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Health problems associated with morbid obesity

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23/12/2006



The following health problems are associated with morbid obesity:

High Blood Pressure
Persistently elevated blood pressure, or hypertension is much more common in people who are obese. Hypertension can lead to the development of heart disease, kidney disease, stroke and arterial blockage.

Heart Disease
Heart disease, including heart attack and congestive heart failure, is six times more likely in obese persons. In fact, severely obese persons have 40 times the risk of dying suddenly from a heart attack, as compared to the non-obese.

High Cholesterol Levels
Obesity contributes to high blood cholesterol levels and thus to a higher incidence of heart disease and high blood pressure.

Diabetes
Diabetes mellitus, specifically adult-onset or type II diabetes is ten times more common in people who are obese.  Persistently elevated blood sugar causes tissue damage throughout the body, leading to kidney failure, blindness, heart attack, stroke, and arterial blockage in the legs which can result in amputation.

Respiratory Problems
People who are overweight often feel "winded" after slight physical exertion and need to stop and catch their breath. This is caused by a heavier-than-normal chest wall, which makes full expansion of the lungs more difficult. Any activity that requires a greater demand for oxygen will result in shortness of breath. Exercise or even daily activities, such as climbing stairs, housework, or running to catch a train, become difficult to perform.

The major breathing problems caused by severe obesity are sleep apnea syndrome and obesity hypoventilation syndrome. Sleep apnea is when a person stops breathing temporarily during sleep.  In an overweight person, this is caused by fat compressing the neck and blocking the windpipe, which causes loud snoring and periods of "not breathing". This results in poor quality and restless sleep due to the lack of oxygen and daytime drowsiness.

Most people are unaware that they have this problem, but the health effects can be devastating, including heart rhythm disturbances and even sudden death.


Gastroesophageal Reflux
Acid reflux or heartburn is common. Acid in the stomach is normally prevented from going back up the esophagus by a valve.  The valve can be overcome by increased pressure in the stomach eg a large meal.  A heavy belly only aggravates this condition.  Consequently, food and acid can wash back up into the esophagus and cause a burning sensation.  In severe cases, the food and acid can reach all the way up into the wind-pipe (trachea) and be inhaled, which can result in pneumonia.

Urinary Stress Incontinence
Many obese women experience urinary stress incontinence. This typically occurs when the bladder valve is overcome by the pressure of a heavy belly pressing against the bladder, combined with increased pressure from a cough, sneeze or laugh.

Degenerative Arthritis
Obesity can accelerate wear and tear of the lower back and weight-bearing joints (hips, knees, ankles, feet), leading to degenerative arthritis.  Arthritis in the lower back can lead to nerve compression and chronic pain.  Arthritis in the joints can cause problems with walking and may eventually require joint replacement surgery.  However, many orthopedic surgeons refuse to perform surgery in severely overweight patients, until they lose much of their weight.

Cancer
Studies have shown that overweight women have a higher risk of cancer of the breast, uterus, and ovaries. Obese men have a higher risk of having esophageal, colon and prostate cancer.

Skin Infections
Many overweight persons have skin that folds over on itself.  The areas within the creases can become irritated from sweating and chafing, often leading to infections despite frequent bathing, and causes pain and discomfort.  Skin cuts created from bra straps can also cause pain and become infected.

Infertility
The excess fat in women plays a significant role in changing the levels of estrogen and progesterone, resulting in irregular menstrual cycles and infertility. This is reversible once weight loss is achieved. In fact, women who lose weight should take birth-control precautions if pregnancy is not desired.


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SPIRE Hospital, Bristol. 
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