The Price of Obesity

With obesity at epidemic proportions around the globe, an unprecedented number of individuals may now find themselves at greater risk of developing a wide range of additional health problems. Asthma, type-2 diabetes, and certain types of cancers are just a few of the myriad diseases and conditions that health care professionals and research scientists have associated with elevated body mass index.

One of the many experts who have sounded the alarm on the health ramifications of excess weight is Dr. David Satcher, who served as Surgeon General of the United States from 1998 to 2002. In 2002, Satcher was quoted as observing that "overweight and obesity may soon cause as much preventable disease and death as cigarette smoking."

The following are some of the major health consequences that have been associated with overweight and obesity:

• Arthritis - Osteoarthritis, also known as degenerative joint disease, is the leading type of arthritis in the United States, affecting more than 16 million individuals. Noting that 70 percent of women and 35 percent of men who suffer from osteoarthritis of the knee are overweight, the Obesity Action Coalition identifies excess weight as "a well-established risk factor" for afflictions in the knee and possibly also the hip.

There is no known cure for osteoarthritis, and treatment focuses upon reducing the symptoms, which include joint pain and decreased mobility. The American College of Rheumatology recommends weight loss and exercise as primary treatment options - guidance that is supported by an 18-month study of obese older adults in which a 5 percent decrease in body weight corresponded with an 18 percent gain in overall knee function.

• Asthma - According to the website Medical News Today, three out of four adults who seek emergency room treatment for asthma in the United States are obese. In addition to being evaluated as a cause of asthma, obesity has been identified as a factor for amplifying the effects of the disease.

A study published in the May 1, 2008 edition of the American Journal of Respiratory and Critical Care Medicine establishes a link between obesity and a condition known as "dynamic hyperinflation," in which air that has been inhaled into the lungs cannot be exhaled. Jeffrey Fredberg of the Harvard School of Public Health, who authored a 2005 study on the connection between obesity and asthma, told Medical News Today that "obesity has the capacity to impact lung function in a variety of ways. None of them are good and all of them are poorly understood. More research is needed to explain the relationship between asthma and obesity."

• Cancer - Reports and studies cited by the National Cancer Institute estimate that 14 percent of cancer-related deaths in men and 20 percent of cancer-related deaths in women are attributable to overweight and obesity.

The Overweight and Obesity: Health Consequences fact sheet that Satcher distributed during his tenure as surgeon general indicates that overweight and obesity are linked to an increased risk for developing cancers of the colon, kidney, prostate, and lining of the uterus. Also, women who gain more than 20 pounds from age 18 to midlife are twice as likely to develop postmenopausal breast cancer as are women whose weight remains constant.

• Dementia - A study that was funded by the National Institutes of Health and performed by the Kaiser Permanente Medical Foundation determined that obese women are 200 percent more likely to develop dementia in middle age than are women with a body mass index under 24.9. Obese men were found to be 30 percent more likely than men with sub-24.9 BMIs to develop the condition. The NIH/KPMF study followed 10,000 adults (aged 40 to 45 at the start of the study) for 27 years.

• Diabetes - Cases of type-2 diabetes in the United States have increased by 25 percent in the past 20 years, a development The Obesity Society attributes to "to the marked increase in the prevalence of obesity" in this nation.

Information collected during the Third National Health and Nutrition Examination Survey (NHANES III), which sampled more than 33,000 Americans from 1988 to 1994, indicated that two-thirds of adults with type-2 diabetes had a body mass index of 27 or greater. Risk factors for type-2 diabetes (marked by the body's inability to produce ample supplies of insulin, or cells' failure to utilize that insulin) include abdominal fat distribution and weight gain.

• Gout - Also known as metabolic arthritis, gout announces itself with a sudden onset of intense joint pain, usually in the largest joint of the big toe, and often at night. Left untreated, the pain can last from five to 10 days, and will often be accompanied by redness and inflammation.

Gout is caused by an accumulation of urate crystals around the joint - indicating a failure of the body's natural ability to manage the amount of uric acid it consumes, produces, and excretes. According to the American Obesity Association, obesity has been associated with both increases in the production of uric acid and decreases in the ability to eliminate the substance from the body.

• Heart Disease - The American Heart Association leaves little room for misinterpretation in its official stance on the relationship between obesity and heart disease: "Obesity is now recognized as a major risk factor for coronary heart disease, which can lead to heart attack."

According to the AHA, obesity earned this status because it raises blood cholesterol and triglyceride levels, reduces "good" HDL cholesterol, increases blood pressure, and can induce diabetes (which, in turn, can exacerbate the other risk factors). In case its position wasn't clear enough, the AHA also notes that "even when there are no adverse effects on the known risk factors, obesity by itself increases risk of heart disease."

• Hypertension - Commonly referred to as high blood pressure, hypertension is a chronic condition in which a person's systolic pressure is 140 mmHg or above and his or her diastolic pressure is 90 or greater. The condition causes the heart to work harder to pump blood, and is a risk factor for stroke, heart attack, and heart failure. According to the American Physiological Society, "risk estimates suggest that approximately 75 and 65 percent of the cases of hypertension in men and women, respectively, are directly attributable to an overweight condition and obesity."

• Incontinence - In an article published on the HealthCentral web site, Dr. Jennifer Sobol writes that obesity is a "major contributor" to the development of stress incontinence (the "stress" alludes not to a psychological condition, but to constant pressure on the bladder that leads to a weakening of the urethral sphincter, resulting in involuntary urination during exercise or activities such as laughing, coughing, or sneezing). Among the other risk factors for stress incontinence, which is much more common among women than men, are smoking, childbirth, and chronic coughing conditions such as bronchitis and asthma.

• Reproductive Complications - Obesity in pregnant women has been associated with an increased risk of health problems for both mother and child. In the Overweight and Obesity: Health Consequences fact sheet, the surgeon general states that obese pregnant women are more likely to develop maternal high blood pressure and gestational diabetes, and may experience more problems during labor and delivery in comparison to non-obese women. Also, the surgeon general notes that obesity during pregnancy has been linked to low blood sugar in the baby as well as an increased likelihood of neural tube birth defects such as spina bifida.

• Sleep Apnea - Sleep apnea is a potentially life-threatening disorder that causes sufferers to stop breathing for 10 seconds or more while sleeping, prompting them to awaken - often gasping - in order to resume breathing. These sleep disruptions can occur hundreds of times each night. In addition to the fatigue associated with sleep deprivation, sleep apnea has also been linked to a wide range of health disorders, including hypertension, memory problems, immune system abnormalities, and acid reflux. More than 90 percent of individuals who are diagnosed with sleep apnea are overweight or obese.

Though experts are careful to note that obesity has not been found to be a direct cause of most of the conditions addressed in this article, ongoing research supports the growing consensus that excess body weight puts an individual at much greater risk for developing a number of debilitating - and in some cases fatal - diseases.