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Associated Co-morbid Conditions of Clinically Severe Obesity

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Management of Nutritional and Metabolic Complications of Bariatric Surgery

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Abstract

Obesity is an important public health problem. Its prevalence has progressively increased worldwide to an extent that it is now a significant problem not only in affluent societies but also in developing countries. It is associated with higher mortality and this is due to the great burden of its associated co-morbidities. These range from impaired glucose tolerance and type 2 diabetes mellitus, heart disease, dyslipidemia, cerebrovascular disease, metabolic syndrome, obstructive sleep apnea syndrome (OSAS), asthma, gastroesophageal reflux disease, non-alcoholic fatty liver disease (NAFLD), non-alcoholic fatty liver steatohepatitis (NASH), polycystic ovary syndrome (PCOS), psychosocial and psychiatric problems, osteoarthritis to cancer. A greater part of these co-morbidities is likely to regress or at least improve after weight loss. For this reason, along with BMI, they are the basis for the indication for Bariatric Surgery in most national guidelines. At the same time, the resolution or improvement of these co-morbidities has to be considered as another goal of bariatric surgery and must be given the same importance as weight loss in its outcomes.

It is important to note that the obesity-associated diseases require a more careful pre-operative examination of the patient and can impact the post-operative outcome.

This chapter aims to give an overview of the most important pathologies associated with clinically severe obesity.

A thorough knowledge of the associated co-morbid conditions of clinically severe obesity is warranted for every health care professional interested in bariatric therapy.

Maurizio De Luca

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References

  1. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA. 2002;288(14):1723–7.

    Article  PubMed  Google Scholar 

  2. The Malawi STEPS survey for chronic non-communicable diseases and their risk factors. 2010 [Google Scholar].

    Google Scholar 

  3. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Global burden of disease and risk factors. The World Bank and Oxford University Press; 2006. Available http://www.dcp2.org/pubs/GBD [Google Scholar].

  4. Murray C, Lopez A. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020, vol. 1. Geneva: World Health Organization; 1996.

    Google Scholar 

  5. Baingana FK, Bos ER. Changing patterns of disease and mortality in sub-Saharan Africa: An overview. In: Jamison DT, Feachem RG, Makgoba MW, Bos ER, Baingana FK, et al., editors. Disease and mortality in sub-Saharan Africa. 2nd edn. World Bank; 2008. pp. 1–9 [Google Scholar].

    Google Scholar 

  6. World Health Organization. Report of a WHO Consultation on Obesity. Geneva, Switzerland: World Health Organization; 1998. Obesity: preventing and managing the global epidemic [Google Scholar].

    Google Scholar 

  7. NHLBI Expert Panel. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: evidence report. Bethesda, MD: NIH; 2002 (NIH publication no. 02-4084) [Google Scholar].

    Google Scholar 

  8. Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med. 2003;138:24–32.

    Article  PubMed  Google Scholar 

  9. Dhana K, Kavousi M, Ikram MA, Tiemeier HW, Hofman A, Franco OH. Body shape index in comparison with other anthropometric measures in prediction of total and cause-specific mortality. J Epidemiol Community Health. 2016;70(1):90–6. https://doi.org/10.1136/jech-2014-205257. Epub 2015 Jul 9

    Article  PubMed  Google Scholar 

  10. Krakauer JC. Untangling waist circumference and hip circumference from body mass index with a body shape index, hip index, and anthropometric risk indicator. Metab syndr Related Disord. 2018;16(4):160–5. https://doi.org/10.1089/met.2017.0166. Epub 2018 Mar 13

    Article  Google Scholar 

  11. Dietz WH, Robinson TN. Clinical practice. Overweight children and adolescents. N Engl J Med. 2005;352:2100.

    Article  CAS  PubMed  Google Scholar 

  12. NIH conference. Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med. 1991;115(12):956–61.

    Article  Google Scholar 

  13. Forestieri P, et al. Linee guida e stat dell’arte della chirurgia bariatrica e metabolica in Italia. EDISES s.r.l. – Napoli; 2008. ISBN: 978 88 7959 455 4.

