obesity and health Obesity reached the status of
health crisis in the United States in the 1990s. In
2005, one third of Americans—nearly 60 million
people—weighed 20 percent or more above
healthy body weight, the key clinical marker for
diagnosing obesity. An equal number were over-
weight, weighing 5 to 20 percent above healthy
body weight. Many health experts believe obesity
is as significant a health risk factor as cigarette
smoking, complicit in a broad spectrum of health
conditions.
HEALTH CONDITIONS
IN WHICH OBESITY CAN BE A FACTORATHEROSCLEROSIS BREAST CANCER
COLORECTAL CANCER CORONARY ARTERY DISEASE(CAD)
ENDOMETRIAL CANCER ERECTILE DYSFUNCTION
GALLBLADDER DISEASE GASTROESOPHAGEAL REFLUX
HEART FAILURE DISORDER(GERD)
HYPERTENSION INSULIN RESISTANCE
MENSTRUAL DYSFUNCTION OBSTRUCTIVE SLEEP APNEA
OSTEOARTHRITIS OVARIAN CANCER
POLYCYSTIC OVARY SYNDROME PROSTATE CANCER
(PCOS) SEXUAL DYSFUNCTION
STEATOHEPATITIS type 2 DIABETES
How Obesity Affects the Body and HealthObesity has numerous negative influences on
health. It is the leading cause of HYPERTENSION
(high BLOOD PRESSURE) and type 2 DIABETESand is
an independent risk factor for the development of
ATHEROSCLEROSIS, CORONARY ARTERY DISEASE (CAD),
PERIPHERAL VASCULAR DISEASE(PVD), OSTEOARTHRITIS,
GALLBLADDER DISEASE, COLORECTAL CANCER, hormone-
driven BREAST CANCER, and PROSTATE CANCER. Health
risk for these conditions and their complications
or consequences increases moderately for over-
weight and significantly for obesity. In addition to
its role as a key risk factor for numerous health
conditions, obesity is itself a health condition with
significant and potentially fatal consequences
when it remains untreated.
Obesity and type 2 diabetes More than 95 per-
cent of people who have type 2 diabetes are over-
weight and many have obesity. Increased body fat
decreases cell sensitivity to INSULIN, which sets in
motion a cascade of adaptations that ultimately
overwhelm the body’s normal metabolic balance.
Cells become resistant to insulin (the prediabetes
condition INSULIN RESISTANCE), which requires
increasingly higher levels of GLUCOSEin the BLOOD
circulation to initiate an appropriate insulin
response. The high blood glucose levels essentially
“burn out” the cells that form delicate nerves and
blood vessels, causing them to die. The resulting
irreversible damage manifests as PVD and NEU-
ROPATHY.
In an effort to bring blood glucose levels down,
the ISLETS OFLANGERHANSin the pancreas, which
contain the cells that produce insulin, pump out
increasing amounts of insulin. The environment
within the body reaches the state of type 2 dia-
betes when the islet cells can no longer keep pace
with the body’s demands. The amount of glucose
in the blood circulation ultimately reaches levels
that cause symptoms such as excessive thirst and
URINATIONthat represent the body’s efforts to rid
itself of the excessive glucose. Symptoms that
reflect damage resulting from elevated blood glu-
cose also occur, such as vision changes, develop-
ment of cataracts, tingling or loss of sensation in
the feet, and wounds that do not heal.
Obesity and cardiovascular disease (CVD)Obe-
sity sets the stage for HYPERLIPIDEMIA, the pathologic
circumstance of excessive lipids (fatty acids) in the
blood circulation. Hyperlipidemia is the founda-
tion of occlusive forms of CARDIOVASCULAR DISEASE
(CVD) such as CAD, atherosclerosis, and CAROTID
STENOSIS. Obesity is also the primary cause of
hypertension, partly as a consequence of obstruc-
tive CVD such as atherosclerosis and partly
because the pressure excessive body fat places on
the arteries, veins, and organs increases the resist-
ance blood encounters as it flows through the cir-
culation and forces the HEARTto work harder to
pump blood. The increased workload of the heart
may lead to HEART FAILURE.
Obesity and osteoarthritis Excessive body
weight places considerable stress on the structures
of the musculoskeletal system, most notably the
back, hips, knees, ankles, and feet. The CARTILAGE
that pads and cushions the joints distorts under
such pressure, and over time sustains permanent
damage. Physical inactivity exacerbates the situa-
tion. Osteoarthritis symptoms dramatically
improve with weight loss, however, and much of
the temporary damage to the structures of the
joints is able to heal.obesity and health 301