Society has an oversimplified and myopic view that obesity is a personal choice or moral failure. Obese people are often stigmatized, and exposed to public disapproval and discrimination. Obesity is not a moral failing but a complex disease with the interplay of many factors – Inherited, physiological, environmental, and lifestyle choices. Hence it is difficult for some people to lose weight.
Obesity increases the risk of diseases and health problems. There is a striking reduction in life expectancy. However, the good news is that even a modest reduction in weight can improve or prevent problems.
What are the Criteria for Overweight or Obesity?
Body mass index (BMI) is used to diagnose Overweight and Obesity and is calculated by dividing weight in kilograms by height in meters squared.
| Whites, Hispanixcs, Blacks | Indians | Asians | |
| Overweight | BMI ≥ 25.0-29.9 kg/m2 | BMI ≥ 23 to 24.9 kg/m2 | BMI ≥ 23 to 24.9 kg/m2 |
| Pre-Obese | BMI ≥25 to 29.9 kg/m2 | ||
| Obesity | BMI ≥ 30.0 and higher Kg/m2 | BMI ≥30 kg/m2 | BMI ≥ 25 kg/m2 |
What are the health consequences of obesity?
Obesity is a ticking time bomb waiting to go off. Along with diminishing the overall quality of life Obesity can cause various health problems and some can be serious. These health problems include:
Diabetes mellitus
More than 80 percent of cases of type 2 diabetes can be attributed to obesity. Insulin resistance has been attributed to overweight and Obesity along with other factors such as overeating, sedentary lifestyle, and genetics.
Changes in lipid metabolism
Obesity can result in:
- High blood levels of triglycerides and bad cholesterol – low-density lipoprotein (LDL) cholesterol and very-low-density lipoprotein (VLDL) cholesterol can increase the risk of clogged arteries causing a heart attack, stroke.
- A reduction in good cholesterol – High-density lipoprotein (HDL) cholesterol. Good cholesterol is needed to remove excess bad cholesterol {Low-density lipoprotein (LDL-C)} by attaching to it and returning it to the liver where bad cholesterol is broken down. This also increases the risk of clogged arteries causing a heart attack, stroke
High Blood Pressure
The amount of work your heart and blood vessels must do is increased to meet the energy needs if the body mass is higher. This can make the blood vessels stiffer with an increase in pressure. The risk of hypertension is greatest in people with upper body and abdominal obesity.
Heart disease
Obesity is associated with an increased risk of:
- Coronary artery disease – The frequent coexistence of other cardiovascular risk factors with obesity such as diabetes, hypertension, and high cholesterol levels contribute to the clogging of the coronary arteries, the arteries that supply the blood to the heart. When the blood supply to the heart is compromised, it will lead to Angina, and heart attack.
- Other heart disease includes Heart failure because of the increased workload by the heart to meet the needs; fat accumulation in the heart; Heart rhythm disorder called atrial fibrillation due to an increase in the size of the left atrium, one of the chambers of the heart
Stroke
Plaque formation or clogging of arteries supplying the brain is increased with cardiovascular risk factors such as Obesity, Hypertension, and Diabetes. The clogging of these arteries can compromise the blood supply to the brain causing a stroke.
Deep vein thrombosis
Deep vein thrombosis is a condition that occurs when the clots form in deep veins of the body, usually in the legs. Several studies have found a significantly increased risk for deep vein thrombosis, and/or pulmonary embolism in obese people, and the risk is reduced in underweight people.
Cancer
There is strong evidence supporting the association between obesity and cancers – Uterine cancer, Kidney cancer, Colorectal cancer, Ovarian cancer, Breast cancer, multiple myeloma, Liver cancer, and Stomach cancer. The mechanisms include alterations in sex hormone metabolism; insulin and insulin-like growth factor levels.
Osteoarthritis
Osteoarthritis is a condition wherein protective cartilage that cushions the ends of the bones wears down over time. Obesity is a risk factor for the development of osteoarthritis and studies have shown that weight loss is associated with a decreased risk of osteoarthritis.
Gout
Increased fat deposition and weight gain are risk factors for incident gout. Weight loss in overweight people is likely beneficial in reducing blood urate levels and gout symptoms in people with established gout.
Gall bladder disease and Nonalcoholic Fatty liver disease (NAFLD)
There is an increased risk of gall stones with obesity. Nonalcoholic fatty liver is a condition with no history of alcohol use that resembles alcohol-induced liver injury with fat accumulation in the liver cells. Increased delivery of triglycerides to the liver as seen with obesity; excessive conversion of carbohydrates and proteins to triglycerides secondary to overfeeding leads to NAFLD.
Reproductive effects
Irregular and absence of ovulatory menstrual cycles are common in obese women. Pregnancy complications are increased in people with Obesity.
Kidney disease, Kidney stones and Urinary incontinence
Obesity along with other commonly associated risk factors such as Hypertension, Diabetes, metabolic syndrome can cause compromised kidney function. There is an increased risk of kidney stones with Obesity. Women who are obese are also at increased risk of Urinary incontinence.
Sleep apnea
Sleep apnea is a sleep-breathing disorder. The risk correlates well with the Body mass index. There was a six-fold increase in the risk of sleep apnea with a 10 percent increase in weight, as per one study.
Psychosocial issues
- There is an increased risk of depression, especially in younger women.
- Obese people are also at increased risk of dementia (loss of memory, language, and problem-solving)
The takeaway message
Obesity, a chronic disease, should be addressed to prevent complications. It is important to set clear behavioral goals and find people around you who support your weight loss. You can start off with first by trying to avoid gaining more weight. You can create milestones and health-related goals once you know your starting point. Work with your healthcare provider who can assist and guide you to lose weight in safe and effective ways.