    Google Scholar 

  14. Frank B, Hu FB, Manson JE, Stumpfer MJ, Colditz G, Liu S, Solomon CG, Willett WC. Diet, Lifestyle, and the risks of type 2 diabetes in women. N Engl J Med. 2001;345(11):790–7.

    Article  Google Scholar 

  15. Koh-Banerjee P, Wang Y, Hu FB, Spiegelman D, Willett WC, Rimm EB. Changes in body weight and body fat distribution as risk factors for clinical diabetes in US men. Am J Epidemiol. 2004;159(12):1150–9.

    Google Scholar 

  16. Tuomilehto J. The emerging global epidemic of type 1 diabetes. Curr Diab Rep. 2013;13:795–804.

    Article  CAS  PubMed  Google Scholar 

  17. Knowler WC, Barrett-Connor E, Fowler SE, et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.

    Article  CAS  PubMed  Google Scholar 

  18. UK Prospective. Diabetes Study 7. UK Prospective Diabetes Study 7: response of fasting plasma glucose to diet therapy in newly presenting type II diabetic patients, UKPDS Group. Metabolism. 1990;39:905–12.

    Article  Google Scholar 

  19. Rothberg AE, McEwen LN, Kraftson AT, Fowler CE, Herman WH. Very-low-energy diet for type 2 diabetes: an underutilized therapy? J Diabetes Complication. 2014;28:506–10.

    Article  Google Scholar 

  20. Pastors JG, Warshaw H, Daly A, Franz M, Kulkarni K. The evidence for the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care. 2002;25:608–13.

    Article  PubMed  Google Scholar 

  21. Day JW, Ottaway N, Patterson JT, et al. A new glucagon and GLP-1 co-agonist eliminates obesity in rodents. Nat Chem Biol. 2009;5:749–57.

    Article  CAS  PubMed  Google Scholar 

  22. Steven S, Hollingsworth KG, Al-Mrabeh A, et al. Very low-calorie diet and 6 months of weight stability in type 2 diabetes: pathophysiological changes in responders and nonresponders. Diabetes Care. 2016;39:808–15.

    Article  CAS  PubMed  Google Scholar 

  23. Rubino F, Nathan DM, Eckel RH, et al. Delegates of the 2nd Diabetes Surgery Summit. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care. 2016;39:861–77.

    Article  CAS  PubMed  Google Scholar 

  24. De Luca M, Angrisani L, et al. Indications for surgery for obesity and weight-related diseases: position statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg. 2016;26:1659–96. https://doi.org/10.1007/s11695-016-2271-4.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Rubino F, Kaplan LM, Schauer PR, Cummings DE, Delegates DSS. The Diabetes Surgery Summit consensus conference: recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus. Ann Surg. 2010;251:399–405.

    Article  PubMed  Google Scholar 

  26. Cohen JB. Hypertension in obesity and the impact of weight loss. Curr Cardiol Rep. 2017;19(10):98. https://doi.org/10.1007/s11886-017-0912-4.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Wilson PW, D’Agostino RB, Sullivan L, Parise H, WB K. Overweight and obesity as determinants of cardiovascular risk; the Framingham experience. Arch Intern Med. 2002;162:1867–72.

    Article  PubMed  Google Scholar 

  28. Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004;79:379–84.

    Article  CAS  PubMed  Google Scholar 

  29. Luo J, Rossouw J, Margolis KL. Smoking cessation, weight change and coronary heart disease among postmenopausal women with and without diabetes. JAMA. 2013;310(1):94–6. https://doi.org/10.1001/jama.2013.6871.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Kenchaiah S, Evans JC, Levy D, Wilson PW, Benjamin EJ, Larson MG, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347:305–13.

    Article  PubMed  Google Scholar 

  31. Curtis JP, Selter JG, Wang Y, Rathore SS, Jovin IS, Jadbabaie F, et al. The obesity paradox. Body mass index and outcomes in patients with heart failure. Arch Intern Med. 2005;165:55–61.

    Article  PubMed  Google Scholar 

  32. Davos CH, Doehner W, Rauchhaus M, et al. Body mass and survival in patients with chronic heart failure without cachexia: the importance of obesity. J Card Fail. 2003;929–35.

