Obesity-Related Conditions From A-Z
It is not uncommon that people affected by morbid obesity, defined as a body mass index of 40 or greater, also deal with obesity-related illnesses. Once a patient is considered morbidly obese, these conditions become serious health risks. These diseases also negatively impact the quality of life for obese patients and their families. In this article, I have listed common conditions affecting the obese and morbidly obese. Many of these co-morbidities are serious and may even be as life threatening as obesity itself.
Cancer: Cancer involves the uncontrolled growth of abnormal cells that have mutated from normal tissues. These cells prevent normal function of vital organs, damaging essential systems. Recent studies suggest that those with a Body Mass Index (BMI) more than 40 (morbidly obese) had death rates from cancer that were 52 percent higher for men and 62 percent higher for women, as compared to rates for normal-weight men and women. In both men and women, higher BMI is associated with higher death rates from cancers of the esophagus, colon and rectum, liver, gallbladder, pancreas and kidney. The same trend applies to cancers of the stomach and prostate in men, and cancers of the breast, uterus, cervix and ovaries in women. Almost half of post-menopausal women diagnosed with breast cancer have a BMI greater than 29. One study indicates that women who gain more than 20 pounds from age 18 to midlife double their risk of breast cancer, compared to women whose weight remained stable.
Diabetes: Diabetes is a life-long disease marked by high levels of sugar in the blood. It can be caused by too little insulin (a hormone produced by the pancreas to regulate blood sugar), resistance to insulin or both. Among those diagnosed with type 2 (non insulin-dependent) diabetes, 67 percent have a BMI greater than 27 and 46 percent have a BMI greater than 30. Nearly 17 million people in the U.S. have type 2 diabetes, accounting for more than 90 percent of diabetes cases. An additional 20 million have impaired glucose tolerance, sometimes called pre-diabetes, which is a strong risk factor for developing diabetes later in life. An estimated 70 percent of diabetes risk in the U.S. can be attributed to excess weight.
Gallbladder Disease: Gallbladder disease includes inflammation, infection, stones or obstruction of the gallbladder. Gallstones can also cause blockages in the bile system, leading to pancreatitis, a potentially fatal inflammation of the pancreas.
Gastroesophageal Reflux Disease: (GERD) is a digestive disorder that affects the lower esophageal sphincter (LES), and causes injury to the esophagus from chronic exposure to stomach acid. The LES is the muscle connecting the esophagus with the stomach, allowing food to pass through. Heartburn, which is commonly a result of GERD, is a painful burning sensation in the esophagus, just below the breastbone. The pain often rises in your chest and may radiate to your neck or throat. Studies have shown that the higher the BMI of the patient, the worse the reflux symptoms were for both men and women, although the association was stronger in the female group. Severely obese men (those with a BMI more than 35) were 3.3 times more likely to have reflux symptoms than men of normal weight. Severely obese women, however, were 6.3 times more likely to have these same symptoms than women of normal weight.
Heart Disease: Heart disease is any disorder that affects the heart’s ability to function normally. The most common cause of heart disease is narrowing or blockage of the coronary arteries, which supply blood to the heart. Excess weight causes an increased strain on the body requiring a greater cardiac workload at a given level of activity compared to non-obese individuals. Obesity is also known to increase patients’ risk of heart failure, produce irregular and fatal heart rhythms and lead to heart attacks or sudden death.
High Cholesterol: Lipid disorders are when you have excess fatty substances in your blood. These substances include cholesterol and triglycerides. Having a lipid disorder makes you more likely to develop hardening of the arteries of the heart, legs, and brain. This hardening, known as peripheral vascular disease, is directly related to heart attacks, poor leg circulation, and stroke.
High Blood Pressure: Blood pressure is measured in millimeters of mercury (mm Hg). Hypertension (high blood pressure) is when your blood pressure frequently goes higher than 140/90 mm Hg. About one in every five adults in the U.S. has high blood pressure. High blood pressure occurs more often in men than in women. In addition, African Americans are affected almost twice as much as Caucasians. More than 75 percent of hypertension cases are reported to be directly attributed to obesity.
Osteoarthritis: Osteoarthritis is a chronic disease causing deterioration of the joint cartilage (the softer parts of bones which cushion their connections to each other) and the formation of new bone (bone spurs) at the margins of the joints. More than 70 percent of women and 35 percent of men with OA of the knee are overweight. It is characterized by pain at the knee on beginning motion, such as arising from a chair, and increased pain with prolonged use. In the early stages of OA, the pain is relieved by rest, but as the disease progresses, the pain can persist after activity, and even interfere with sleep.
The American College of Rheumatology recommends weight-loss and exercise to reduce the painful and incapacitating effects of OA. A weight-loss of 5 percent of body weight in obese older adults brought a gain in overall function of 18 percent in a recent study. There was a significant association between the weight-loss and reduction in compressive knee joint loads. The force reduction was four times greater than the actual weight reduction. In other words, for every pound lost, there is a four pound reduction in the load exerted on the knee for each step taken.
Psychological Depression: Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods. True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended time. One recent study found that overall, obese individuals have a 20 percent elevated risk of depression, and specifically for Caucasian college-educated people with obesity, the depression risk rises to as high as 44 percent. Although females with obesity have previously been found to suffer more depression, this study showed that there were no differences between sexes.
Sleep Apnea: Sleep apnea is a condition characterized by episodes of stopped breathing during sleep. There is a direct correlation between obesity and sleep apnea. The cumulative effect can lead to chronic sleepiness, trouble concentrating and even depression. The body’s repeated lack of restorative sleep over an extended period can also lead to more serious problems as well, including high blood pressure, heart attack, stroke, lung disorders, and memory disturbances.
Those who are affected by obesity and morbid obesity are encouraged to talk with their physician concerning the co-morbidities listed here. The earlier these are detected, the easier it is to keep them under control with the assistance of a physician. We have found that decreasing ones body weight by as little as 5-10% can result in significant reduction of the medical complications of obesity.
Dr. Linda G. Everett is pleased to announce the recent opening of The Center for Medical Weight Loss. As a practicing Internist, she sees the effects of obesity on a daily basis and decided to start taking a proactive approach to the epidemic. At The Center, she offers rapid, long-lasting weight loss even for the most difficult cases. Unlike commercial programs, Dr. Everett is able to use products and techniques only available to medical doctors. These include FDA approved prescription appetite suppressants, medically prescribed low calorie diets, and metabolic enhancing injections. Emphasis is also placed on behavior modification and exercise, which is the key to long term weight management. Dr. Everett conducts one on one counseling sessions with each patient at every visit and monitors all medical conditions that may be affected by rapid weight loss.
Since insurance coverage for the treatment of obesity is variable, insurance is not accepted for care at The Center, but she does provide the necessary information so that eligible patients can submit their own claims for reimbursement.
Dr. Everett received her undergraduate degree at Johns Hopkins University, and her Medical Degree at Jefferson Medical College. She also has a Masters in Healthcare Administration from Widener University. She completed her residency in Internal Medicine at Christiana Hospital in Newark, DE. Dr. Everett is board certified in Internal Medicine, and has received extensive additional training in bariatrics. She is a member of the American Society of Bariatric Medicine, and the American College of Physicians.
The Center for Medical Weight Loss is located at 2217 Baltimore Pike, Oxford, PA. For more information or to schedule an appointment, call 610-467-0446.