Obesity is characterized by excessive accumulation of body fat. It is clinically defined by measures that "estimate" adiposity based on body weight, body build, and height. (1)
No longer considered a cosmetic problem caused by overeating and a lack of self-control, the World Health Organization (WHO), along with national and international medical and scientific societies, now recognizes obesity as a chronic, progressive disease resulting from multiple environmental and genetic factors.
It is a number one risk factor, which can be controlled, and which is directly related to many diseases (called comorbidities) such as hypertension, diabetes, arteriosclerosis, embolisms, infertility, heart attacks and certain types of cancer.
Obesity management has become a key factor in preventing many diseases and treating many patients who already suffer from them.
Obesity is a risk factor for type 2 diabetes mellitus (T2DM). Therefore, there has been a parallel increase in the prevalence of T2DM, which currently stands at 91% of the population worldwide and is projected to reach 121% by 2025. Considering the growing population, the global burden of diabetes is likely to increase by more than 50% in the next decade. Metabolic abnormalities associated with obesity increase the risk of cardiovascular disease, including coronary artery disease and heart failure. (3)
Obesity is often the result of a combination of causes and contributing factors such as the following:
The genes you inherit from your parents can affect the amount of body fat you store and where that fat is distributed. Genetics can also play an important role in how efficiently your body converts food into energy, how your body regulates your appetite, and how your body burns calories during exercise.
Obesity tends to run in families. Not only because of shared genes, but also because family members tend to share similar eating and activity habits.
Unhealthy diet
A high-calorie diet, high-calorie beverages, and overly large portions contribute to weight gain.
Inactivity
If you lead a sedentary lifestyle, it's very easy to consume more calories each day than you burn through exercise and normal daily activities. Staring at computer, tablet, and phone screens is a sedentary activity. The number of hours you spend in front of a screen is highly associated with weight gain.
In some people, obesity may have a medical cause, such as Prader-Willi syndrome, Cushing's syndrome, or other disorders. Medical problems, such as arthritis, can also reduce physical activity, which can lead to weight gain.
Some medications can cause weight gain if not compensated for through diet or physical activity. These medications include some antidepressants, antiseizure medications, diabetes medications, antipsychotics, steroids, and beta-blockers.
There are social and economic factors linked to obesity. Similarly, you may not have been taught healthy cooking methods or may not have access to healthier foods. Additionally, the people you spend time with can influence your weight; you're more likely to develop obesity if you have obese friends or relatives.
Obesity can occur at any age, even in young children. However, as you age, hormonal changes and a less active lifestyle increase your risk of obesity. Likewise, the amount of muscle in your body tends to decrease with age.
Generally, decreased muscle mass leads to a slower metabolism. These changes also reduce your calorie needs, which can make it harder to avoid excess weight. If you don't consciously monitor what you eat and don't get more physical activity as you age, you're likely to gain weight.
PregnancyWeight gain is common during pregnancy. For some women, it's difficult to lose the weight they gained after giving birth. This weight gain can contribute to the development of obesity in women. Breastfeeding may be the best option for losing the weight gained during pregnancy.
Quit smokingQuitting smoking is often associated with weight gain. And for some people, it can lead to enough weight gain to qualify as obesity. This often happens when people use food to cope with smoking withdrawal. However, in the long term, quitting smoking is still a greater health benefit than continuing to smoke. Your doctor can help you prevent weight gain after quitting smoking.
Lack of sleepNot getting enough sleep or getting too much sleep can cause hormonal changes that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
StressMany external factors that affect mood and well-being can contribute to obesity. People often seek out more high-calorie foods when experiencing stressful situations.
MicrobialGut bacteria are affected by what you eat and can contribute to weight gain or difficulty losing weight.
Previous attempts to lose weightPrevious weight loss attempts followed by rapid weight regain can contribute to further weight gain. This phenomenon, sometimes called yo-yo dieting, can slow your metabolism.
Some of the diseases and complications related to Obesity are the following:
High blood pressureObesity is a major risk factor for high blood pressure. Approximately 3 out of 4 cases of high blood pressure are related to obesity (5). High blood pressure increases the risk of other diseases, including coronary heart disease, congestive heart failure, stroke, and kidney disease.
Varicose veins and phlebitisPhlebitis is an inflammation of a vein. When this inflammation is caused by a blood clot that partially or completely blocks a vein, we call it thrombophlebitis. It can occur superficially, in capillaries in the skin, or deep beneath the tissues of the dermis. Varicose veins are venous dilations characterized by preventing blood from effectively returning to the heart (venous insufficiency). They are caused by an alteration of the venous valves, which, when they do not close properly, cause blood to accumulate in the veins, causing them to dilate.
Venostasis in the lower extremitiesVenous stasis, or venostasis, is a condition involving slow blood flow in the veins, usually in the legs. Venous stasis is a risk factor for the formation of blood clots in the veins (venous thrombosis), such as deep vein thrombosis (DVT) in the deep veins of the legs.
Cardiac decompensationHeart disease kills about 600,000 people each year in the United States. The American Heart Association considers obesity a major risk factor for heart disease. Large studies show that the risk of heart disease increases with obesity (6). People with severe obesity have a higher risk of coronary heart disease. This means they have a higher risk of having a heart attack. Obesity increases your risk of heart failure. Severe obesity is associated with irregular heartbeats (arrhythmias). These arrhythmias can triple the risk of cardiac arrest. However, a little excess weight may protect against death from heart failure after the diagnosis is made (7).
Arterial sclerosisArteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from the heart to the rest of the body (arteries) become thick and stiff, sometimes restricting blood flow to organs and tissues. Healthy arteries are flexible and elastic, but over time, artery walls can harden, a condition commonly called hardening of the arteries.
