Consequences of obesity and overweight
Patients with obesity, ie, with BMI of 30 or higher, have an increased risk of death compared with subjects whose body mass index (hereafter BMI) is 20 to 25. It has been estimated that an obese not smoker will live, on average, 5.8 years less than a subject with normal weight, while in the case of the women would be 7.1 years less than those of normal weight.
Although mortality for different reasons is higher in obese people, the main cause of death is cardiovascular disease. In these, the risk triples related to population of normal weight.
In the beginning, cardiovascular disease occurs as a result of the formation of the so-called atheromatous plaque, a buildup of fatty material adhered on the inside of the coronary arteries, which are the ones that carry oxygen and nutrients to the heart.
The bulge formed by atheromatous plaques within the coronary arteries makes that inside diameter narrows, so the flow of oxygen and nutrients to the cells of the heart is reduced. In these conditions increases the possibility of suffering a chronic lack of oxygen to this vital organ, which is revealed when circumstances require more oxygen. In situations of efforts can appear symptoms of angina pectoris (effort's angina), which highlights the difficulty of providing oxygen to a heart forced to work harder and, therefore, consume more oxygen. The disease is manifested by typical anginal pain or oppressive claw in the chest area that corresponds to the location of the heart.
A greater degree of difficulty in the supply of oxygen is evidenced by angina at small efforts and, ultimately, even effortlessly, when the narrowing of the coronary arteries has reached a critical point.
However, the obstruction of the coronary arteries can occur abruptly, because of complete occlusion of the coronary artery branch system, or by detachment of atheroma which moves to be locked into a smaller artery. Other times, it may happen by the growth of the plaque itself that completely obstructs the passage of blood through the coronary artery, resulting in permanent injury to the heart, which seriously endangers the patient's life. It is myocardial infarction. The patient is more likely to experience these types of disorders as BMI increases.
Obesity can trigger or worsen congestive heart failure. This is a disease in which the heart fails globally for carrying oxigen and nutrients to the body. So to speak, the heart is unable to circulate blood at the right volume and the right speed. When body mass increases, also increases cardiac efforts to meet the body's needs, which significantly worsens heart failure.
The overweight or obese patient is more likely to have either a high blood pressure or a greater degree of hypertension than those with normal weight. Although has not be entirely clarified the relationship between obesity and hypertension, scientific evidences, based on several clinical studies, have established that even a modest weight reduction is very beneficial for reducing blood pressure and cardiovascular risk.
For the same reasons that the patient with overweight has a higher chance of developing atheroma formation in coronary arteries, can also develop these lesions in the brain or adjacent arteries to the brain, which can break, or partially obstructing an artery brain. This can lead to brain damage from lack of blood. As excess weight increases, so does the likelihood of having a stroke.
Type 2 diabetes, also called adult-onset diabetes or non insulin-dependent diabetes, is a disease characterized by an increased concentration of glucose in the blood. One of the reasons for this increase in blood glucose is the lack of response from the body's cells to insulin (insulin resistance).
Insulin makes glucose pass within the cells and can be conveniently metabolized, reducing the glucose level in the blood. If it appears insulin resistance, glucose remains in high concentration in the blood, so that may derive in diabetes .
There is a close relationship between type 2 diabetes and obesity. In fact, over 80% of diabetics in this class are overweight. Clinical studies have shown that those with a BMI of 32 or higher have a triple risk of diabetes mellitus type 2 that people with a BMI value 19 to 22.
As it is known, diabetes is a common cause of premature death, heart disease, stroke, kidney failure and blindness.
Excess weight is caused by the body fat stored as triglycerides in adipose tissue. Often the overweight or obese patient also suffers from elevated levels of fats in the blood.
Although obesity and elevated blood cholesterol are independent risk factors, obese patients often presents elevated triglycerides and decreased "good" cholesterol (HDL-cholesterol), which in turn increases the cardiovascular risk .
Metabolic syndrome is a set of risk factors that are associated with overweight and obesity and often occur together. There is talk of metabolic syndrome when a patient presents at once three of the following cardiovascular risk factors:
Increased abdominal diameter (abdominal obesity). Having a high amount of abdominal fat is a major cardiovascular risk factor, of much greater predictive value than the accumulation of fat elsewhere in the body.
Hyperlipidemia, including elevated triglycerides, elevated bad cholesterol (LDL) and decrease good cholesterol (HDL).
High fasting glucose level in blood (more than normal).
Obesity and overweight are associated with an increased risk of various cancers.
In patients with severe obesity (BMI equal or greater than 40), a study lasting more than 16 years has shown an increased risk of esophagus, colon, rectum, liver, gallbladder, pancreas and kidney, breast and uterus (endometrium) and malignancies such as multiple myeloma and non-Hodgkin lymphoma. It is estimated that the additional risk of this type of disease is 50% higher than in normal-weight people.
Although in the case of breast cancer data can be controversial, it is estimated that an obese woman can have a triple risk of uterus cancer that women of normal weight.
In the case of tumors of the digestive tract, it has been indicated that the most likely cause of the increased risk of esophageal cancer is the reflux of gastric juice from the stomach into the esophagus (gastroesophageal reflux), which occurs frequently in obese people and leads to burning of varying intensity.
These are very widespread diseases, mainly affecting the knees, hips and spine, especially the lumbar and dorsal zones. In patients suffering from these ailments and are obese or overweight, the increased pressure due to excess weight is a major factor in overloading and degeneration, also causing an additional increase in joint pain.
It is a disorder that causes momentary stoppages of breathing (phase of apnea), which are produced continuously during sleep. Usually, people who suffer from this disease suffer aggravation if overweight or obese.
Obstructive sleep apnea is caused by a temporary blockage of airflow through the upper airway, which is repeated continuously . Apart from other factors also involved in the production of OSA, obesity creates an fill with fat tissue the spaces around the throat, thus facilitating the emergence or worsening of OSA by narrowing the air passage through this area.
Obesity can cause disturbance of the menstrual cycle and is related to female infertility. A modestly higher proportion of fat (for example, 10%) can collaborate to female infertility. Obesity has also been associated with an increased incidence of uterine fibroids.
Obesity is an added risk to pregnancy. On one hand, it may facilitate the onset of gestational diabetes; secondly, promotes increased blood pressure. It has also been associated with a rise in the rate of fetal death in late pregnancy and an increased incidence of cesarean deliveries.
Obesity and overweight are often associated with the occurrence of gallstones and gallbladder dysfunction.
Obese patients presented more often a fatty degeneration of the liver, similar to that produced in toxic hepatitis, called fatty liver disease.
Due to the lack of social acceptance and the fact that often are excluded, especially the young and the very obese, obese people may present a depression that, in many case, could be due to a possible social rejection by his physical condition.
This is particularly true in young women, in which has been demonstrated a direct relationship between the degree of obesity and depression. The higher the BMI, the greater is the degree of depression. By contrast, young men do not appear to be affected to the same degree.
Derived from this, some social indicators such as level of education and economic well being also deteriorate in the obese, especially in women.
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