IMPACT OF OBESITY ON HEALTH
"Does being obese matters?" This question pops up in your mind every time you realize that you are overweight.
Obesity is now reaching epidemic proportions and is increasingly recognized as an important public health problem. Epidemiological studies have consistently shown it to be associated with increased risks of morbidity, disability and mortality.
Recently, the impact of obesity on मूlity has been presented as being nearly as important as that of cigarette smoking. This chapter attempts to summarize the impact of obesity on noncommunicable diseases and mortality.
Morbidity
Obesity has been associated with a long list of conditions, the more important of which are further discussed below:
1. cardiovascular diseases: coronary heart disease (including ischaemic heart disease, angina pectoris and myocardial infarction), hypertension, dyslipidaemia and stroke;
2. various types of cancer: endometrial, cervical, ovarian, prostate, breast, colon, rectal, kidney, liver and gall bladder;
3. type 2 diabetes and insulin resistance;
4. end-stage kidney disease;
5. fatty liver disease;
6. osteoarthritis;
7. pulmonary embolism;
8. deep vein thrombosis;
9. polycystic ovary syndrome;
10. hyperuricaemia and gout;
11. gallstones;
12. reproductive disorders;
13. low back pain;
14. breathlessness;
15. sleep apnoea;
Metabolic syndrome
The constellation of metabolic abnormalities – including centrally distributed obesity (large waist circumfer-ence), decreased HDL cholesterol level, elevated triglyceride level, elevated blood pressure (hypertension) and high blood glucose level (hyperglycaemia) – is known as the metabolic syndrome . It is associated with in-creases in type 2 diabetes (threefold) and cardiovascular diseases (twofold).
Cardiovascular diseases
Obesity is associated with some of the major risk factors for cardiovascular diseases, such as hypertension and low concentrations of HDL cholesterol, but it is also associated with small-particle-sized LDL cholesterol. The relative risks of cardiovascular disease end-points (myocardial infarction and stroke) in obese versus normal-weight individuals are 1.5–2.5.
Type 2 diabetes
Obesity is a well-known risk factor for type 2 (non-insulin-dependent) diabetes mellitus. Field et al. (11) found that the incidence of type 2 diabetes in middle-aged men and women with pre-obesity (BMI of 25–30 kg/m2), during the 10 years after baseline, was 3.5 and 4.6 times, respectively, that of people of normal weight (BMI of 18.5–24.9 kg/m2). In addition, this relative risk increased exponentially with further increases in BMI. Further, men and women with a BMI of 35 kg/m2 had about 20 times the risk of developing diabetes of those of normal weight.
Cancer
At relatively low levels of BMI, obesity is already related to some forms of cancer, mainly colon cancer and hormone-related malignancies in the uterus, and cancer of the ovary, breast (post-menopausal) and prostate. In a prospectively studied population of more than 900 000 adults in the United States, obese men (BMI ≥ 30 kg/m2) had more than 50% increased risk of dying from cancers of the liver and gall bladder and from non-Hodgkin’s lymphoma; obese women had a more than 50% increased risk of dying from cancers of the gall bladder, breast, uterus and kidneys
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