Skip to main content
SpringerLink
Log in

Costs, Pathology, and Health Risks of Obesity and the Metabolic Syndrome

  • Chapter
The Metabolic Syndrome and Obesity

  • 1611 Accesses

Abstract

We start with the premise that we all want to have a healthy weight, and that no one wants to be labeled obese. One reason for this ideal is self-image or cosmetic, and another is that excessive weight is a harbinger of ill health. This chapter develops the historical context for this understanding and provides ideas about how fatness produces these problems. In this chapter, overweight refers to any individual whose body weight is above 25 kg/m2 (see Chapter 1). Some individuals who are overweight are not at risk from this weight, such as athletes and naturally muscular people. However, for most of the population, the rise in body weight with age is associated with increased fatness and the ill health it produces.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Allison, D. B., et al. (1999). Annual deaths attributable to obesity in the United States. JAMA 282(16): 1530–1538.

    CAS  Google Scholar 

  • Angelico, F., et al. (2005). Insulin resistance, the metabolic syndrome, and nonalcoholic fatty liver disease. J Clin Endocrinol Metab 90(3):1578–1582.

    CAS  Google Scholar 

  • Baik, I., et al. (2000). A prospective study of age and lifestyle factors in relation to community-acquired pneumonia in US men and women. Arch Intern Med 160(20):3082–3088.

    CAS  Google Scholar 

  • Bellentani, S., et al. (2000). Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med 132(2):112–117.

    CAS  Google Scholar 

  • Berenson, G. S., et al. (1998). Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 338(23): 1650–1656.

    CAS  Google Scholar 

  • Black, E., et al. (2005). Long-term influences of body-weight changes, independent of the attained weight, on risk of impaired glucose tolerance and Type 2 diabetes. Diabet Med 22(9): 1199–1205.

    CAS  Google Scholar 

  • Bray, G. (2003). Contemporary Diagnosis and Management of Obesity. Newtown, PA: Handbooks in Health Care.

    Google Scholar 

  • Bray, G. A. (2004a). Medical consequences of obesity. J Clin Endocrinol Metab 89(6):2583–2589.

    CAS  Google Scholar 

  • Bray, G. A. (2004b). Obesity is a chronic, relapsing neurochemical disease. Int J Obes Relat Metab Disord 28(1):34–38.

    CAS  Google Scholar 

  • Bray, G. A. and Champagne, C. M. (2005). Beyond energy balance: there is more to obesity than kilocalories. J Am Diet Assoc 105 (5 Pt 2):17–23.

    Google Scholar 

  • Calle, E. E., et al. (2003). Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348(17):1625–1638.

    Google Scholar 

  • Calle, E. E., et al. (1999). Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 341(15):1097–1105.

    CAS  Google Scholar 

  • Caroli-Bosc, F. X., et al. (1999). Gallbladder volume in adults and its relationship to age, sex, body mass index, body surface area and gallstones. An epidemiologic study in a nonselected population in France. Digestion 60(4):344–348.

    CAS  Google Scholar 

  • Carpenter, K. M., et al. (2000). Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study. Am J Public Health 90(2):251–257.

    CAS  Google Scholar 

  • Chan, J. M., et al. (1994). Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care 17(9):961–969.

    CAS  Google Scholar 

  • Choban, P. S., et al. (1999). A health status assessment of the impact of weight loss following Roux-en-Y gastric bypass for clinically severe obesity. J Am Coll Surg 188(5):491–497.

    CAS  Google Scholar 

  • Colditz, G. A., et al. (1995). Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 122(7):481–486.

    CAS  Google Scholar 

  • Daviglus, M. L., et al. (2004). Relation of body mass index in young adulthood and middle age to Medicare expenditures in older age. JAMA 292(22):2743–2749.

    CAS  Google Scholar 

  • Despres, J. P. and Krauss, R. M. (2002). Obesity and lipoprotein metabolism. In: Handbook of Obesity, edited by G. Bray and C. Bouchard. New York: Marcel Dekker; pp. 845–871.

