HEALTH EFFECT OF OBESTY

Persons with obesity are at risk of developing one or more serious medical conditions, which can cause poor health and premature death. Obesity is associated with more than 30 medical conditions, and scientific evidence has established a strong relationship with at least 15 of those conditions. Preliminary data also show the impact of obesity on various other conditions. Weight loss of about 10% of body weight, for persons with overweight or obesity, can improve some obesity-related medical conditions including diabetes and hypertension. Obesity-Related Medical Conditions The prevalence of various medical conditions increases with overweight and obesity for men and women as shown in Tables 1 and 2. Table 1. Prevalence of Medical Conditions by Body Mass Index (BMI) for Men Medical Condition Body Mass Index 18.5 to 24.9 25 to 29.9 30 to 34.9 > 40 Prevalence Ratio (%) Type 2 Diabetes 2.03 4.93 10.10 10.65 Coronary Heart Disease 8.84 9.60 16.01 13.97 High Blood Pressure 23.47 34.16 48.95 64.53 Osteoarthritis 2.59 4.55 4.66 10.04 Source: NHANES III, 1988 - 1994. Table 2. Prevalence of Medical Conditions by Body Mass Index (BMI) for Women Medical Condition Body Mass Index 18.5 to 24.9 25 to 29.9 30 to 34.9 > 40 Prevalence Ratio (%) Type 2 Diabetes 2.38 7.12 7.24 19.89 Coronary Heart Disease 6.87 11.13 12.56 19.22 High Blood Pressure 23.26 38.77 47.95 63.16 Osteoarthritis 5.22 8.51 9.94 17.19 Source: NHANES III, 1988 - 1994. Arthritis Osteoarthritis (OA) Obesity is associated with the development of OA of the hand, hip, back and especially the knee. At a Body Mass Index (BMI) of > 25, the incidence of OA has been shown to steadily increase. Modest weight loss of 10 to 15 pounds is likely to relieve symptoms and delay disease progression of knee OA. Rheumatoid Arthritis (RA) Obesity has been found related to RA in both men and women. Birth Defects Maternal obesity (BMI > 29) has been associated with an increased incidence of neural tube defects (NTD) in several studies, although variable results have been found in this area. Folate intake, which decreases the risk of NTD’s, was found in one study to have a reduced effect with higher pre-pregnancy weight. Cancers Breast Cancer Postmenopausal women with obesity have a higher risk of developing breast cancer. In addition, weight gain after menopause may also increase breast cancer risk. Women who gain nearly 45 pounds or more after age 18 are twice as likely to develop breast cancer after menopause than those who remain weight stable. High BMI has been associated with a decreased risk of breast cancer before menopause. However, a recent study found an increased risk of the most lethal form of breast cancer, called inflammatory breast cancer (IBC), in women with BMI as low as 26.7 regardless of menopausal status. Premenopausal women diagnosed with breast cancer who are overweight appear to have a shorter life span than women with lower BMI. The risk of breast cancer in men is also increased by obesity. Cancers of the Esophagus and Gastric Cardia Obesity is strongly associated with cancer of the esophagus and the risk becomes higher with increasing BMI. The risk for gastric cardia cancer rises moderately with increasing BMI. Colorectal Cancer High BMI, high calorie intake, and low physical activity are independent risk factors of colorectal cancer. Larger waist size (abdominal obesity) is associated with colorectal cancer. Endometrial Cancer (EC) Women with obesity have three to four times the risk of EC than women with lower BMI. Women with obesity and diabetes are reported to have a 3-fold increase in risk for EC above the risk of obesity alone. Body size is a risk factor for EC regardless of where fat is distributed in the body. Renal Cell Cancer Consistent evidence has been found to associate obesity with renal cell cancer, especially in women. Excess weight was reported in one study to account for 21% of renal cell cancer cases. Cardiovascular Disease (CVD) Obesity increases CVD risk due to its effect on blood lipid levels. Weight loss improves blood lipid levels by lowering triglycerides and LDL (“bad”) cholesterol and increasing HDL (“good”) cholesterol. Weight loss of 5% to 10% can reduce total blood cholesterol. The effects of obesity on cardiovascular health can begin in childhood, which increases the risk of developing CVD as an adult. Overweight and obesity increase the risk of illness and death associated with coronary heart disease. Obesity is a major risk factor for heart attack, and is now recognized as such by the American Heart Association. Carpal Tunnel Syndrome (CTS) Obesity has been established as a risk factor for CTS. The odds of an obese patient having CTS were found in one study to be almost four times greater than that of a non-obese patient. Obesity was found in one study to be a stronger risk factor for CTS than workplace activity that requires repetitive and forceful hand use. Seventy percent of persons in a recent CTS study were overweight or obese. Chronic Venous Insufficiency (CVI) Patients with CVI, an inadequate blood flow through the veins, tend to be older, male, and have obesity. Daytime Sleepiness People with obesity frequently complain of daytime sleepiness and fatigue, two probable causes of mass transportation accidents. Severe obesity has been associated with increased daytime sleepiness even in the absence of sleep apnea or other breathing disorders. Deep Vein Thrombosis (DVT) Obesity increases the risk of DVT, a condition that disrupts the normal process of blood clotting. Patients with obesity have an increased risk of DVT after surgery. Diabetes (Type 2) As many as 90% of individuals with type 2 diabetes are reported to be overweight or obese. Obesity has been found to be the largest environmental influence on the prevalence of diabetes in a population. Obesity complicates the management of type 2 diabetes by increasing insulin resistance and glucose intolerance, which makes drug treatment for type 2 diabetes less effective. A weight loss of as little as 5% can reduce high blood sugar. End Stage Renal Disease (ESRD) Obesity may be a direct or indirect factor in the initiation or progression of renal disease, as