Your excess fat increases your need for oxygen and simultaneously decreases your breathing capacity. This is why you may feel short of breath when you exert yourself. People with obesity have reduced lung capacity. These individuals are at greater risk for respiratory infections. They are more likely to have asthma and other respiratory disorders. Asthma has been shown to be three to four times more common among obese people (8).
Pickwick syndrome (respiratory failure) or Hypoventilation and obesity syndrome (OHSS): is a respiratory disease of obese people that causes low oxygen levels and too much carbon dioxide in the blood. The oxygen level is low and the carbon dioxide level is high because of a condition called daytime hypoventilation (diurnal hypoventilation). The three main characteristics of OHSS are: 1) obesity; 2) daytime hypoventilation (difficulty removing carbon dioxide); and 3) sleep-disordered breathing (such as obstructive sleep apnea syndrome). OHSS is also known as Pickwickian syndrome because people with OHSS may have symptoms like those described by Charles Dickens in his essay “The Posthumous Papers of the Pickwick Club.”
Sleep apnea (OSA)More than half of people affected by obesity (about 50-60 percent) have obstructive sleep apnea (OSA). In cases of severe obesity, this figure is around 90 percent (9). OSA is a very serious breathing disorder. OSA occurs when excess fat in the neck, throat, and tongue blocks air passages during sleep. This blockage causes apnea, which means a person stops breathing for a while. A person with OSA can have hundreds of apnea episodes each night. Apnea episodes reduce the amount of oxygen in a person's blood. OSA can lead to high blood pressure, pulmonary hypertension, and heart failure. OSA can cause sudden cardiac death and stroke. Because apnea episodes disrupt the normal sleep cycle, you may not be able to achieve restful sleep. This can lead to fatigue and drowsiness. If left untreated, this drowsiness can increase your risk of car accidents.
Drowsiness (sleepiness and tiredness due to lack of oxygen): is an exaggerated sleep pattern. It is a state in which there is a strong need to sleep or in which one sleeps for prolonged periods (hypersomnia).
Bronchitis: is an inflammation of the lower airways. It occurs when the bronchi, located between the lungs, become inflamed due to an infection or other causes.
Accumulation of pulmonary secretions
Pulmonary Embolism
Gallbladder stones
Cirrhosis of the liverLiver cirrhosis refers to scarring of the liver that results in abnormal liver function as a result of chronic (long-term) liver injury. Cirrhosis is a leading cause of illness and death in the United States. Approximately 5.5 million people (21% of the U.S. population) are affected by cirrhosis. The disease causes 26,000 deaths each year and is the seventh leading cause of death in the United States for adults between the ages of 25 and 64. The number of people affected by cirrhosis is expected to continue to increase in the near future.
Gastroesophageal reflux and heartburnGastroesophageal reflux disease (GERD) causes stomach acid or intestinal secretions to leak into the esophagus. Common GERD symptoms include heartburn, indigestion, vomiting, coughing (especially at night), hoarseness, and belching. Between 10 and 20 percent of the general population experience GERD symptoms regularly.
Obesity has been associated with an increased risk of GERD, erosive esophagitis, and, rarely, esophageal cancer (adenocarcinoma) (10).
Pancreatitis
Obesity, particularly severe obesity, contributes to a host of bone and joint problems. These problems can increase the risk of accidents and personal injuries. Bone and joint problems may include:
Stress Urinary Incontinence
Idiopathic intracranial hypertension (IHE)
Alzheimer's disease: Studies find that obesity during middle age may contribute to conditions that increase the risk of dementia and Alzheimer's disease later in life. (15).
Kidney diseaseHypertension, type 2 diabetes, and congestive heart failure are major contributors to kidney disease and kidney failure. All of these conditions are caused or worsened by obesity.
Suicide: Studies have shown a correlation between severe obesity and major depressive disorder (16)Obesity-related physical and social discrimination may contribute to this depression. Studies are mixed on whether obesity is associated with higher suicide rates. However, most studies seem to suggest lower suicide rates in people with obesity.
SepticemiaSepsis is a serious infection that can quickly lead to septic shock and death. Studies have shown that people with obesity, particularly severe obesity, are at increased risk for sepsis.
Liver diseaseObesity is the main cause of fatty liver disease and non-alcoholic fatty liver disease. Most people with severe obesity have non-alcoholic fatty liver disease. Fatty liver disease can cause scarring of the liver, which worsens liver function and can lead to cirrhosis and liver failure.
Obesity can have a dramatic impact on your body. Obesity-related conditions can be detrimental to your health. However, many of these complications can be prevented or cured through weight loss.
Cancer affects more than half a million lives each year in the United States alone. Obesity is believed to cause up to 90,000 cancer deaths per year. As your body mass index (BMI) increases, so does your risk of cancer and cancer death. These cancers include:
For people with severe obesity, the mortality rate increases for all types of cancer. The mortality rate is 52 percent higher for men and 62 percent higher for women. (17).
Cerebrovascular disease and stroke
Obesity puts pressure on your entire circulatory system. This strain increases your risk of stroke. Obesity can lead to other stroke risk factors. Stroke risk factors include heart disease, metabolic syndrome, hypertension, lipid abnormalities, type 2 diabetes, and obstructive sleep apnea. (18).
Medical Net – 4th Floor Calle Rafael Augusto Sánchez No. 4, Ens. Piantini, Santo Domingo, Dom. Rep.
Dr. Luis A. Betances Bariatric Institute ® All Rights Reserved ® 2024
Website by Ktech Solutions