    Google Scholar 

  • Dixon, J. B., et al. (2003). Depression in association with severe obesity: changes with weight loss. Arch Intern Med 163(17):2058–2065.

    Google Scholar 

  • Douketis, J. D., et al. (2005). Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes (Lond) 29(10):1153–1167.

    CAS  Google Scholar 

  • Emberson, J. R., et al. (2005). Lifestyle and cardiovascular disease in middle-aged British men: the effect of adjusting for within-person variation. Eur Heart J 26(17):1774–1782.

    Google Scholar 

  • Ensrud, K. E., et al. (2005). Voluntary weight reduction in older men increases hip bone loss: the osteoporotic fractures in men study. J Clin Endocrinol Metab 90(4):1998–2004.

    CAS  Google Scholar 

  • Escalante, A., et al. (2005). Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation. Arch Intern Med 165(14):1624–1629.

    Google Scholar 

  • Felson, D. T., et al. (1988). Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med 109(1):18–24.

    CAS  Google Scholar 

  • Finkelstein, E. A., et al. (2003). National medical spending attributable to overweight and obesity: how much, and who’s paying? Health Aff (Millwood) Suppl Web Exclusives:W3-219-W3-226.

    Google Scholar 

  • Finkelstein, E. A., et al. (2004). State-level estimates of annual medical expenditures attributable to obesity. Obes Res 12(1):18–24.

    Google Scholar 

  • Flegal, K. M., et al. (2005). Excess deaths associated with underweight, overweight, and obesity. JAMA 293(15):1861–1867.

    CAS  Google Scholar 

  • Flemyng, M. (1760). A discourse on the nature, causes, and cure of corpulency. Illustrated by a remarkable case. Read before the Royal Society November 1757. London: L. Davis and C. Reymers.

    Google Scholar 

  • Flum, D. R. and Dellinger, E. P. (2004). Impact of gastric bypass operation on survival: a population-based analysis. J Am Coll Surg 199(4):543–551.

    Google Scholar 

  • Fontaine, K. R., et al. (1996). Health-related quality of life in obese persons seeking treatment. J Fam Pract 43(3):265–270.

    CAS  Google Scholar 

  • Fontaine, K. R., et al. (2003). Years of life lost due to obesity. JAMA 289(2):187–193.

    Google Scholar 

  • Freedman, D. S. (2002). Risk of CVD Complications. In: Child and Adolescent Obesity Cambridge (Burniat, W., ed.): Cambridge University Press; pp. 221–239.

    Google Scholar 

  • Freedman, D. S., et al. (2004). The relation of obesity throughout life to carotid intima-media thickness in adulthood: the Bogalusa Heart Study. Int J Obes Relat Metab Disord 28(1): 159–166.

    CAS  Google Scholar 

  • Garcia Hidalgo, L. (2002). Dermatological complications of obesity. Am J Clin Dermatol 3(7):497–506.

    Google Scholar 

  • Garg, A. (2004). Acquired and inherited lipodystrophies. N Engl J Med 350(12): 1220–1234.

    CAS  Google Scholar 

  • Goodman, N., et al. (1963). Variant reactions to physical disabilities. Am Sociol Rev 28:429–435.

    Google Scholar 

  • Gortmaker, S. L., et al. (1993). Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 329(14):1008–1012.

    CAS  Google Scholar 

  • Gregg, E. W., et al. (2005). Secular trends in cardiovascular disease risk factors according to body mass index in US adults. JAMA 293(15):1868–1874.

    CAS  Google Scholar 

  • Gregg, E. W., et al. (2003). Intentional weight loss and death in overweight and obese U.S. adults 35 years of age and older. Ann Intern Med 138(5):383–389.

    Google Scholar 

  • Grodstein, F., et al. (1994). Body mass index and ovulatory infertility. Epidemiology 5(2):247–250.

    Article  CAS  Google Scholar 

  • Gu, D., et al. (2006). Body weight and mortality among men and women in China. JAMA 295(7):776–783.