suggested in preliminary data. Gallbladder Disease Obesity is an established predictor of gallbladder disease. Obesity and rapid weight loss in obese persons are known risk factors for gallstones. Gallstones are common among overweight and obese persons. Gallstones appear in persons with obesity at a rate of 30% versus 10% in non-obese. Gout Obesity contributes to the cause of gout -- the deposit of uric acid crystals in joints and tissue. Obesity is associated with increased production of uric acid and decreased elimination from the body. Heat Disorders Obesity has been found to be a risk factor for heat injury and heat disorders. Poor heat tolerance is often associated with obesity. Hypertension Over 75% of hypertension cases are reported to be directly attributed to obesity. Weight or BMI in association with age is the strongest indicator of blood pressure in humans. The association between obesity and high blood pressure has been observed in virtually all societies, ages, ethnic groups, and in both genders. The risk of developing hypertension is five to six times greater in obese adult Americans, age 20 to 45, compared to non-obese individuals of the same age. Impaired Immune Response Obesity has been found to decrease the body’s resistance to harmful organisms. A decrease in the activity of scavenger cells, that destroy bacteria and foreign organisms in the body, has been observed in patients with obesity. Impaired Respiratory Function Obesity is associated with impairment in respiratory function. Obesity has been found to increase respiratory resistance, which in turn may cause breathlessness. Decreases in lung volume with increasing obesity have been reported. Infections Following Wounds Obesity is associated with the increased incidence of wound infection. Burn patients with obesity are reported to develop pneumonia and wound infection with twice the frequency of non-obese. Infertility Obesity increases the risk for several reproductive disorders, negatively affecting normal menstrual function and fertility. Weight loss of about 10% of initial weight is effective in improving menstrual regularity, ovulation, hormonal profiles and pregnancy rates. Liver Disease Excess weight is reported to be an independent risk factor for the development of alcohol related liver diseases including cirrhosis and acute hepatitis. Obesity is the most common factor of nonalcoholic steatohepatitis, a major cause of progressive liver disease. Low Back Pain Obesity may play a part in aggravating a simple low back problem, and contribute to a long-lasting or recurring condition. Women who are overweight or have a large waist size are reported to be particularly at risk for low back pain. Obstetric and Gynecologic Complications Women with severe obesity have a menstrual disturbance rate three times higher than that of women with normal weight. High pre-pregnancy weight is associated with an increased risk during pregnancy of hypertension, gestational diabetes, urinary infection, Cesarean section and toxemia. Obesity is reportedly associated with the increased incidence of overdue births, induced labor and longer labors. Women with maternal obesity have more Cesarean deliveries and higher incidence of blood loss during delivery as well as infection and wound complication after surgery. Complications after childbirth associated with obesity include an increased risk of endometrial infection and inflammation, urinary tract infection and urinary incontinence. Pain Bodily pain is a prevalent problem among persons with obesity. Greater disability, due to bodily pain, has been reported by persons with obesity compared to persons with other chronic medical conditions. Obesity is known to be associated with musculoskeletal or joint-related pain. Foot pain located at the heel, known as Sever’s disease, is commonly associated with obesity. Pancreatitis Obesity is a predictive factor of outcome in acute pancreatitis. Obese patients with acute pancreatitis are reported to develop significantly more complications, including respiratory failure, than non-obese. Patients with severe pancreatitis have been found to have a higher body-fat percentage and larger waist size than patients with mild pancreatitis. Sleep Apnea Obesity, particularly upper body obesity, is the most significant risk factor for obstructive sleep apnea. There is a 12 to 30-fold higher incidence of obstructive sleep apnea among morbidly obese patients compared to the general population. Among patients with obstructive sleep apnea, at least 60% to 70% are obese. Stroke Elevated BMI is reported to increase the risk of ischemic stroke independent of other risk factors including age and systolic blood pressure. Abdominal obesity appears to predict the risk of stroke in men. Obesity and weight gain are risk factors for ischemic and total stroke in women. Surgical Complications Obesity is a risk factor for complications after a surgery. Surgical patients with obesity demonstrate a higher number and incidence of hospital acquired infections compared to normal weight patients. Urinary Stress Incontinence Obesity is a well-documented risk factor for urinary stress incontinence, involuntary urine loss, as well as urge incontinence and urgency among women. Obesity is reported to be a strong risk factor for several urinary symptoms after pregnancy and delivery, continuing as much as 6 to 18 months after childbirth. Other Several other obesity-related conditions have been reported by various researchers including: abdominal hernias, acanthosis nigricans, endocrine abnormalities, chronic hypoxia and hypercapnia, dermatological effects, depression, elephantitis, gastroesophageal reflux, heel spurs, hirsutism, lower extremity edema, mammegaly (causing considerable problems such as bra strap pain, skin damage, cervical pain, chronic odors and infections in the skin folds under the breasts, etc.), large anterior abdominal wall masses (abdominal paniculitis with frequent panniculitis, impeding walking, causing frequent infections, odors, clothing difficulties, low back pain), musculoskeletal disease, prostate cancer, pseudo tumor cerebri (or benign intracranial hypertension), and sliding hiatil hernia.

