Obesity and diseases

Many chronic and potentially fatal diseases are all linked to obesity: if you are obese (BMI equal to or greater than 30), then the risk you run of developing the following diseases increases dramatically:

• diseases of the heart and circulatory system such as coronary heart disease, stroke, congestive heart failure and blood vessel disease in the legs. Obesity is a direct risk factor associated with heart disease in men and also increases risk of heart disease in women.
   
• hypertension or high blood pressure and stroke. Obese individuals are three times more likely to develop high blood pressure than people who not overweight. In South Africa, rural black people who have moved to the cities and adopted a western lifestyle and diet, have a high incidence of obesity and associated hypertension, particularly black women.
   
• type 2 diabetes (also called age-onset diabetes or non-insulin-dependent diabetes) is also strongly linked to obesity. Obese women appear to be 40 times more likely to develop type 2 diabetes than their normal weight counterparts. The most significant factors that predispose individuals to developing type 2 diabetes are: 1) obesity during childhood, 2) weight gain starting after the age of 18 and 3) accumulation of large amounts of fat in the abdomen.
   
• cancer of the endometrium (lining of the uterus), ovary, breast, and cervix in women and the prostate in men, of the colon, gallbladder, pancreas, liver and kidneys, has been linked to obesity although additional research is still needed to determine if obesity is directly responsible for these malignancies, or if other factors such as a high-fat diet or low-fibre intake are the causative factors.
   
• gallbladder disease and gallstones are 3-4 times more likely to occur in obese people particularly women. When such patients have to undergo surgery they also run a greater risk of dying than normal weight patients.
   
• digestive diseases, including gastroesophageal reflux and hiatus hernia are more common in obese individuals.
   
• syndrome X or insulin resistance syndrome, which includes symptoms like insulin resistance, and high blood insulin levels, and is associated with other diseases such as type 2 diabetes, high blood pressure and heart disease, occurs more frequently in obese people. Syndrome X is also linked to reduced fertility and polycystic ovary syndrome in obese women. Obese men may also experience problems with fertility as their testosterone levels are reduced.
   
• abnormal blood fat levels, namely increased total cholesterol, triglycerides, low density lipoprotein (LDL) cholesterol and very low density lipoprotein (VLDL) (the latter two types of cholesterol are classified as “bad” cholesterol which increases the risk of heart disease) and a decrease in high density lipoprotein (HDL) cholesterol (“good” cholesterol which protects us against heart disease), and raised blood glucose levels which expose the patient to the risk of developing type 2 diabetes.
   
• osteoarthritis and gout occur more commonly in overweight and obese individuals. In gout it is, however, not a good idea to fast or try to lose weight rapidly as this makes the condition worse, rather try to lose weight gradually and consistently.
   
• sleep apnoea (problems with breathing during sleep) is found in up to 75% of obese patients. It interrupts sleep patterns and may put the individual at risk of dying due to lack of oxygen.
   
• psychological problems increase dramatically as obesity increases. The idea that fat people are jolly, is a myth. Most obese patients are highly dissatisfied with their appearance and frustrated and angry that they seem helpless to do something about their condition. Many obese individuals are depressed and anxious because they feel trapped in a mountain of fat. Up to 30% of obese patients also suffer from binge eating disorder indulging in massive binge eating bouts particularly at night. These patients feel that they have lost control of their eating behaviour and are caught in a downward spiral of destruction.

If you are obese and suffer from one or more of the above mentioned medical conditions, then it is vital that you take steps to remedy the situation as soon as possible. Losing weight and increasing your fitness will improve these medical conditions signficantly and may even save your life.

- Dr IV van Heerden, DietDoc

- (Health24, updated June 2012)

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