    CAS  Google Scholar 

  • Gunnell, D. J., et al. (1998). Childhood obesity and adult cardiovascular mortality: a 57-y follow-up study based on the Boyd Orr cohort. Am J Clin Nutr 67(6): 1111–1118.

    CAS  Google Scholar 

  • Hamaguchi, M., et al. (2005). The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med 143(10):722–728.

    CAS  Google Scholar 

  • Hampel, H., et al. (2005). Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med 143(3):199–211.

    Google Scholar 

  • Hansen, B. C., et al. (1999). Calorie restriction in nonhuman primates: mechanisms of reduced morbidity and mortality. Toxicol Sci 52 (2 Suppl):56–60.

    CAS  Google Scholar 

  • Hsu, C. Y., et al. (2006). Body mass index and risk for end-stage renal disease. Ann Intern Med 144(1): 21–28.

    Google Scholar 

  • Istvan, J., et al. (1992). Body weight and psychological distress in NHANES I. Int J Obes Relat Metab Disord 16(12):999–1003.

    CAS  Google Scholar 

  • Janssen, I., et al. (2004). Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 79(3):379–384.

    CAS  Google Scholar 

  • Jin, R., et al. (2005). Is obesity a risk factor for mortality in coronary artery bypass surgery? Circulation 111(25):3359–3365.

    Google Scholar 

  • Kambham, N., et al. (2001). Obesity-related glomerulopathy: an emerging epidemic. Kidney Int 59(4): 1498–1509.

    CAS  Google Scholar 

  • Kenchaiah, S., et al. (2002). Obesity and the risk of heart failure. N Engl J Med 347(5):305–313.

    Google Scholar 

  • Knowler, W. C., et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346(6):393–403.

    CAS  Google Scholar 

  • Ko, C. W. and Lee, S. P. (2002). Obesity and gallbladder disease. In: Handbook of Obesity: Etiology and Pathophysiology, edited by G. A. Bray and C. Bouchard. New York: Marcel Dekker; pp. 919–934.

    Google Scholar 

  • Latner, J. D. and Stunkard, A. J. (2003). Getting worse: the stigmatization of obese children. Obes Res 11(3):452–456.

    Google Scholar 

  • Lee, E. S., et al. (2005). Depressive mood and abdominal fat distribution in overweight premenopausal women. Obes Res 13(2):320–325.

    Google Scholar 

  • Lew, E., et al. (1979). The new build and blood pressure study. Trans Assoc Life Insur Med Dir Am 62:154–174.

    CAS  Google Scholar 

  • Lew, E. A. (1985). Mortality and weight: insured lives and the American Cancer Society studies. Ann Intern Med 103 (6 Pt 2): 1024–1029.

    CAS  Google Scholar 

  • Mahoney, L. T., et al. (1996). Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 27(2):277–284.

    CAS  Google Scholar 

  • Manson, J. E., et al. (1995). Body weight and mortality among women. N Engl J Med 333(11):677–685.

    CAS  Google Scholar 

  • Matteoni, C. A., et al. (1999). Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology 116(6):1413–1419.

    CAS  Google Scholar 

  • Meigs, J. B., et al. (1997). Risk variable clustering in the insulin resistance syndrome. The Framingham Offspring Study. Diabetes 46(10): 1594–1600.

    CAS  Google Scholar 

  • Moore, L. L., et al. (2005). Weight loss in overweight adults and the long-term risk of hypertension: the Framingham study. Arch Intern Med 165(11): 1298–1303.

    Google Scholar 

  • Must, A., et al. (1992). Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 327(19):1350–1355.

    Article  CAS  Google Scholar 

  • N. A. (1998). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. National Institutes of Health. Obes Res 6(Suppl 2):51S–209S.

    Google Scholar 

  • N. A. (2000). Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894:i–xii, 1–253.

    Google Scholar 

  • N. A. (2004). Prevalence of overweight and obesity among adults with diagnosed diabetes—United States, 1988–1994 and 1999–2000. MMWR CDC Surveillance Summaries 53:1066–1068.

    Google Scholar 

  • N. A. (2005). National Center for Health Statistics. Retrieved March 2005 from http://www.cdc.gov/nchs/.