RESEARCH OBJECTIVES

• to give exposure about causes of obesity
• to explain the effect of obesity
• to expose the ways to solve obesity problem
  

Obesity Statistics

Latest Obesity Statistics
USA Obesity Rates Reach Epidemic Proportions
58 Million Overweight; 40 Million Obese; 3 Million morbidly Obese
Eight out of 10 over 25's Overweight
78% of American's not meeting basic activity level recommendations
25% completely Sedentary
76% increase in Type II diabetes in adults 30-40 yrs old since 1990
Obesity Related Diseases
80% of type II diabetes related to obesity
70% of Cardiovascular disease related to obesity
42% breast and colon cancer diagnosed among obese individuals
30% of gall bladder surgery related to obesity
26% of obese people having high blood pressure
Childhood Obesity Running Out of Control
4% overweight 1982 16% overweight 1994
25% of all white children overweight 2001
33% African American and Hispanic children overweight 2001
Hospital costs associated with childhood obesity rising from $35 Million (1979) to $127 Million (1999)
Childhood Metabolic and Heart Risks
New study suggests one in four overweight children is already showing early signs of type II diabetes (impaired glucose intolerance)
60% already have one risk factor for heart disease
Surge in Childhood Diabetes
Between 8% - 45% of newly diagnosed cases of childhood diabetes are type II, associated with obesity.
Whereas 4% of Childhood diabetes was type II in 1990, that number has risen to approximately 20%
Depending on the age group (Type II most frequent 10-19 group) and the racial/ethnic mix of group stated
Of Children diagnosed with Type II diabetes, 85% are obese

The Real Cause of Obesity

obesity is not a personal choice. The obese are so primarily as a result of their genes.


