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Obesity Related Risk Factors
Some risk factors or comorbidities associated with obesity place patients at a higher risk for premature mortality and require aggressive management; other conditions associated with obesity are less dangerous, but still require treatment.
High absolute risk factors include6
- Coronary artery disease (CAD)
- Presence of other atherosclerotic diseases (peripheral arterial disease, abdominal aortic aneurysm, symptomatic carotid artery disease)
- Diabetes Type 2 (fasting plasma glucose ≥7.0 mmol/L or 2-h postprandial plasma glucose ≥11.1 mmol/L)
- Obstructive sleep apnea (OSA)
- Three or more of these multiple risk factors:
- Cigarette smoking
- Hypertension
- Lipid disorders (high TC, high LDL, low HDL, high TR)
- Impaired fasting glucose (IFG is between 6.0 and 7.0 mmol/L)
- Family history of early cardiovascular disease
- Metabolic syndrome (atherogenic lipoprotein phenotype, hypertension, insulin resistance, glucose intolerance, prothrombotic states)
Other medical implications of obesity include9
- Asthma
- Gastroesophageal reflux (GERD)
- Gynecological abnormalities
- Osteoarthritis
- Gout
- Stress incontinence
- Nonalcoholic steatohepatitis (NASH)
- Obstetric complications
- Low back pain
- Depression
- Immobility
- Some cancers such as, breast, colon, endometrial, kidney, and gallbladder
- Skin infections
- Accident proneness
Obesity & Comorbidities References:
1. Mathus-Vliegen EM, Tytgat GN. Intragastric balloon for treatment-resistant obesity: safety, tolerance, and efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up. Gastrointest Endosc. 2005;61:19-27 9.2. World Health Organisation. Factsheet No 311, Overweight and Obesity, September 2006. Accessable at: http://www.who.int/mediacentre/factsheets/fs311/en/index.html
3. Fried M, Hainer V, Basdevant A et al. Inter-disciplinary European guidelines on surgery of severe obesity. International Journal of Obesity 2007; 31: 569-577
4. Buchwald H. Consensus Conference Statement. Bariatric surgery for morbid obesity: Health implications for patients, health professionals, and third-party payers. Surgery for Obesity and Related Diseases 2005; 1: 371-381
5. Lau DCW for the Obesity Canada Clinical Practice Guidelines Steering Committee and Expert Panel. Synopsis of the 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children. Canadian Medical Association Journal 2007; 176; 1103-1106
6. National Heart, Lung, and Blood Institute Web site. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults. Available at: http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf. Accessed March 29, 2007.
7. Dixon JB, O’Brien PE. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care. 2002;25:2:358-363.
8. Obesity in the U.S. American Obesity Assocation. http://www.obesity.org/subs/fastfacts/obesity_US.shtml.
9. Sugerman HJ. The pathophysiology of severe obesity and the effects of surgically induced weight loss. Surgery for Obesity and Related Diseases. 2005;109-119.