    Google Scholar 

  • Okoro, C. A., et al. (2004). Disability, arthritis, and body weight among adults 45 years and older. Obes Res 12(5):854–861.

    Google Scholar 

  • Olshansky, S. J., et al. (2005). A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 352(11):1138–1145.

    CAS  Google Scholar 

  • Peeters, A., et al. (2003). Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med 138(1):24–32.

    Google Scholar 

  • Peppard, P. E., et al. (2000). Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 284(23):3015–3021.

    CAS  Google Scholar 

  • Quesenberry, C. P., et al. (1998). Obesity, health services use, and health care costs among members of a health maintenance organization. Arch Intern Med 158(5):466–472.

    Google Scholar 

  • Ravussin, E. (1993). Energy metabolism in obesity. Studies in the Pima Indians. Diabetes Care 16:232–238.

    CAS  Google Scholar 

  • Rich-Edwards, J. W., et al. (1994). Adolescent body mass index and infertility caused by ovulatory disorder. Am J Obstet Gynecol 171(1):171–177.

    CAS  Google Scholar 

  • Richardson, S. A., et al. (1961). Cultural uniformity in reaction of physical disabilities. American Sociological Review 26:241–247.

    Google Scholar 

  • Ridker, P. M., et al. (2002). Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 347(20):1557–1565.

    CAS  Google Scholar 

  • Rocchini, A. P. (2002). Obesity and blood pressure regulation. In: Handbook of Obesity, edited by G. Brayand C. Bouchard. New York: Marcel Dekker; pp. 873–897.

    Google Scholar 

  • Rosenberg, T. J., et al. (2005). Maternal obesity and diabetes as risk factors for adverse pregnancy outcomes: differences among 4 racial/ethnic groups. Am J Public Health 95(9):1545–1551.

    Google Scholar 

  • Schapira, D. V., et al. (1994). Visceral obesity and breast cancer risk. Cancer 74(2):632–639.

    CAS  Google Scholar 

  • Schwimmer, J. B., et al. (2003). Health-related quality of life of severely obese children and adolescents. JAMA 289(14):1813–1819.

    Google Scholar 

  • Sjostrom, C. D., et al. (1997). Relationships between changes in body composition and changes in cardiovascular risk factors: the SOS Intervention Study. Swedish Obese Subjects. Obes Res 5(6):519–530.

    CAS  Google Scholar 

  • Sjostrom, L., et al. (2004). Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351(26):2683–2693.

    Google Scholar 

  • Sjostrom, L. V. (1992). Mortality of severely obese subjects. Am J Clin Nutr 55 (2 Suppl):516S–523S.

    CAS  Google Scholar 

  • Smith, S. R., et al. (2005). Effect of pioglitazone on body composition and energy expenditure: a randomized controlled trial. Metabolism 54(1):24–32.

    CAS  Google Scholar 

  • Stampfer, M. J., et al. (1992). Risk of symptomatic gallstones in women with severe obesity. Am J Clin Nutr 55(3):652–658.

    CAS  Google Scholar 

  • Stevens, J., et al. (1998). The effect of age on the association between body-mass index and mortality. N Engl J Med 338(1):1–7.

    CAS  Google Scholar 

  • Stevens, V. J., et al. (2001). Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann Intern Med 134(1):1–11.

    CAS  Google Scholar 

  • Strauss, R. S. and Pollack, H. A. (2003). Social marginalization of overweight children. Arch Pediatr Adolesc Med 157(8):746–752.

    Google Scholar 

  • Strohl, K. P., et al. (2004). Obesity and pulmonary function. In: Handbook of Obesity: Evaluation and Treatment, edited by G. Bray and C. Bouchard. New York: Marcel Dekker; pp. 935–952.

    Google Scholar 

  • Sturm, R. (2002). The effects of obesity, smoking, and drinking on medical problems and costs. Health Aff (Millwood) 21(2):245–253.

    Google Scholar 

  • Sweeney, C., et al. (2004). Risk factors for breast cancer in elderly women. Am J Epidemiol 160(9): 868–875.