Genetic studies have shown that the particular set of weight-regulating genes that a person has is by far the most important factor in determining how much that person will weigh. The heritability of obesity—a measure of how much obesity is due to genes versus other factors—is about the same as the heritability of height. It's even greater than that for many conditions that people accept as having a genetic basis, including heart disease, breast cancer, and schizophrenia. As nutrition has improved over the past 200 years, Americans have gotten much taller on average, but it is still the genes that determine who is tall or short today. The same is true for weight. Although our high-calorie, sedentary lifestyle contributes to the approximately 10-pound average weight gain of Americans compared to the recent past, some people are more severely affected by this lifestyle than others. That's because they have inherited genes that increase their predisposition for accumulating body fat. Our modern lifestyle is thus a necessary, but not a sufficient, condition for the high prevalence of obesity in our population.

Over the past decade, scientists have identified many of the genes that regulate body weight and have proved that in some instances, different variants of these genes can lead a person to be fat or thin. These genes underlie a weight-regulating system that is remarkably precise. The average person takes in a million or more calories per year, maintaining within a narrow range over the course of decades. This implies that the body balances calorie consumption with calorie expenditure, and does with a precision greater than 99.5 percent. Even the most vigilant calorie counter couldn't compete, if for no other reason than that the calorie counts on food labels are often off by 10 percent or more.



The genes that control food intake and metabolism act to keep weight in a stable range by creating a biological force that resists weight change in either direction. When weight is gained, hunger is reduced. When weight is lost, the unconscious drive to eat is stimulated and acts to return weight to the starting point. Moreover, the greater the amount of weight that is lost, the greater the sense of hunger that develops. Thus, when the obese lose large amounts of weight by conscious effort, their bodies fight back even more strongly by increasing hunger and reducing energy expenditure. If you think it is hard to lose 10 to 20 pounds (and it is), try to imagine what it would feel like to lose many tens or even hundreds of pounds.

Anyone who doubts the power of this biologic system should study the case of a young boy in England a few years back. He had a mutation in a critical gene, the one that produces the hormone leptin. Leptin is made by fat tissue and sends a signal informing the brain that there are adequate stores of energy. When leptin drops, appetite increases. Because of a genetic error, this boy could not make this hormone, which left him ravenously hungry all of the time. At age 4 he ate 1,125 calories at a single meal—about half of what a normal adult eats in an entire day. As a result he already weighed 90 pounds and was well on his way to developing diabetes. At the time, his similarly affected cousin was 8 and weighed 200 pounds. After a few leptin injections, the boy's calorie intake dropped to 180 calories per meal, and by the time he was 6 his weight had dropped into the normal range. Nothing changed except the hormone levels: his parents weren't more or less permissive, his snacks did not switch from processed to organic, his willpower was not bolstered. Rather this boy was a victim of a malfunctioning weight-regulating system that led to an uncontrollable drive to eat. This examples illustrates that feeding behavior is a basic drive, similar to thirst and other life-sustaining drives. The key role of leptin and other molecules to control feeding behavior undercuts the common misconception that food intake is largely under voluntary control.

While mutations in the leptin gene like the cases described above are rare, nearly 10 percent of morbidly obese individuals carry defects in genes that regulate food intake, metabolism, and body weight. The evidence further indicates that the rest of the obese population carries genetic alterations in other, as yet unidentified, single genes or combinations of genes (polygenes) interacting with environmental factors.

So if you are thin, it might be more appropriate for you to thank your own "lean" genes and refrain from stigmatizing the obese. A broad acceptance of the biologic basis of obesity would not only be fair and right, but would also allow us to collectively focus on what is most important—one's health rather than one's weight. There is no evidence that obese individuals need to "normalize" their weight to reap health benefits. In fact, it is not even clear whether there are enduring health benefits to weight loss among obese individuals who do not suffer from diabetes, heart disease, hypertension, or liver disease. What is known is that the obese who do suffer from these conditions receive a disproportionately large benefit from even modest weight loss, which together with exercise and a heart-healthy diet can go a long way toward improving health.

