Common Medical Problems Associated with Morbid Obesity

If your weight is 20% or more over the ideal weight for your height you are considered to be obese. If you are 100 pounds or more above your ideal weight, you are considered to be in a morbid obesity category.

Obesity is most often defined as being 20% or more over ideal body weight. According to the Centers for Disease Control and Prevention, more than 36% of Americans are obese. Morbid obesity is a much more severe form of obesity in which a person is 100 or more pounds overweight. Obesity is a common condition which can have profoundly negative health and social consequences. Morbid obesity is considered a serious disease and has been linked to shortened life expectancy. According to C. Everett Koop, former Surgeon General of the United States, morbid obesity is the second leading cause of preventable death in America.

Medical problems commonly resulting from untreated morbid obesity include the following:

Certain cancers

Depression

Hypertension

Heart disease

Stroke

Diabetes

Osteoarthritis

Affected people may gradually develop hypoxemia (decreased blood oxygen saturation) and have problems with sleep apnea (periodic cessation of breathing while asleep).

Decreased blood oxygen and problems associated with sleep apnea may result in feeling drowsy through the day (somnolence), high blood pressure, and pulmonary hypertension.

Common Causes  

Excessive caloric intake
Thyroid disorders
Lack of physical activity

Cardiac Function

In extreme cases, especially when medical treatment is not sought, this can lead to right-sided heart failure (cor pulmonale), and ultimately death. Obese are at risk of a specific form of obesity induced cardiac dysfunction. Left ventricular systolic and diastolic functions are affected. Obesity induced cardiomyopathy is well-documented.  Blood volume is increased and cardiac output increase by 20-30ml/kg of excess body fat. They tolerate exercise very poorly. Any increase in cardiac output is by an increase in heart rate.

Higher incidence of cardiovascular morbidity is associated with morbid obesity. Mild to moderate hypertension is found in 60-70% of men and women and severe in 5-10%, with 3-4mmHg increase in systolic and 2mmHg increase in diastolic pressure for every 20 pound increase of weight is noted. It is the most common problem followed by ischaemic heart disease. An expansion of extracellular volume resulting in hypervolaemia and increase in cardiac output is characteristic of obesity-induced hypertension.

Exact mechanism is not known but interplay of genetic, hormonal, renal and haemodynamic factors are implicated. Hyperinsulinaemia activating sympathetic nervous system, causing sodium retention, increase in pressor norepinephrine and angiotensin II activity. Concentric hypertrophy of left ventricle leads to cardiac failure. Obesity is independent risk factors for Ischaemic Heart Disease (IHD) and is more common in individuals with central morbid obesity. Blood volume is increased, most extra volume being distributed to fat organ. Splanchnic blood flow is increased by 20%, renal and cerebral blood flows are normal. Cardiac arrhythmias can be precipitated in obese by any number of factors such as an electrolyte imbalance, diuretic therapy, hypoxia, hypercapnia, and fatty infiltration of conducting tissue.

Morbid Obesity Treatment Options:

The fact remains that morbid obesity is a complex, multifactorial chronic disease and a lot of people have to revert to gastric bypass surgery. For many patients, the risk of death from not having the surgery is greater than the risks from the possible complications of having the procedure.

The number of bariatric surgeries increased to 179,000 in 2013 with 34.2% of surgeries as Roux-en-Y gastric bypass, 14% gastric banding, 42.1% gastric sleeve, 1% as duodenal switch, 6% as revisional surgery and 2.7% classified as other. Patients who had the procedure are benefiting from its results and most are reporting improvements in their quality of life, social interactions, and psychological well-being.

In clinical studies, candidates for the procedure who had multiple obesity-related health conditions questioned whether they could safely have the surgery. These studies show that selection of surgical candidates is based on very strict criteria and surgery is an option for the majority of patients.

Clearly, the best method is to try and lose weight through proper diet and exercise before electing a surgical route. Here at Total Body Fitness we can help you do just that by designing a program that is tailored to fit your needs and goals. Not only will we focus on your weight loss goals, but also any medical ailments you may be suffering from as a consequence of being overweight. Become a member today and let us help you get your life back!