Obesity natural history, complications and prognosis: Difference between revisions

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===Prognosis===
===Prognosis===
Excessive body [[Human weight|weight]] is associated with various [[diseases]], particularly [[cardiovascular diseases]], [[diabetes mellitus type 2]], [[obstructive sleep apnea]], certain types of [[cancer]], and [[osteoarthritis]].<ref name=HaslamJames/> As a result, obesity has been found to reduce [[life expectancy]].<ref name=HaslamJames/>
===Mortality===
Obesity is one of the leading preventable causes of death worldwide.<ref name=Barn1999>{{cite journal |author=Barness LA, Opitz JM, Gilbert-Barness E |title=Obesity: genetic, molecular, and environmental aspects |journal=Am. J. Med. Genet. A |volume=143A |issue=24 |pages=3016–34 |year=2007 |month=December |pmid=18000969 |doi=10.1002/ajmg.a.32035 |url=}}</ref> <ref>{{cite journal |author=Mokdad AH, Marks JS, Stroup DF, Gerberding JL |title=Actual causes of death in the United States, 2000 |journal=JAMA |volume=291 |issue=10 |pages=1238–45 |year=2004 |month=March |pmid=15010446 |doi=10.1001/jama.291.10.1238 |url=http://www.csdp.org/research/1238.pdf|format=PDF}}</ref><ref name=Allison>{{cite journal |author=Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB |title=Annual deaths attributable to obesity in the United States |journal=JAMA |volume=282 |issue=16 |pages=1530–8 |year=1999 |month=October |pmid=10546692 |doi= 10.1001/jama.282.16.1530|url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=10546692}}</ref>  Large scale American and European studies have found that mortality risk varies with BMI; the lowest risk is found at a BMI of 22.5–25&nbsp;kg/m<sup>2</sup><ref name=Lancet2009>{{cite journal |author=Whitlock G, Lewington S, Sherliker P, ''et al'' |title=Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies |journal=Lancet |volume=373 |issue=9669 |pages=1083–96 |year=2009 |month=March |pmid=19299006 |doi=10.1016/S0140-6736(09)60318-4 |url=}}</ref> in non smokers and at a BMI of 24–27&nbsp;kg/m<sup>2</sup> in current smokers and increases with changes in either direction.<ref>{{cite journal |author=Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW |title=Body-mass index and mortality in a prospective cohort of U.S. adults |journal=N. Engl. J. Med. |volume=341 |issue=15 |pages=1097–105 |year=1999 |month=October |pmid=10511607 |doi= 10.1056/NEJM199910073411501|url=http://content.nejm.org/cgi/content/full/341/15/1097}}</ref><ref name=Euro2008>{{cite journal |author=Pischon T, Boeing H, Hoffmann K, ''et al'' |title=General and abdominal adiposity and risk of death in Europe |journal=N. Engl. J. Med. |volume=359 |issue=20 |pages=2105–20 |year=2008 |month=November |pmid=19005195 |doi=10.1056/NEJMoa0801891 |url=}}</ref> Obesity increases the risk of death in current and former smokers as well as in those who have never smoked.<ref name=Euro2008/>  A BMI of over 32 has been associated with a doubled [[mortality rate]] among women over a 16-year period<ref>{{cite journal |author=Manson JE, Willett WC, Stampfer MJ, ''et al.'' |title=Body weight and mortality among women |journal=N. Engl. J. Med. |volume=333 |issue=11 |pages=677–85 |year=1995 |pmid=7637744| doi = 10.1056/NEJM199509143331101 }}</ref> and obesity is estimated to cause an excess 111,909 to 365,000 death per year in the United States.<ref name=Allison/><ref name=HaslamJames>{{cite journal |author=Haslam DW, James WP |title=Obesity |journal=Lancet |volume=366 |issue=9492 |pages=1197–209 |year=2005 |pmid=16198769 |doi=10.1016/S0140-6736(05)67483-1}}</ref> Obesity on average reduces life expectancy by six to seven&nbsp;years.<ref>{{cite journal |author=Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L |title=Obesity in adulthood and its consequences for life expectancy: A life-table analysis |journal=Ann. Intern. Med. |volume=138 |issue=1 |pages=24–32 |year=2003 |month=January |pmid=12513041 |doi= |url=http://www.annals.org/cgi/reprint/138/1/24 | format=PDF}}</ref><ref name=HaslamJames/>  A BMI of 30–35 reduces life expectancy by two to four&nbsp;years<ref name=Lancet2009/> while severe obesity (BMI&nbsp;>&nbsp;40) reduces life expectancy by 20&nbsp;years for men and five&nbsp;years for women.<ref name=emedicine>
{{cite web |url=http://www.emedicine.com/med/TOPIC1653.HTM |author=Schwarz, Steven| title=Obesity |accessdate=2008-09-30 |work= |publisher=emedicine |date=November 1, 2007 }}</ref>
===Morbidity===
Obesity increases the risk of many physical and mental conditions. These comorbidities are reflected predominantly in [[metabolic syndrome]].<ref name=HaslamJames/>  Metabolic syndrome being a combination of medical disorders, which includes [[diabetes mellitus type 2]], [[hypertension|high blood pressure]], [[hypercholesterolemia|high blood cholesterol]], and [[hypertriglyceridemia|high triglyceride levels]].<ref>{{cite journal |author=Grundy SM |title=Obesity, metabolic syndrome, and cardiovascular disease |journal=J. Clin. Endocrinol. Metab. |volume=89 |issue=6 |pages=2595–600 |year=2004 |pmid=15181029 |doi=10.1210/jc.2004-0372}}</ref>
Complications are either directly caused by obesity or indirectly related through mechanisms sharing a common cause such as a poor diet or a [[sedentary lifestyle]]. The strength of the link between obesity and specific conditions varies. One of the strongest is the link with [[type 2 diabetes]]. Excess body fat underlies 64% of cases of diabetes in men and 77% of cases in women.<ref>Seidell 2005 p.9</ref>


