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Obesity-Related Health Conditions
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, can cause endless frustration and can seriously shorten your life. Co-morbidities or Obesity-related health conditions include:
Heart Disease Severely obese people are approximately 6 times as likely to develop heart disease as those whose weight is considered normal. 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 people 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 people, and leads to development of heart disease and damage to the blood vessels throughout the body. This causes susceptibility to strokes, kidney damage, and hardening of the arteries.
High Blood Cholesterol Cholesterol levels are commonly elevated in the severely obese - another factor predisposing the development of heart and blood vessel disease.
Diabetes Mellitus Overweight people are 10 times as likely to develop Type II (Adult-Onset) Diabetes. Elevation of the blood sugar 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. It is the Number Three cause of death in the United States.
Sleep Apnoea Syndrome Sleep apnoea - the stoppage of breathing during sleep - commonly occurs in the obese when the neck is compressed, causing 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 he 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, including high blood pressure, cardiac rhythm disturbances, and sudden death. Affected people awaken exhausted and often fall asleep during the day - sometimes even while driving. This condition 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 waking hours, and is caused by abnormalities in breathing and accumulation of toxic levels of carbon dioxide in the blood. It is often associated with sleep apnoea, and may be hard to distinguish from it.
Respiratory Insufficiency Obese people find that exercise causes them to be out of breath very quickly. The lungs are decreased in size, and the chest wall is very heavy and difficult to lift. 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, and can be completely debilitating.
Heartburn - Reflux Disease and Reflux Nocturnal Aspiration Acid belongs in the stomach and 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 "heartburn" or "acid indigestion." The real problem is not with digestion, but with the burning of the esophagus by the powerful stomach acid. 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, violent coughing and gasping. This condition is dangerous, because of the possibility of pneumonia or lung injury. The esophagus may become 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 does not itself cause asthma or bronchitis directly, but it does interfere with breathing. Gastroesophageal reflux caused by obesity may seriously aggravate asthma, and may cause severe bronchitis.
Gallbladder Disease Gallbladder disease occurs several times as frequently in the obese, in part due to repeated efforts at dieting. 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. This may lead to leakage of urine when a person coughs, sneezes, or laughs. This condition is usually relieved through weight loss.
Degenerative Disease of the Spine Because the entire weight of the upper body falls on the base of the spine, being overweight causes the spine to wear out or even fail. The consequence may be accelerated arthritis of the spine, or a "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 normally 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. For this reason, 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, and 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.
Emotional/Psychological Disease Seriously overweight people face constant challenges with 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 theater seats, or a ride in a bus or airplane. 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 Seriously obese people suffer an inability to qualify for many types of employment, and also experience discrimination in employment opportunities. They tend to have higher rates of unemployment and a lower socioeconomic status. Ignorant people 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 people find it preferable to avoid social interactions or public places, choosing to limit their own freedom, rather than suffer embarrassment.
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