Cardiovascular & Related Problems
Hypertension, or high blood pressure, can be associated with morbid obesity. Over time this may lead to problems as blood vessels and organs are gradually damaged by higher blood pressures than they are able to handle. Hypertension tends to worsen arteriosclerosis (hardening of the arteries). Organs particularly at risk for damage from high blood pressure include the kidneys and, especially in the case of diabetics, the eyes, hardening of the arteries, kidney failure and erectile dysfunction.
Because of the way that the body breaks down fat stores, morbidly obese individuals are more likely to have higher than average blood cholesterol levels. This condition speeds up the rate at which arteriosclerosis (hardening of the arteries) and/or other arterial diseases progress. This can increase the risks for stroke or heart attack.
People with a BMI over 40 are 15 times more likely to develop Type II Non-Insulin Dependent Diabetes (usually adult onset) than people with a BMI below 27 or “normal weight” individuals. Insulin is a chemical the body releases which enables glucose “sugar” to enter the cells from the blood vessels. It’s important to note that Type II Non-Insulin diabetics are resistant to this process; thus the associated term “insulin resistance.” Having a high body fat content increases the chance of a person being insulin resistant. After meals glucose is released into the blood. In an insulin resistant or Type II Diabetic patient, glucose “sugar” is unable to enter the cells. Chronically elevated levels of glucose in the blood cause damage to many tissues and organs.
Heart disease is about 6 times more common in morbidly obese individuals. Hypertension, high cholesterol, and arteriosclerosis (all part of this list) makes the heart more susceptible to fatigue or strain as it struggles to push blood through the body. This may lead to heart rhythm disorders, which could lead to heart attack or sudden cardiac death.
Venous Stasis Disease
The heart pumps blood under pressure to the body through the arteries. Blood is returned to the heart through veins. We rely on a series of one-way valves in our veins to get blood back “uphill” to our heart. Normal physical motion squeezes vein segments, pushing blood up to the next level. Large fat deposits in the vessels can hamper this process, especially for blood returning from the feet and lower legs. Edema (swelling) and skin problems, including ulceration, (venous stasis) can result.
“Apnea” means “without breath.” Sleep apnea is when people literally stop breathing during their sleep, usually for many seconds at a time. This disorder is almost always associated with obese anatomy of the neck region and may be associated with snoring.
Sleep can be interrupted without the morbidly obese patient remembering it in the morning. The most noticeable result of sleep apnea is extreme fatigue and day time drowsiness. Other problems may include hypertension, heart rhythm disorders and sometimes sudden death.
Obesity Hypoventilation Syndrome
When sleep apnea is left untreated, it may cause carbon dioxide levels to reach toxic levels in the blood. This leads to a wide range of metabolic imbalances.
An additional breathing disorder related to obesity is respiratory insufficiency. Sufferers may find themselves constantly out of breath upon any type of exertion. Lung capacity is diminished due to reduced strength and size. The oxygen requirements of normal activities exceed the body’s ability to supply it.
Asthma can be made much worse by obesity. Oversized body mass can interfere with breathing.
Few people have spinal columns strong enough to bear the increased stress of a morbidly obese body.
Cartilage between the vertebrae of the spine begins to wear out prematurely, especially with frequent physical exertion such as lifting or carrying.
Degeneration can take the form of arthritis or a “slipped disk.” These conditions can result in painful nerve damage (which may run down nerves in the leg) and can be very difficult to repair with surgery.
Arthritis of Weight-Bearing Joints
All weight bearing joints are at increased risk of wearing out prematurely in morbidly obese individuals. Arthritis and painful inflammation is most common in the knees, but may also occur in the hips, ankles and feet. This can cause previously active people to become mostly immobile -- making it difficult for morbidly obese people to engage in physical activity, thus contributing to their obesity problem. Often, joint replacement is not advisable in morbidly obese people due to a high failure rate following this surgery.
Psychological & Social Problems
As any overweight person can attest to, obesity adds additional emotional stress to the normal range of daily emotions. Feelings of guilt, inadequacy, embarrassment and failure often contribute to an increase in emotional stress levels. This may lead to overeating which only compounds the problem.
Impaired Social Function
Overweight people may become socially isolated, this often leads to decreased social skills and comfort.
A common misconception, “heart burn” is not associated with the heart. Heart burn is the result of stomach acids going beyond the protective barrier between the stomach and the esophagus, causing injury or irritation to the esophagus. Overweight individuals may have fat stores that push or change their stomach anatomy so that this barrier can no longer function properly. With time, exposing the esophagus to stomach acid may lead to a precancerous condition called Barrett’s esophagus which requires close monitoring. Gastric reflux or “heartburn” may also lead to aspiration or swallowing of stomach acids into the lungs. This can cause pneumonia and other serious medical complications.
Urinary Stress Incontinence
A significant percentage of morbidly obese women suffer from urinary stress incontinence, especially if they have had children. The pelvic muscles become relaxed and displaced by a heavy abdomen, causing a weakening of the urinary valve. Leakage may result during laughing, coughing, sneezing or lifting.
Gallbladder disease is more than three times more common in obese people than non-obese people. This condition may result from repeated attempts at dieting. Painful stones may develop in the gallbladder.
This may require surgical removal of the gallbladder.