==References==
==References==

Revision as of 14:12, 27 August 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Natural History, Complications and Prognosis

Complications

Health consequences can be categorized by the effects of increased fat mass (osteoarthritis, obstructive sleep apnea, social stigmatization) or by the increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease).[1][2] Increases in body fat alter the body's response to insulin, potentially leading to insulin resistance. Increased fat also creates a proinflammatory state, increasing the risk of thrombosis.[2]

Medical field Condition Medical field Condition
Cardiology Dermatology
Endocrinology and Reproductive medicine Gastrointestinal
Neurology Oncology[13]
Psychiatry Respirology
Rheumatology and Orthopedics Urology and Nephrology

Prognosis

Excessive body weight is associated with various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, and osteoarthritis.[1] As a result, obesity has been found to reduce life expectancy.[1]

Mortality

Obesity is one of the leading preventable causes of death worldwide.[23] [24][25] Large scale American and European studies have found that mortality risk varies with BMI; the lowest risk is found at a BMI of 22.5–25 kg/m2[26] in non smokers and at a BMI of 24–27 kg/m2 in current smokers and increases with changes in either direction.[27][28] Obesity increases the risk of death in current and former smokers as well as in those who have never smoked.[28] A BMI of over 32 has been associated with a doubled mortality rate among women over a 16-year period[29] and obesity is estimated to cause an excess 111,909 to 365,000 death per year in the United States.[25][1] Obesity on average reduces life expectancy by six to seven years.[30][1] A BMI of 30–35 reduces life expectancy by two to four years[26] while severe obesity (BMI > 40) reduces life expectancy by 20 years for men and five years for women.[31]

Morbidity

Obesity increases the risk of many physical and mental conditions. These comorbidities are reflected predominantly in metabolic syndrome.[1] Metabolic syndrome being a combination of medical disorders, which includes diabetes mellitus type 2, high blood pressure, high blood cholesterol, and high triglyceride levels.[32]

Complications are either directly caused by obesity or indirectly related through mechanisms sharing a common cause such as a poor diet or a sedentary lifestyle. The strength of the link between obesity and specific conditions varies. One of the strongest is the link with type 2 diabetes. Excess body fat underlies 64% of cases of diabetes in men and 77% of cases in women.[33]