    Google Scholar 

  33. Lavie CJ, Osman AF, Mlani RV, Mehra MR. Body composition and prognosis in chronic systolic heart failure: the obesity paradox. Am J Cardiol. 2003:91891–4.

    Google Scholar 

  34. Piché ME, Vasan SK, Hodson L, Karpe F. Relevance of human fat distribution on lipid and lipoprotein metabolism and cardiovascular disease risk. Curr Opin Lipidol. 2018;29(4):285–92. https://doi.org/10.1097/MOL.0000000000000522.

    Article  CAS  PubMed  Google Scholar 

  35. Sun L, Ishida T, Miyashita K, Kinoshita N, Mori K, Yasuda T, Toh R, Nakajima K, Imamura S, Hirata K. Plasma activity of endothelial lipase impacts high-density lipoprotein metabolism and coronary risk factors in humans. J Atheroscler Thromb. 2014;21(4):313–21. Epub 2013 Dec 26

    Article  PubMed  CAS  Google Scholar 

  36. Despres JP, Moorjani S, Pouliot MC, Tremblay A, Nadeau A, Lupien PJ, Bouchard C. Correlates of plasma very-low-density lipoprotein concentration and composition in premenopausal women. Metabolism. 1990;39:577–83.

    Article  CAS  PubMed  Google Scholar 

  37. Song YM, Sung J, Davey Smith G, Ebrahim S. Body mass index and ischemic and hemorrhagic stroke; a prospective study in Koreanmen. Stroke. 2004;35:831–6.

    Article  PubMed  Google Scholar 

  38. Tanne D, Medalie JH, Goldbourt U. Body fat distribution and long-term risk of stroke mortality. Stroke. 2005;36:1021–5.

    Article  PubMed  Google Scholar 

  39. Executive summary of the third report of the National Cholesterol Education Program (NCEP), author Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497

    Google Scholar 

  40. Eckel RH, Albert KG, Grund SM. The metabolic syndrome. Lancet. 2010;375:181–3.

    Article  PubMed  Google Scholar 

  41. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.

    Article  CAS  PubMed  Google Scholar 

  42. Genta PR, Schorr F, Eckert DJ, Gebrim E, Kayamori F, Moriya HT, Malhotra A, Lorenzi-Filho G. Upper airway collapsibility is associated with obesity and hyoid position. Sleep. 2014;37(10):1673–8. https://doi.org/10.5665/sleep.4078.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Isono S. Obesity and obstructive sleep apnoea: mechanisms for increased collapsibility of the passive pharyngeal airway. Respirology. 2012;17(1):32–42. https://doi.org/10.1111/j.1440-1843.2011.02093.x.

    Article  PubMed  Google Scholar 

  44. Weiss ST, Shore S. Obesity and asthma: directions for research. Am J Respir Care Med. 2004;169:963–8.

    Article  Google Scholar 

  45. Shore SA, Fredberg JJ. Obesity, smooth muscle and airway hyper responsiveness. J Allergy Clin lmmunol. 2005;115:925–7.

    Article  CAS  Google Scholar 

  46. Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal relux disease and its complications. Ann Intern Med. 2005;143:199–211.

    Article  PubMed  Google Scholar 

  47. Bonfrate L, Wang DQ, Garruti G, Portincasa P. Obesity and the risk and prognosis of gallstone disease and pancreatitis. Best Pract Res Clin Gastroenterol. 2014;28(4):623–35. https://doi.org/10.1016/j.bpg.2014.07.013.

    Article  CAS  PubMed  Google Scholar 

  48. Lebovics E, Rubin J. Non-alcoholic fatty liver disease (NAFLD): why you should care, when you should worry, what you should do. Diabetes Metab Res Rev. 2011;27:419–24.

    Article  PubMed  Google Scholar 

  49. Pais R, Pascale A, Fedchuck L, Charlotte F, Poynard T, Ratziu V. Progression from isolated steatosis to steatohepatitis and fibrosis in nonalcoholic fatty liver disease. Clin Res Hepatol Gastroenterol. 2011;35:23–8.

