
It is often associated with sleep apnea, and may be hard to
distinguish from it |
| Respiratory Insufficiency |
| Obese persons find that exercise causes them to be
out of breath very quickly and even during ordinary activities.
The lungs are decreased in size, and the chest wall is very
heavy and difficult to lift. At the same time, the demand for
oxygen is greater, with any physical activity. This condition
prevents normal physical activities and exercise, often
interferes with usual daily activities, such as shopping,
yard-work or stair climbing, making even ordinary living
difficult or miserable, and it can become completely disabling. |
| Heartburn
- Reflux Disease and Reflux Nocturnal Aspiration |
| Acid
belongs to the stomach, which makes it to help digest food, and
it seldom causes any problem when it stays there. When it
escapes into the esophagus, through a weak or overloaded valve
at the top of the stomach, the result is called “gastro-esophageal
reflux”. The real problem is not with digestion, but with
the burning of the esophagus by the powerful stomach acid,
getting to where it doesn't belong. When one belches, the acid
may bubble up into the back of the throat, causing a fiery
feeling there as well. Often this occurs at night, especially
after a large or late meal and if one is asleep when the acid
regurgitates, it may actually be inhaled, causing a searing of
the airway, and violent coughing and gasping. |
| This
condition is dangerous, because of the possibility of pneumonia
or lung injury. The esophagus may become strictured, or scarred
and constricted, causing trouble with swallowing. Approximately
10 - 15% of patients with even mild sporadic symptoms of
heartburn will develop a condition called Barrett's esophagus,
which is a pre-malignant change in the lining membrane of the
esophagus, a cause of esophageal cancer |
| Asthma
and Bronchitis |
| Obesity is associated with a higher
rate of asthma, about 3 times normal. Much of this effect is
probably due to acid reflux (described above), which can
irritate a sensitive airway and provoke an asthmatic attack. The
improvement of asthma after surgery is often very dramatic, even
before much weight loss has occurred. |
| Gallbladder
Disease |
| Gallbladder disease occurs several times
as frequently in the obese, in part due to repeated efforts at
dieting, which predispose to this problem. When stones form in
the gallbladder, and cause abdominal pain or jaundice, the
gallbladder must be removed. |
| Stress Urinary
Incontinence |
| A large heavy abdomen and relaxation
of the pelvic muscles, especially associated with the effects of
childbirth, may cause the valve on the urinary bladder to be
weakened, leading to leakage of urine with coughing, sneezing,
or laughing. This condition is strongly associated with being
overweight, and is usually relieved by weight loss. |
| Degenerative
Disease of Lumbo-Sacral Spine |
| The entire weight of
the upper body falls on the base of the spine and overweight
causes it to wear out, or to fail. The consequence may be
accelerated arthritis of the spine, or "slipped disk",
when the cartilage between the vertebrae squeezes out. Either of
these conditions can cause irritation or compression of the
nerve roots and lead to sciatica -- a dull, intense pain down
the outside of the leg. |
| Degenerative Arthritis
of Weight-Bearing Joints |
| The hips, knees, ankles
and feet have to bear most of the weight of the body. These
joints tend to wear out more quickly, or to develop degenerative
arthritis much earlier and more frequently, than in the
normal-weighted person. Eventually, joint replacement surgery
may be needed to relieve the severe pain. Unfortunately, the
obese person faces a disadvantage there too -- joint replacement
has much poorer results in the obese and complications are more
likely. Many orthopedic surgeons refuse to perform the surgery
in severely overweight patients |
| Venous Stasis
Disease |
| The veins of the lower legs carry blood
back to the heart. They are equipped with an elaborate system of
delicate one-way valves, to allow them to carry blood "uphill".
The pressure of a large abdomen may increase the load on these
valves, eventually causing damage or destruction. The blood
pressure in the lower legs then increases, causing swelling,
thickening of the skin, and sometimes ulceration of the skin.
Blood clots also can form in the legs, further damaging the
veins, and can also break free and float into the lungs --
called a Pulmonary Embolism -- a serious or even fatal event. |
| Emotional
/ Psychological Illness |
| Seriously overweight
persons face constant challenges to their emotions: repeated
failure with dieting, disapproval from family and friends,
sneers and remarks from strangers. They often experience
discrimination at work, and cannot enjoy theatre seats, or a
ride in a bus or airliner. The severely overweight person takes
challenges even in small routine acts like that others cannot
fathom. Many may be on starvation diet but friends and relatives
scrutinize their eating habits – convinced that that are
sneaking food. They cannot perform simple things ; walking up
stairs or tying shoes is a major ordeal. Stereotypes of obese
people – such as that they are lazy – may result in
lower self esteem and poor body image. There is no wonder that
anxiety and depression might accompany years of suffering from
the effects of a genetic condition -- one which skinny people
all believe should be controlled easily by will power. |
| Social
Effects |
| Severely obese persons suffer inability to
qualify for many types of employment, and discrimination in
employment opportunities, as well. They tend to have higher
rates of unemployment, Ignorant persons often make rude and
disparaging comments, and there is a general societal belief
that obesity is a consequence of a lack of self-discipline, or
moral weakness. Many severely obese persons find it preferable
to avoid social interactions or public places, choosing to limit
their own freedom, rather than suffer embarrassment. |
