A healthy weight sets the stage for bones, muscles, brain, heart, and others to play their parts smoothly and efficiently for many years. Obesity, diminishes almost every aspect of health, from reproductive and respiratory function to memory and mood. Obesity increases the risk of several debilitating, and deadly diseases, including diabetes, heart disease, and some cancers (CDC 2022). It does this through a variety of pathways, some as straightforward as the mechanical stress of carrying extra pounds and some involving complex changes in hormones and metabolism.
Obesity and Diabetes
Weight gain during adulthood increases diabetes risk, even among women with BMIs in the healthy range.
In a systematic review of 89 studies on weight-related diseases, a statistical summary of the data showed diabetes was at the top of the risk list. They compared men and women in the normal weight range (BMI lower than 25), men with BMIs of 30 or higher had a sevenfold greater risk of developing type 2 diabetes, and women with BMIs of 30 or higher had a 12-fold higher risk.
Fat cells, especially those stored around the waist,secrete hormones and other substances that promote inflammation. Inflammation can make the body less responsive to insulin and change the way it metabolizes fats and carbohydrates, leading to higher blood sugar levels and, eventually, diabetes and its many complications.
Obesity and Cardiovascular Disease
Obesity is an independent risk factor for cardiovascular disease (CVD) and one of the main causes of the increased risk of diseases such as dyslipidemia, insulin resistance, high blood pressure (HBP) or hypertension, and atherosclerosis both in adults and children (Cercato & Fonseca, 2019)
Pathogenesis of atherosclerosis
Obesity and increased adipose tissue infuence . Adiponectin is a peptide produced in adipose tissue, that is expressed at high levels by lean, healthy people and becomes dysregulated in obesity, The dysregulations are contributing factors to the imbalance of body homeostasis and pro- and anti-infammatory mechanisms, which contribute to obesity‐induced metabolic complications and vascular breakdown leading to cardiometabolic alteration (Cercato & Fonseca, 2019). Coronary calcifcation is a result of the atherosclerotic inflammatory process, and is associated with obesity.
Ischemic Stroke
A meta-analysis of 25 prospective cohort studies with 2.3 million participants demonstrated a direct, graded association between excess weight and stroke risk. Overweight increased the risk of ischemic stroke by 22 percent, and obesity increased it by 64 percent. There was no significant relationship between overweight or obesity and hemorrhagic (bleeding-caused) stroke (Harvard T.H.Chan School of Public Health, 2021).
Cardiovascular mortality
Obesity is significantly associated with death from CAD and cardiovascular disease. Women with BMIs of 30 or higher had a 62 percent greater risk of dying early from CAD and also had a 53 percent higher risk of dying early from any type of cardiovascular disease, compared with women who had BMIs in the normal range (18.5 to 24.9). Men with BMIs of 30 or higher had similarly elevated risks. (Harvard T.H.Chan School of Public Health, 2021).
Obesity, Depression, and Quality of Life
An analysis of 17 cross-sectional studies found that people who were obese were more likely to have depression than people with healthy weights. Although a biological link between obesity and depression has not yet been definitively identified, possible mechanisms include activation of inflammation, changes in the hypothalamic-pituitary-adrenal axis, insulin resistance, and social or cultural factors. (Harvard T.H.Chan School of Public Health, 2021).
Other systems
Obesity can influence various aspects of reproduction, from sexual activity to conception. Among women, the association between obesity and infertility, primarily ovulatory infertility. Excess weight impairs respiratory function via mechanical and metabolic pathways. The accumulation of abdominal fat, for example, may limit the descent of the diaphragm, and in turn, lung expansion, while the accumulation of visceral fat can reduce the flexibility of the chest wall, sap respiratory muscle strength, and narrow airways in the lung. (Harvard T.H.Chan School of Public Health, 2021).
Excess weight places mechanical and metabolic strains on bones, muscles, and joints. In the United States, an estimated 46 million adults (about one in five) report doctor-diagnosed arthritis. (1) Osteoarthritis of the knee and hip are both positively associated with obesity, and obese patients account for one-third of all joint replacement operations
Non alcoholic fatty liver disease fast becoming the key reason for liver transplantation is directly related to Obesity (Harvard T.H.Chan School of Public Health, 2021).
Comorbidities of Obesity by System
Cardiac/vascular
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Pulmonary
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Psychological
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Musculoskeletal
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GI
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Endocrine
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Metabolic
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Neurologic
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Dermatologic
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GU
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Neoplastic
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References
Centers for Disease Control and Prevention. (2022). Health effects of overweight and obesity. Centers for Disease Control and Prevention. Retrieved April 1, 2022, from https://www.cdc.gov/healthyweight/effects/index.html
Cercato, C., & Fonseca, F. A. (2019). Cardiovascular risk and obesity. Diabetology & metabolic syndrome, 11, 74. https://doi.org/10.1186/s13098-019-0468-0
Harvard T.H.Chan School of Public Health (2021). Obesity Prevention Source https://www.hsph.harvard.edu/obesity-prevention-source/
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