    Article  CAS  PubMed  Google Scholar 

  50. Kim MY. The progression of liver fibrosis in non-alcoholic fatty liver disease. Korean J Gastroenterol. 2017;69(6):341–7. https://doi.org/10.4166/kjg.2017.69.6.341.

    Article  PubMed  Google Scholar 

  51. Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, Loomba R. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13(4):643–54.e1–9; quiz e39–40. https://doi.org/10.1016/j.cgh.2014.04.014

  52. Lee RG. Nonalcoholic steatohepatitis: a study of 49 patients. Hum Pathol. 1989;20:594–8.

    Article  CAS  PubMed  Google Scholar 

  53. Wree A, Broderick L, Canbay A, Hoffman HM, Feldstein AE. From NAFLD to NASH to cirrhosis-new insights into disease mechanisms. Nat Rev Gastroenterol Hepatol. 2013;10(11):627–36. https://doi.org/10.1038/nrgastro.2013.149.

    Article  CAS  PubMed  Google Scholar 

  54. Ratziu V, Bonyhay L, Di Martino V, et al. Survival, liver failure, and hepatocellular carcinoma is obesity-related cryptogenic cirrhosis. Hepatology. 2002;35:1485–93.

    Article  PubMed  Google Scholar 

  55. Yatsuji S, Hashimoto E, Tobari M, et al. Clinical features and outcomes of cirrhosis due to non-alcoholic steatohepatitis compared with cirrhosis caused by chronic hepatitis C. J Gastoenterol Hepatol. 2009;24:248–54.

    Article  CAS  Google Scholar 

  56. Pandey S, Pandey S, Maheshwari A, Bhattacharya S. The impact of female obesity on the outcome of fertility treatment. J Hum Reprod Sci. 2010;3(2):62–7.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Delitala AP, Capobianco G, Delitala G, Cherchi PL, Dessole S. Polycystic ovary syndrome, adipose tissue and metabolic syndrome. Arch Gynecol Obstet. 2017;296(3):405–19. https://doi.org/10.1007/s00404-017-4429-2.

    Article  CAS  PubMed  Google Scholar 

  58. van der Steeg JW, Steures P, Eijkemans MJ, Habbema JD, Hompes PG, Burggraaff JM, et al. Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women. Hum Reprod. 2008;23(2):324–8.

    Article  PubMed  Google Scholar 

  59. Gil-Campos M, Cañete RR, Gil A. Adiponectin, the missing link in insulin resistance and obesity. Clin Nutr. 2004;23(5):963–74.

    Article  CAS  PubMed  Google Scholar 

  60. Motta AB. The role of obesity in the development of polycystic ovary syndrome. Curr Pharm Des. 2012;18(17):2482–91.

    Article  CAS  PubMed  Google Scholar 

  61. Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health. 2001;91(3):436–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol. 2004;103(2):219–24.

    Article  PubMed  Google Scholar 

  63. Dietl J. Maternal obesity and complications during pregnancy. J Perinat Med. 2005;33:100–5.

    Article  PubMed  Google Scholar 

  64. Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D’Andrea F, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291:2978–84.

    Article  CAS  PubMed  Google Scholar 

  65. Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH. Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med. 1993;329:1008–12.

    Article  CAS  PubMed  Google Scholar 

  66. Juonala M, Harcourt BE, Saner C, Sethi M, Saffery R, Magnussen CG, Burgner DP, Sabin MA. Neighbourhood socioeconomic circumstances, adiposity and cardiometabolic risk measures in children with severe obesity. Obes Res Clin Pract. 2019;pii:S1871-403X(19)30068-7. https://doi.org/10.1016/j.orcp.2019.05.004.

  67. Rosik CH. Psychiatric symptoms among prospective bariatric surgery patients: rates of prevalence and their relation to social desirability, pursuit of surgery, and follow-up attendance. Obes Surg. 2005;15:677–83.

    Article  PubMed  Google Scholar 

  68. Mitchell JE, Selzer F, Kalarchian MA, Devlin MJ, Strain GW, Elder KA, et al. Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis. 2012;8(5):533–41.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89.

