Obesity with comorbidities
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Obesity Related Comorbidity

What is meant by obesity?

The World Health Organisation defines obesity as a condition in which abnormal or excessive fat accumulation poses a health concern. Obesity is defined by the Centers for Disease Control and Prevention as having a body mass index (BMI) of 30 kg/m^2 or above.

One screening method for determining if a person is overweight or obese is BMI. Three classifications can be used to categorize obesity further:

  • Class 1: BMI between 30 and less than 35 kg/m^2.
  • Class 2: BMI between 35 and less than 40 kg/m^2.
  • Class 3: Severe obesity, defined as a BMI of 40 kg/m^2 or above

Obesity’s intricate mechanism:

Obesity is a complicated condition that affects the body through several underlying processes. The gut microbiota and inflammation are two hypothesized pathways of obesity problems. Obesity causes the liver, brain, pancreas, and adipose tissues to have a persistently low inflammatory response. The activated immune cells and mediators trigger a dysregulated immune system that results in vascular and metabolic problems.

The gut microbiota is the second mechanism of obesity that has been postulated. The natural bacteria or germs that reside in your gut and support your health and well-being are known as the microbiome. The gut microbiota affects your metabolism through signaling pathways, inflammatory effects, fat deposition, and insulin resistance. Changes in gut flora are linked to obesity.

Numerous comorbid disorders are caused by the underlying processes of obesity, which also impact several organs and contribute to systemic problems.

Describe comorbidity:

When a patient has two or more illnesses or medical problems at the same time, this is known as comorbidity. They could coexist for a variety of reasons, such as risk factors and common causes. Patients who have obesity comorbidities are at higher risk for health problems.

Comorbidities may raise the chance of problems or possibly lead to the emergence of a new medical condition.

What is a comorbidity connected to weight?

A weight-related comorbidity is when a person with obesity acquires another illness as a result of their weight. Obesity affects 42% of Americans and is associated with several chronic conditions, including cancer, heart disease, high blood pressure, type 2 diabetes, and obstructive sleep apnoea.

Obesity and overweight increase the likelihood of getting these illnesses. This page responds to the question, “What is a weight-related comorbidity? And explains how various medical conditions might be brought on by weight.

Common comorbidities associated with weight:

When BMI exceeds 30 kg/m^2, the risk of obesity-related comorbidities, especially cardiovascular disease, increases dramatically. Obesity increases the risk of heart disease, stroke, sleep apnoea, gallbladder disease, gout, osteoarthritis, type 2 diabetes, hypertension, and dyslipidemia.

Obesity is linked to several malignancies, including endometrial, breast, and gallbladder cancer in women and colorectal and pancreatic cancer in males. Obesity is also associated with psychosocial comorbidities, including depression. Losing weight and managing it can help several of these comorbidities.

Diabetes
A significant risk factor for type 2 diabetes is obesity. Type 2 diabetes is almost ten times more common in those who are obese or severely obese. The chance of dying can almost double if you have type 2 diabetes. Amputations, heart disease, stroke, blindness, kidney disease, high blood pressure, circulation and nerve problems, infections that are difficult to cure, impotence, and more can all result from type 2 diabetes.

Sleep Apnea
When someone has sleep apnoea, their breathing pauses while they are asleep. In a single night, this can occur thirty or more times. Since being overweight is nearly always the cause of sleep apnoea, losing weight will frequently resolve the issue.

GERD
One of the main comorbidities of obesity is GERD (gastro-oesophageal reflux disease), commonly referred to as heartburn or reflux. Although medical therapy is often used to treat GERD that is not responsive to medication, people with morbid obesity often do not respond well to the standard surgical procedure known as Nissen fundoplication. Consequently, bariatric surgery is used to address reflux in individuals who are very obese.

Hypertension
Obese persons are far more likely than those of normal weight to have hypertension or high blood pressure. Hypertension affects over 40% of Americans with a BMI above 30, compared to just 15% of those with a BMI under 25. Therefore, losing weight will probably lower blood pressure if it is being caused by excess weight.

Heart Conditions
Several disorders that impact the heart or its components together are collectively referred to as heart diseases. Nearly all forms of heart disease, such as coronary artery disease, heart attacks, and heart failure, are made more likely by obesity.

Cancer
It has been demonstrated that obesity raises a person’s risk of developing malignancies of the uterus, breast, colon, kidney, and gallbladder. According to research published in the New England Journal of Medicine, men and women of normal weight had a 50% lower risk of dying from cancer than those with a BMI of above 40.

Stroke
A stroke occurs when blood flow to the brain or other nervous system components is disrupted. Within minutes, brain cells start to die as a result of this disruption, which deprives the brain of oxygen and essential nutrients. In the US, stroke ranks as the third most common cause of death. Strokes are more likely to occur in obese people.

Dyslipidaemia
A condition of lipoprotein metabolism, dyslipidemia is often brought on by abnormally elevated cholesterol. One of the main risk factors for coronary artery disease is dyslipidemia. Obesity contributes to the development of dyslipidemia by raising triglyceride levels and lowering high-density lipoprotein (HDL) levels.