References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 Haslam DW, James WP (2005). "Obesity". Lancet. 366 (9492): 1197–209. doi:10.1016/S0140-6736(05)67483-1. PMID 16198769.
  2. ↑ 2.0 2.1 Bray GA (2004). "Medical consequences of obesity". J. Clin. Endocrinol. Metab. 89 (6): 2583–9. doi:10.1210/jc.2004-0535. PMID 15181027.
  3. ↑ Darvall KA, Sam RC, Silverman SH, Bradbury AW, Adam DJ (2007). "Obesity and thrombosis". Eur J Vasc Endovasc Surg. 33 (2): 223–33. doi:10.1016/j.ejvs.2006.10.006. PMID 17185009. Unknown parameter |month= ignored (help)
  4. ↑ 4.0 4.1 4.2 4.3 4.4 Yosipovitch G, DeVore A, Dawn A (2007). "Obesity and the skin: skin physiology and skin manifestations of obesity". J. Am. Acad. Dermatol. 56 (6): 901–16, quiz 917–20. doi:10.1016/j.jaad.2006.12.004. PMID 17504714. Unknown parameter |month= ignored (help)
  5. ↑ Hahler B (2006). "An overview of dermatological conditions commonly associated with the obese patient". Ostomy Wound Manage. 52 (6): 34–6, 38, 40 passim. PMID 16799182. Unknown parameter |month= ignored (help)
  6. ↑ 6.0 6.1 6.2 Arendas K, Qiu Q, Gruslin A (2008). "Obesity in pregnancy: pre-conceptional to postpartum consequences". J Obstet Gynaecol Can. 30 (6): 477–88. PMID 18611299. Unknown parameter |month= ignored (help)
  7. ↑ Anand G, Katz PO (2008). "Gastroesophageal reflux disease and obesity". Rev Gastroenterol Disord. 8 (4): 233–9. PMID 19107097.
  8. ↑ Harney D, Patijn J (2007). "Meralgia paresthetica: diagnosis and management strategies". Pain Med. 8 (8): 669–77. doi:10.1111/j.1526-4637.2006.00227.x. PMID 18028045.
  9. ↑ Bigal ME, Lipton RB (2008). "Obesity and chronic daily headache". Curr Pain Headache Rep. 12 (1): 56–61. doi:10.1007/s11916-008-0011-8. PMID 18417025. Unknown parameter |month= ignored (help)
  10. ↑ Sharifi-Mollayousefi A, Yazdchi-Marandi M, Ayramlou H; et al. (2008). "Assessment of body mass index and hand anthropometric measurements as independent risk factors for carpal tunnel syndrome". Folia Morphol. (Warsz). 67 (1): 36–42. PMID 18335412. Unknown parameter |month= ignored (help)
  11. ↑ Beydoun MA, Beydoun HA, Wang Y (2008). "Obesity and central obesity as risk factors for incident dementia and its subtypes: A systematic review and meta-analysis". Obes Rev. 9 (3): 204–18. doi:10.1111/j.1467-789X.2008.00473.x. PMID 18331422. Unknown parameter |month= ignored (help)
  12. ↑ Wall M (2008). "Idiopathic intracranial hypertension (pseudotumor cerebri)". Curr Neurol Neurosci Rep. 8 (2): 87–93. doi:10.1007/s11910-008-0015-0. PMID 18460275. Unknown parameter |month= ignored (help)
  13. ↑ Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003). "Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults". N. Engl. J. Med. 348 (17): 1625–38. doi:10.1056/NEJMoa021423. PMID 12711737. Unknown parameter |month= ignored (help)
  14. ↑ 14.0 14.1 14.2 Poulain M, Doucet M, Major GC; et al. (2006). "The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies". CMAJ. 174 (9): 1293–9. doi:10.1503/cmaj.051299. PMC 1435949. PMID 16636330. Unknown parameter |month= ignored (help)
  15. ↑ Adams JP, Murphy PG (2000). "Obesity in anaesthesia and intensive care". Br J Anaesth. 85 (1): 91–108. doi:10.1093/bja/85.1.91. PMID 10927998. Unknown parameter |month= ignored (help)
  16. ↑ Choi HK, Atkinson K, Karlson EW, Curhan G (2005). "Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study". Arch. Intern. Med. 165 (7): 742–8. doi:10.1001/archinte.165.7.742. PMID 15824292. Unknown parameter |month= ignored (help)