    Article  PubMed  Google Scholar 

  70. Georgiev T, Angelov AK. Modifiable risk factors in knee osteoarthritis: treatment implications. Rheumatol Int. 2019;39(7):1145–57. https://doi.org/10.1007/s00296-019-04290-z. Epub 2019 Mar 25. Review. PMID: 30911813

    Article  PubMed  Google Scholar 

  71. Herrero-Beaumont G, Pérez-Baos S, Sánchez-Pernaute O, Roman-Blas JA, Lamuedra A. Targeting chronic innate inflammatory pathways, the main road to prevention of osteoarthritis progression. Biochem Pharmacol. 2019;165:24–32. https://doi.org/10.1016/j.bcp.2019.02.030. Epub 2019 Feb 27

    Article  CAS  PubMed  Google Scholar 

  72. Aspeden RM, Scheven BA, Hutchison JD. Osteoarthritis as a systemic disorder including stromal cell differentiation and lipid metabolism. Lancet. 2001;357(9262):1118–20.

    Article  Google Scholar 

  73. Baren-Engquist K, Chang M. obesity and cancer risk: recent review and evidence. Curr Oncol Resp. 2011;13(1):71–6.

    Article  Google Scholar 

  74. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body mass index and the incidence of cancer: a systematic review and meta analysis of prospective observational studies. Lancet. 2008;371–578.

    Google Scholar 

  75. Kabat GC, Xue X, Kamensky V, Lane D, Bea JW. Risk of breast, endometrial, colorectal, and renal cancers in postmenopausal women in association with a body shape index and other anthropometric measures. Cancer Causes Control. 2015;26(2):219–29. https://doi.org/10.1007/s10552-014-0501-4. Epub 2014 Nov 28

    Article  PubMed  Google Scholar 

  76. Sjöström L, Gummesson A, Sjöström CD, et al. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol. 2009;10:653–62.

    Article  PubMed  Google Scholar 

  77. Adams TD, Stroup AM, Gress RE, et al. Cancer incidence and mortality after gastric bypass surgery. Obesity (Silver Spring). 2009;17:796–802.

    Article  Google Scholar 

  78. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.

    Article  PubMed  Google Scholar 

  79. Tumminia A, Vinciguerra F, Parisi M, Graziano M, Sciacca L, Baratta R, Frittitta L. Adipose tissue, obesity and adiponectin: role in endocrine cancer risk. Int J Mol Sci. 2019;20(12). pii:E2863. https://doi.org/10.3390/ijms20122863

  80. Schmandt RE, Iglesians DA, Co NN, Lu KH. Understanding Obesity and Endometrial Cancer Risk: Opportunities for prevention. Am J Obstet Gynecol. 2011;205:518–25.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of General and Metabolic Surgery, Montebelluna and Castelfranco Hospitals, Treviso, Italy

    Maurizio De Luca, Nicola Clemente, Giacomo Piatto, Alberto Sartori, Cesare Lunardi & Natale Pellicanò

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Editors and Affiliations

  1. Bariatric and Laparoscopic Surgery, Global Hospital, Mumbai, India

    Aparna Govil Bhasker

  2. Bhatia Hospital, Mumbai, India

    Nimisha Kantharia

  3. Belle Vue Clinic, Kolkata, India

    Sarfaraz Baig

  4. Belle Vue Clinic, Kolkata, India

    Pallawi Priya

  5. Dr. Aparna’s - Laparoscopy & Bariatric Surgery Centre, Currae Specialty Hospital, Mumbai, India

    Mariam Lakdawala

  6. Dr. Aparna’s - Laparoscopy & Bariatric Surgery Centre, Sterling hospital, Mumbai, Maharashtra, India

    Miloni Shah Sancheti

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De Luca, M., Clemente, N., Piatto, G., Sartori, A., Lunardi, C., Pellicanò, N. (2021). Associated Co-morbid Conditions of Clinically Severe Obesity. In: Bhasker, A.G., Kantharia, N., Baig, S., Priya, P., Lakdawala, M., Sancheti, M.S. (eds) Management of Nutritional and Metabolic Complications of Bariatric Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-33-4702-1_2

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