Top 10 health hazards of obesity

In a series of articles for rediff.com, weight loss expert Dr Vidyut Sodha shares his insights on obesity.

Obesity can lead to a lot of health issues. Weight loss expert Dr Vidyut Sodha spells out the dangers of being obese.

1. Diabetes mellitus type 2 (dm 2)

Type 2 Diabetes is a state where there is an insulin resistance in the body leading to high insulin and high glucose levels in the blood, due to obesity problems it is estimated that at present 90% of diabetic cases are obese. In a normal state the pancreas release insulin to control the sugar levels in the body, but as we become overweight the demand for insulin increases and ultimately the pancreas cells burn out and cannot keep up the demand, in which case the sugars become resistant to the insulin and therefore there is a diabetic like state termed as Type 2 Diabetes. It is said that with just 15% weight loss this diabetes can be eliminated all together.

Medications used to control diabetes often cause weight gain

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2. Cardiovascular diseases

Obesity is defined as an independent risk factor of Cardiovascular Disease(CVD),defined as Coronary Heart disease(CHD),Myo Cardial Infraction(MI),Congestive Heart Failure(CHF)Hypertension,Atrial Fibrillation and stroke. The Framingham Heart study showed obesity to increase CVD by 1.46 times in males and 1.64 times in females. Also the risk of Hypertension was 2,21 times in male and 2.75 in females. a weight increase of just 14 kgs doubles the load on the heart.

Cardiovascular system manifestations associated with obesity include:

• Increase blood volume
• Increase Cardiac Output
• Increase stroke Volume
• Increase heart rate
• Increase left ventricular filling and pressure (especially exercise)
• Increased Left atrial hypertrophy
• Increased left ventricular Hypertrophy
• Fatty Heart
• ECG Changes

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3. Hypertension (blood pressure)

The prevalence of Hypertension is about 6 times more frequent in the obese and a majority of people with hypertension are overweight. A 10 kg higher weight is associated with a 3 mm higher Systolic and 2.3 mm higher diastolic bold pressure.

An increased in BMI 25 to 30 kg /M2 is associated with an increased prevalence of Hypertension from 15% to 40%. Increase in BMI is associated with a 1.4 times higher risk in Blood pressure. Weight loss is associated with a reduction in blood pressure. In more than 50 % of individuals, blood pressure decreases an average of 1-4 mm HG Systolic and 1-2 Diatolic per Kg of weight reduction.

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4. Metabolic syndrome (mets)

Metabolic Syndrome was first described by Reaven and is associated with an increased of mortality from CVD.

Diagnostic criteria for metabolic syndrome 3 out 5 of the following:

• Abdominal obesity (Waist circumference )= 40 Inches in men >35 Inches in women
• Triglycerides>=150 mg/dg
• HDL <=40mg/dl in males and <= 50 mg/dl in females
• Blood Pressure   >=130/80mmHg
• Fasting glucose   >=100mg/Dl

Weight reduction even as little as 8 kgs has been shown to lower the prevalence of Mets significantly.

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5. Cancer

Numerous studies have shown a correlation between obesity and the risk of developing or dying from cancer. The million women study showed a significant increase in the incidence of cancer and cancer mortality. Cancers associated with obesity are:

• Leukemia
• Multiple Myeloma
• Non Hodgkin's Lymphoma
• Cancer of Endometrium
• Oesphagus
• Kidney cancer
• Breast Cancer (Post Menopausal women)
• Colon /Rectum Cancer (In pre-menopausal women)
• Prostate cancer

A prospective study in the USA involving 900,000 subjects for more than 15 years, showed those with a BMI >39.9 had a 50%-60% increase in overall Cancer mortality and more specifically with higher death rates from Cancer of the colon and rectum.

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6. Osteoarthritis (OA)

Osteroarthritis is a common problem which leads to decreased mobility ,lost productivity, chronic pain and disability.

Obesity has been shown to increase the risk of Osteoarthritis especially in the knee and hip joints. In Rotterdam study over 61/2 years it was found that the risk of Rotterdam was 3 times more with people of Bmi  > 27 kg/mg.Weight loss has been shown to significantly reduce the signs and symptoms of OA and improve functional capacity and quality of life in afflicted obese patients.

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7. Non-alcoholic fatty liver disease (NAFLD)

Non-alcoholic fatty liver disease affects 15-30% of general population up to 70%of patients with dn2. Nafd is associated with obesity hypertension and dyslipidemia.

In one Multivarate study and increased BMI(>26.9)was shown to be the main variable associated with NAFLD. BMI > 30 and the lack of physical fitness were shown to be significantly and independently associated with NAFLD in a group of non-smoking healthy men.

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8. Obstructive sleep apnoea (OSA)

OSA is 30 per cent more in obese patients and around 50-98% more in severely obese patients. Obesity is the most important risk factor for the development of OSA and the relative risk is high. Complications include pulmonary hypertension, right heart failure, stroke, hypertension and cardiac arrhythmias.

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9. Gall bladder disease

An alternative characterisation of those at high risk for gall bladder disease is that they are fat, forty, female, fertile and flatulent.

A study of 1 million Scottish and English women showed a strong association between gall bladder and obesity. Men who have a BMI >28 were at 2.5 times greater risk of having gallstones.

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10. Mental health issues

Studies have shown that BMI was significantly associated with anxiety, mood and personality disorders. Major depressive disorder (MDD) increased 1.5 to 2 times more in obese individuals.

It increased from 6.5 to 25.9 % with an increase in BMI from 25 to 35 Kg /M2.Weight loss improves depression in majority of the people.