The Serious Medical Issues Linked to Obesity

January 4, 2021

Medical Issues With Obesity

There are over 230 comorbidities and serious medical issues with obesity. Were you aware that obesity was not declared a disease by the American Medical Association (AMA) until 2013? The prevalence of this disease has doubled in over 70 countries since 1980 and it is estimated that over 42% of the US population is obese per the Centers for Disease Control and Prevention (CDC).

Some associated cardiovascular risk factors include coronary heart disease, heart failure, high blood pressure, stroke, abnormal cholesterol levels, diabetes mellitus, atrial fibrillation, and obstructive sleep apnea.

Other associated complications include painful arthritis, gallstones, fatty liver disease, depression and impaired quality of life. Non-alcoholic fatty liver disease (NAFLD) also known as “fatty liver” is now the most common liver disorder in Western industrialized countries. Fat deposition in the liver can lead to inflammation of the liver, this is known as nonalcoholic steatohepatitis (NASH). In one study the prevalence of NAFLD by ultrasound was found to be 46 percent with the average patient age of 55 years.

Obesity and Viral Infections

Obesity has also been linked to an increased risk for certain viral infections in particular more severe respiratory infections. For example a patient that suffers from obesity is more likely to be hospitalized with influenza (the flu) when compared to the normal weight individual. Trends with the novel corona virus, COVID-19, and obesity are now being observed. Scientists have noted that obesity contributes to a blunted immune response, increased inflammation and a decreased response rate to certain vaccinations.

To put things into perspective, obesity has surpassed smoking as the number one cause of preventable disease and disability.

Studies have found strong evidence supporting an association between obesity and 13 different forms of cancer. Examples include cancer of the liver, breast, pancreas, and colon.

Rates of cancer related to obesity are noted to be higher in women than in men.

Psychological aspects are also important to recognize. Those who suffer from obesity may be subjected to discrimination. Disapproval and the stigma of obesity itself have been noted in the educational, healthcare, and employment setting. Depression is linked to obesity and some have also suggested an increased risk of dementia later in life. With regard to depression, it has seen more commonly diagnosed in younger patients and women. 

Medical issues with obesity does not only affect adults but also our children. Specialists have noticed a surge in our pediatric population with the CDC estimating more than 13.7 million children and adolescents as being affected by this disease. The earlier onset of disease contributes to the development of serious medical conditions later in life if not treated early on.

The pediatric and adolescent rates of associated illnesses are increasing. Once thought of only as an adult disease, type 2 diabetes, hypertension, obstructive sleep apnea, and fatty liver are increasing in prevalence. 

I Suffer With Medical Issues With Obesity, What Can I Do?

Something that a lot of people are not aware of is that healthy weight loss can actually mitigate some of the complications mentioned earlier. For example, obesity is associated with an increased risk of stroke, and the risk of having a stroke is mitigated by weight loss. Other associated complications may improve or even resolve.

Fatty Liver

Take fatty liver for example, losing ≥ 5 percent of body weight may result in improvement of potential disease. It is estimated that 25% of the adult US population have fatty liver. If not managed this disease may potentially lead to fibrosis and cirrhosis or the liver.

Specific dietary changes may also help prevent the progression of fatty liver as well as specific drug therapy in certain patients. It should also be noted that certain medications can cause fatty liver disease.

Type II Diabetes

Type II Diabetes, one of the most prevalent disease in the United States. This form of diabetes is related to insulin resistance, meaning the cells in out body become less responsive to insulin. In 2018 it was estimated that 34.1 million adults aged 18 years or older had type II diabetes mellitus. Although millions of people have this diagnosis it may be prevented.

Ways to prevent development include losing weight (if overweight), improving the way you eat, and being more active. Medications are also helpful in preventing progression to full-blown diabetes. Long term complications associated with diabetes include kidney disease, nerve damage or neuropathy, and eye disease, just to name a few.

Don't Postpone Care

The most important point that cannot be stressed enough – do not postpone care. This is not a sprint, it is a marathon. In fact, losing weight too fast could be detrimental to your health. The power of being able to prevent disease or halt is progression is something we as a humans need to continue focusing on. This is crucial, especially for our pediatric population.

Either you will be re-gaining your health or preventing future health (both physical and psychological) problems, but most likely it’s going to be both.

Fighting these battles alone is not always feasible, so working with a multidisciplinary team will help you. These types of teams typically consist of a physician that specializes in bariatric medicine, a registered dietician, a behavior health specialist, and an exercise physiologist. Regain your independence from the disease and the medical issues with obesity.

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References

1. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. AU Williams CD, Stengel J, Asike MI, Torres DM, Shaw J, Contreras M, Landt CL, Harrison SA SO Gastroenterology. 2011;140(1):124. Epub 2010 Sep 19.
2. Andronescu CI, Purcarea MR, Babes PA. Nonalcoholic fatty liver disease: epidemiology, pathogenesis and therapeutic implications. J Med Life. 2018;11(1):20-23.
3. Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomized trials. AU Musso G, Cassader M, Rosina F, Gambino R SO Diabetologia. 2012;55(4):885. Epub 2012 Jan 27.
4. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. AU Younossi ZM, Stepanova M, Afendy M, Fang Y, Younossi Y, Mir H, Srishord M SO Clin Gastroenterol Hepatol. 2011 Jun;9(6):524-530.e1; quiz e60. Epub 2011 Mar 25.
5. Luzi L, Radaelli MG. Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic. Acta Diabetol. 2020;57(6):759-764. doi:10.1007/s00592-020-01522-8
6. Obesity Discrimination in the Recruitment Process: "You're Not Hired!". AU Flint SW,Čadek M, Codreanu SC, IvićV, Zomer C, Gomoiu A SO Front Psychol. 2016;7:647. Epub 2016 May 3.
7. Depression in association with severe obesity: changes with weight loss. AU Dixon JB, Dixon ME, O'Brien PE SO Arch Intern Med. 2003;163(17):2058.
8. Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity - United States, 2005-2014. AU Steele CB, Thomas CC, Henley SJ, Massetti GM, Galuska DA, Agurs-Collins T, Puckett M, Richardson LC SO MMWR Morb Mortal Wkly Rep. 2017;66(39):1052. Epub 2017 Oct 3.
9. https://www.cdc.gov/obesity/data/databases.html
10. Obesity and respiratory hospitalizations during influenza seasons in Ontario, Canada: a cohort study. AU Kwong JC, Campitelli MA, Rosella LC SO Clin Infect Dis. 2011 Sep;53(5):413-21

Dr. Jurdi is associated with OhioHealth Weight Management.

ABOUT THE AUTHOR Shadi R. Jurdi, MD is currently a quadruple board certified physician that currently specializes in bariatric medicine. As a diplomat of the American Board of Obesity Medicine (ABOM), Dr. Jurdi currently practices in Columbus Ohio and cares for both non-surgical and surgical patients and is associated with OhioHealth Weight Management. He has a strong interest in fetal origins of adult disease given his history of practicing Neonatal Intensive Care. He also has interest in nutrition, vitamin/mineral deficiencies as well as pulmonary hypertension.

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