lunes, 27 de enero de 2014

Health Risks of Adult Obesity

There is now good evidence to show that adult obesity is associated with a wide range of health problems, these are summarised below.

Musculoskeletal system
  • Raised body weight puts strain on the body's joints, especially the knees, increasing the risk of osteoarthritis (degeneration of cartilage and underlying bone within a joint).
  • There is also an increased risk of low back pain.

Circulatory system
  • Raised BMI increases the risk of hypertension (high blood pressure), which is itself a risk factor for coronary heart disease and stroke and can contribute to other conditions such as renal failure.
  • The risk of coronary heart disease (including heart attacks and heart failure) and stroke are both substantially increased.
  • Risks of deep vein thrombosis and pulmonary embolism are also increased.

Metabolic and endocrine systems
  • The risk of Type 2 diabetes is substantially raised: it has been estimated that excess body fat underlies almost two-thirds of cases of diabetes in men and three quarters of cases in women. Diabetes currently affects nearly 200 million people worldwide and International Diabeted Federation predict that this will increase to over 330 million by 2025, with a massive burden in developing countries. Worldwide, the number of people with diabetes has tripled since 1985.
  • There is a greater risk of dyslipidemia (for example, high total cholesterol or high levels of triglycerides), which also contributes to the risk of circulatory disease by speeding up atherosclerosis (fatty changes to the linings of the arteries).
  • Metabolic syndrome is a combination of disorders including high blood glucose, high blood pressure and high cholesterol and triglyderide levels. It is more common in obese individuals and is associated with significant risks of coronary heart disease and Type 2 diabetes.

  • The risk of several cancers is higher in obese people, including endometrial, breast and colon cancers.

Reproductive and urological problems
  • Obesity is associated with greater risk of stress incontinence in women.
  • Obese women are at greater risk of menstrual abnormalities, polycystic ovarian syndrome and infertility.
  • Obese men are at higher risk of erectile dysfunction.
  • Maternal obesity is associated with health risks for both the mother and the child during and after pregnancy. Click here for more information on maternal obesity

Respiratory problems
  • Overweight and obese people are at increased risk of sleep apnoea (interruptions to breathing while asleep) and other respiratory problems such as asthma.

Non-alcoholic fatty liver disease
  • The term ‘non-alcoholic fatty liver disease’ (NAFLD) refers to a range of conditions resulting from the accumulation of fat in cells inside the liver. It is one of the commonest forms of liver disease in the UK. If left untreated, it may progress to severe forms such as non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis. It has also been linked to liver cancer.
  • Obesity is an important risk factor for the condition: over 66% of overweight people, and over 90% of obese individuals, have NAFLD [1]. As levels of obesity have risen, so has the prevalence of NAFLD.
  • There is a lack of high quality data related to the prevalence of NAFLD in the UK, but international studies estimate that NAFLD is likely to affect around 20% of adults (estimates across countries range from 6% to 35%) and 10-15% of children worldwide [2, 3]. This is due to a number of factors including variations in diagnostic criteria, the invasive nature of diagnosis, and the lack of symptoms in people with mild forms of the condition.
  • Approaches to tackling the condition focus on weight reduction through a combination of diet and physical activity, but there is no specific evidence-based treatment for NAFLD.

Gastrointestinal disease
Obesity is associated with:
  • Increased risk of gastro-oesophageal reflux
  • Increased risk of gall stones
  • Psychological and social problems
  • Overweight and obese people may suffer from stress, low self-esteem, social disadvantage, depression and reduced libido.
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