    Google Scholar 

  • Taylor, E. N., et al. (2005). Obesity, weight gain, and the risk of kidney stones. JAMA 293(4):455–462.

    CAS  Google Scholar 

  • Thompson, D., et al. (2001). Body mass index and future healthcare costs: a retrospective cohort study. Obes Res 9(3):210–218.

    CAS  Google Scholar 

  • Thompson, D., et al. (1999). Lifetime health and economic consequences of obesity. Arch Intern Med 159(18):2177–2183.

    CAS  Google Scholar 

  • Usha Kiran, T. S., et al. (2005). Outcome of pregnancy in a woman with an increased body mass index. BJOG 112(6):768–772.

    CAS  Google Scholar 

  • Visscher, T. L., et al. (2004). Obesity and unhealthy life-years in adult Finns: an empirical approach. Arch Intern Med 164(13): 1413–1420.

    Google Scholar 

  • Visscher, T. L. and Seidell, J. C. (2001). The public health impact of obesity. Annu Rev Public Health 22:355–375.

    CAS  Google Scholar 

  • Waaler, H. T. and Lund, E. (1983). Association between body height and death from breast cancer. BrJ Cancer 48(1): 149–150.

    CAS  Google Scholar 

  • Wadd, W. (1810). Cursory remarks on corpulence: by a member of the Royal College of Surgeons. London: J. Callow.

    Google Scholar 

  • Wang, T. J., et al. (2004). Obesity and the risk of new-onset atrial fibrillation. JAMA 292(20):2471–2477.

    CAS  Google Scholar 

  • Weinstein, A. R., et al. (2004). Relationship of physical activity vs body mass index with type 2 diabetes in women. JAMA 292(10):1188–1194.

    CAS  Google Scholar 

  • Williams, J., et al. (2005). Health-related quality of life of overweight and obese children. JAMA 293(1): 70–76.

    CAS  Google Scholar 

  • Williamson, D. A. and O’Neil, P. M. (1998). Obesity and quality of life. In: Handbook of Obesity: Evaluation and Treatment, edited by G. Bray and C. Bouchard. New York: Marcel Dekker; pp. 1005–1022.

    Google Scholar 

  • Williamson, D. F., et al. (1995). Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40–64 years. Am J Epidemiol 141(12):1128–1141.

    CAS  Google Scholar 

  • Williamson, D. F., et al. (2000). Intentional weight loss and mortality among overweight individuals with diabetes. Diabetes Care 23(10):1499–1504.

    CAS  Google Scholar 

  • Wolf, A. M. and Colditz, G. A. (1994). The cost of obesity: the US perspective. Pharmacoeconomics 5(Suppl 1):34–37.

    CAS  Google Scholar 

  • Wolf, A. M. and Colditz, G. A. (1998). Current estimates of the economic cost of obesity in the United States. Obes Res 6(2):97–106.

    CAS  Google Scholar 

  • Yan, L. L., et al. (2006). Midlife body mass index and hospitalization and mortality in older age. JAMA 295(2):190–198.

    CAS  Google Scholar 

  • Yen, S., S., C. (1999). Chronic anovluation due to CNS-hypothalamic-pituitary dysfunction. In: Reproductive endocrinology: physiology, pathophysiology and clinical management, edited by S. S. C. Yen, R. B. Jaffee, and R. L. Barbieri. Philadelphia: Saunders; p. 516.

    Google Scholar 

  • Young, T., et al. (2005). Excess weight and sleep-disordered breathing. J Appl Physiol 99(4):1592–1599.

    Google Scholar 

  • Yusuf, S., et al. (2005). Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet 366(9497):1640–1649.

    Google Scholar 

Download references

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

(2007). Costs, Pathology, and Health Risks of Obesity and the Metabolic Syndrome. In: The Metabolic Syndrome and Obesity. Humana Press. https://doi.org/10.1007/978-1-59745-431-5_3

Download citation

Publish with us

Policies and ethics

Search

Navigation