  17. ↑ Tukker A, Visscher T, Picavet H (2008). "Overweight and health problems of the lower extremities: osteoarthritis, pain and disability". Public Health Nutr: 1–10. doi:10.1017/S1368980008002103. PMID 18426630. Unknown parameter |month= ignored (help)
  18. ↑ Molenaar EA, Numans ME, van Ameijden EJ, Grobbee DE (2008). "[Considerable comorbidity in overweight adults: results from the Utrecht Health Project]". Ned Tijdschr Geneeskd (in Dutch; Flemish). 152 (45): 2457–63. PMID 19051798. Unknown parameter |month= ignored (help)
  19. ↑ Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D'Andrea F, D'Armiento M, Giugliano D (2004). "Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial". JAMA. 291 (24): 2978–84. doi:10.1001/jama.291.24.2978. PMID 15213209.
  20. ↑ Hunskaar S (2008). "A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women". Neurourol. Urodyn. 27 (8): 749–57. doi:10.1002/nau.20635. PMID 18951445.
  21. ↑ Ejerblad E, Fored CM, Lindblad P, Fryzek J, McLaughlin JK, Nyrén O (2006). "Obesity and risk for chronic renal failure". J. Am. Soc. Nephrol. 17 (6): 1695–702. doi:10.1681/ASN.2005060638. PMID 16641153.
  22. ↑ Makhsida N, Shah J, Yan G, Fisch H, Shabsigh R (2005). "Hypogonadism and metabolic syndrome: Implications for testosterone therapy". J. Urol. 174 (3): 827–34. doi:10.1097/01.ju.0000169490.78443.59. PMID 16093964. Unknown parameter |month= ignored (help)
  23. ↑ Barness LA, Opitz JM, Gilbert-Barness E (2007). "Obesity: genetic, molecular, and environmental aspects". Am. J. Med. Genet. A. 143A (24): 3016–34. doi:10.1002/ajmg.a.32035. PMID 18000969. Unknown parameter |month= ignored (help)
  24. ↑ Mokdad AH, Marks JS, Stroup DF, Gerberding JL (2004). "Actual causes of death in the United States, 2000" (PDF). JAMA. 291 (10): 1238–45. doi:10.1001/jama.291.10.1238. PMID 15010446. Unknown parameter |month= ignored (help)
  25. ↑ 25.0 25.1 Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB (1999). "Annual deaths attributable to obesity in the United States". JAMA. 282 (16): 1530–8. doi:10.1001/jama.282.16.1530. PMID 10546692. Unknown parameter |month= ignored (help)
  26. ↑ 26.0 26.1 Whitlock G, Lewington S, Sherliker P; et al. (2009). "Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies". Lancet. 373 (9669): 1083–96. doi:10.1016/S0140-6736(09)60318-4. PMID 19299006. Unknown parameter |month= ignored (help)
  27. ↑ Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW (1999). "Body-mass index and mortality in a prospective cohort of U.S. adults". N. Engl. J. Med. 341 (15): 1097–105. doi:10.1056/NEJM199910073411501. PMID 10511607. Unknown parameter |month= ignored (help)
  28. ↑ 28.0 28.1 Pischon T, Boeing H, Hoffmann K; et al. (2008). "General and abdominal adiposity and risk of death in Europe". N. Engl. J. Med. 359 (20): 2105–20. doi:10.1056/NEJMoa0801891. PMID 19005195. Unknown parameter |month= ignored (help)
  29. ↑ Manson JE, Willett WC, Stampfer MJ; et al. (1995). "Body weight and mortality among women". N. Engl. J. Med. 333 (11): 677–85. doi:10.1056/NEJM199509143331101. PMID 7637744.
  30. ↑ Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L (2003). "Obesity in adulthood and its consequences for life expectancy: A life-table analysis" (PDF). Ann. Intern. Med. 138 (1): 24–32. PMID 12513041. Unknown parameter |month= ignored (help)
  31. ↑ Schwarz, Steven (November 1, 2007). "Obesity". emedicine. Retrieved 2008-09-30.
  32. ↑ Grundy SM (2004). "Obesity, metabolic syndrome, and cardiovascular disease". J. Clin. Endocrinol. Metab. 89 (6): 2595–600. doi:10.1210/jc.2004-0372. PMID 15181029.
  33. ↑ Seidell 2005 p.9

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