While research into the biologic system that controls weight is moving toward the development of effective therapies for obesity, we are not there yet. In the meantime we must change our attitudes toward the obese and focus less on appearance and more on health. In their efforts to lose weight they are fighting against their biology. But they also are fighting against a society that wrongly believes that obesity is a personal failing.

Jeffrey M. Friedman, M.D., Ph.D. is the Marilyn M. Simpson professor and head of the Laboratory of Molecular Genetics at The Rockefeller University, and an investigator at the Howard Hughes Medical Institute.

© 2009

By Jeffrey Friedman | Newsweek Web Exclusive
Sep 10, 2009

RESEARCH QUESTIONS

* What are the causes of obesity?
* What are the effect of obesity?
* What are the ways to solve obesity problem?

Obesity Statistics

Latest Obesity Statistics
USA Obesity Rates Reach Epidemic Proportions
58 Million Overweight; 40 Million Obese; 3 Million morbidly Obese
Eight out of 10 over 25's Overweight
78% of American's not meeting basic activity level recommendations
25% completely Sedentary
76% increase in Type II diabetes in adults 30-40 yrs old since 1990
Obesity Related Diseases
80% of type II diabetes related to obesity
70% of Cardiovascular disease related to obesity
42% breast and colon cancer diagnosed among obese individuals
30% of gall bladder surgery related to obesity
26% of obese people having high blood pressure
Childhood Obesity Running Out of Control
4% overweight 1982 16% overweight 1994
25% of all white children overweight 2001
33% African American and Hispanic children overweight 2001
Hospital costs associated with childhood obesity rising from $35 Million (1979) to $127 Million (1999)
Childhood Metabolic and Heart Risks
New study suggests one in four overweight children is already showing early signs of type II diabetes (impaired glucose intolerance)
60% already have one risk factor for heart disease
Surge in Childhood Diabetes
Between 8% - 45% of newly diagnosed cases of childhood diabetes are type II, associated with obesity.
Whereas 4% of Childhood diabetes was type II in 1990, that number has risen to approximately 20%
Depending on the age group (Type II most frequent 10-19 group) and the racial/ethnic mix of group stated
Of Children diagnosed with Type II diabetes, 85% are obese
SOURCE: Wellness International Network Ltd - web.winltd.com
Weight Loss AdviceNo matter how much excess weight or fat you have, if you want to lose weight permanently, your diet program should be directed toward a slow, steady weight loss. According to official government dietary guidelines, unless your doctor feels your particular health condition would benefit from more rapid weight loss, you should expect to lose no more than 2 pounds of fat a week, although initial loss (mainly water) may be greater. Losing more weight is no guarantee that weight loss is likely to be permanent.

What Are The Major Causes Of Child Obesity?

Sedentary lifestyle and poor eating habits are the most prominent factor causing child obesity. Low physical activity makes child more capable of storing fat. Due to lack of physical activity they burn fewer calories than what they consume. So to accelerate calorie burn, they need to take active part in outdoor games and sports. Diet is another factor that must be taken into consideration. Low fat, low sugar diets have proved to be safer and healthier food for growing children.
Overweight is a serious problem of appetite regulation and energy metabolisms affected by a combination of genetic, social, cultural, economic, psychological and environmental factors. Obesity which is defined as a chronic, degenerative disease that debilitates individuals is on the rise among children. Being overweight is directly related to diabetes, high BP, heart disease, cancers, gall bladder disease, gout and osteoarthritis. Fatty lesions can develop into atherosclerosis in children as young as three years old! Children eat more but there has been a decrease in active lifestyle. Lack of physical activity is the main factor in causing obesity. One-fourth of the children already have the cholesterol levels of 170 or more. Children spend more time in passive TV watching, computer, videogames. Making your child free from obesity requires two measures
1. Low fat, low sugar diet2. Encouraging an active lifestyle.
More fruits and vegetables should be included in child's diet. Consuming fruits and vegetables can reduce the incidence of heart disease by 31%, heart strokes and stomach cancer by 19% and lung cancer by 20%. Vegetable salads and fruit juices are healthy choices and contain vital vitamins and nutrients.
Disclaimer: This article is not meant to provide health advice and is for general information only. Always seek the insights of a qualified health professional before embarking on any health program.
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