Adult Obesity

PATIENT HANDOUT ON OBESITY IN ADULT

The morbidity and mortality associated with being overweight or obese far outweigh those of taking care of yourself.

The problems associated with obesity are as follows:

• 1Mortality: the risk of dying increases significantly due to the problems that accompany overweight or obesity
• 2Life expectancy: obesity in adulthood in associated with reduction in life expectancy for both men and women
• 3Morbidity: obesity and increased central fat are associated with increased morbidity and mortality

Endocrine

• 1
  Diabetes mellitus: type 2 diabetes mellitus is strongly associated with obesity in all ethnic groups and may account for more than 80% of cases of type 2 diabetes mellitus
• 2
  Insulin resistance: insulin resistance with hyperineulinemia is characteristic of obesity and occur before the onset of diabetes mellitus
• 3
  Hypertension: blood pressure is often increased in obese subjects
• 4
  Dyslipidemia: obesity leads to high level of total cholesterol, LDL-cholesterol, VLDL- cholesterol and triglycerides and a reduction in HDL cholesterol

Hepatobiliary system

• 1
  Hepatobiliary disease: obesity is associated with increased gallstone formation
• 2
  Steatosis: the incidence of fatty liver increases with obesity

Cardiovascular

• 1
  Heart disease: is common in obesity due to the above risk factors and increase in plasma fibrinogen concentrations, prothrombic factors and thromboxane-dependen platelet activation
• 2
  Coronary disease: obesity is associated with increased risk of CAD and cardiovascular mortality
• 3
  Myocardial stentosis increases with increasing BMI
• 4
  Atrial fibrillation/firitter: obese individuals (BMI ≥ 30 kg/m2 are more likely to develop atrial fibrillation than those with normal BMI (<25 kg/m2)
• 5
  Stroke: obesity is associated with increased risk of ischemic stroke
• 6
  Venous thrombosis: obesity is associated with increased risk of deep vein thrombosis and pulmonary embolus
• 7
  Dementia: obesity is associated with increased risk of dementia.

Gastrointestinal: obesity is a risk factor for GERD, erosive esophagitis, esophageal adenocarcinoma and gastric cancer

Orthopedic: obesity is associated with high incidence of osteoarthritis of the knee, carpometacarpal joint, distal interphalangeal joint and proximal interphalangeal joint

Skin changes:

• Stretch marks (strial)
• Acanthosis nigricans
• Hirsutism due to increased production of testosterone

Endocrine changes: obesity is associated with the following

• Diabetes mellitus/hyperlipidemia as noted above
• Irregular menses
• Anovulatory cycles
• Decrease fertility
• Disorders of sexual and orgasm
• Erectile dysfunction

Kidney disease: there is increased formation of kidney stones in obesity.

Respiratory system: sleep apnea

Cancer: obesity is associated with higher rate of the following cancers

• Esophageal
• Colon and rectum
• Liver
• Gallbladder
• Pancreas
• Kidney
• Non-Hodgkin lymphoma
• Multiple myeloma
• Men
  • Stomach
  • Prostate
• Women
  • Breast
  • Uterus
  • Cervix
  • Ovary