Disease of the Gallbladder
Gallstones and gallbladder cancer are examples of gallbladder diseases. Because obesity alters bile production, which can result in gallstones and other issues, it raises the risk of gallbladder illness, according to recent research.

Decreased Fertility
Obesity and infertility have a complicated relationship. Extremely overweight women may experience issues with regular ovulation due to hormones from their adrenal glands that mimic estrogen. Polycystic ovarian syndrome, a disorder that can result in infertility, is also linked to obesity.

Osteoarthritis
A degenerative condition affecting the bones and cartilage is osteoarthritis. Because obesity puts additional strain on the joints, obese persons are more likely to develop osteoarthritis.

Depression
Depression is a severe mental, physical, and emotional condition. It encompasses physical symptoms like exhaustion and persistent aches and pains as well as emotions of worthlessness and despair. Obesity, depression, and other concomitant illnesses including diabetes have been linked in several medical research.

Risk factors for comorbidities connected to weight:

Body mass index (BMI): Your chance of developing comorbidities increases with your BMI. A higher BMI does not, however, invariably indicate a higher risk of illness. While elderly individuals who have lost muscle may have an underestimated BMI, muscular athletes may have an exaggerated BMI.

Waist Circumference: There are other indicators of your risk of weight-related comorbidity than your BMI. Your risk is also influenced by the way your fat cells are carried. Weight-related comorbidities are more common in those with central adiposity, or an excess of adipose cells around the waist.

Genetics: Adipose cell transport is influenced by genes. Along with hormones and lifestyle decisions, your genetics also contribute to your waist circumference. Your risk of heart disease and type 2 diabetes is increased by the amount of fat tissue around your waist Furthermore, a higher risk of obesity is associated with certain gene changes.

Physical Activity: Your risk of weight-related comorbidities can be considerably increased by obesity and a sedentary lifestyle.

Diet: Eating a lot of processed foods and sugar-sweetened drinks (SSBs) raises your risk of obesity and the illnesses that come with being overweight. Cooking at home may lower your chance of becoming obese.

Management of comorbidities associated with weight:

ChanLifestyle changes the main therapy for comorbidities related to weight. Programs for managing your weight can help you change your lifestyle and assess whether you require further care, such as medication or surgery.

Weight management programs: There are a lot of possibilities for weight control programs available in the current digital era. Apps and synchronous telehealth consultations are two ways to control weight.

Lifestyle: Two strategies to lower your risk of weight-related comorbidities are to increase your daily physical activity and include more plant-based foods in your diet.

Drugs: A family of drugs called GLP-1s is recommended for obesity and type 2 diabetes. Only a healthcare professional can administer GLP-1s, and they will assess your medical history to see if you qualify for a prescription.

Surgery: If all other treatments fail, surgery is regarded as the final resort. The most common kind of weight loss surgery for obese people is bariatric surgery.

FAQs

What is meant by obesity with comorbidity?

In the realm of medicine, “morbidity” refers to illness or disease. The word “comorbidity,” which refers to a person having several illnesses or diseases happening at the same time, is also often used by healthcare professionals.

What distinguishes obesity from morbid obesity?

If your body mass index (BMI) is more than 30, you are considered obese, meaning you have too much body fat. Your weight about height are measured by your BMI. Being over 100 pounds overweight or having a BMI of 40 or greater are common definitions of morbid obesity, often known as “clinically severe obesity.”

Which of the following describes an obese comorbidity?

Numerous epidemiologic studies have documented links between obesity and common comorbidities, including diabetes, hypertension, dyslipidemia, and obstructive sleep apnoea.

What is meant by comorbid?

You may be familiar with the medical word “comorbidity” from your doctor. It characterizes having several illnesses or conditions in your body at the same time. Comorbidities are typically chronic, or long-lasting. They might or might not communicate with one another.

Which four categories of obesity exist?

Based on the location and content of body fat, four phenotypes of obesity have been identified: Obese people who are (1) normal weight, (2) metabolically obese, (3) metabolically healthy, and (4) metabolically unwell. All of the traits that have been reported are associated with sarcopenic obesity.

Does comorbidity pose a risk?

Coexisting conditions that arise apart from one another are known as comorbidities. They don’t cause one another directly, even if they could have similar risk factors. Obesity, for instance, may make you more susceptible to the comorbid conditions of diabetes and arthritis.

References

  • What is a Weight-Related Comorbidity? | Everlywell. (n.d.). https://www.everlywell.com/blog/weight-management/what-is-a-weight-related-comorbidity/?srsltid=AfmBOoqTMBv_WWkgRZ0vJb-ZvY3OL1POhn2RJSWQTRTXBL_PFIpTuQ3g
  • Bariatric Weight Loss Surgery – Paul B. Wizman MD PA – Bariatric Florida. (2022, October 5). Obesity Comorbidities – Paul B Wizman MD PA / Bariatric Florida. https://drwizman.com/obesity-comorbidities/#1665001898106-dbca4542-e918
  • Obesity-Related Comorbidities List | EverlyWell. (n.d.). https://www.everlywell.com/blog/weight-management/obesity-related-comorbidities/?srsltid=AfmBOopbXZ9wBAoSFptg8xIKR26hjwkvaKlkvsYt-dBf872UXlBlDgi0

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