Abstract
Obesity is associated with a number of medical conditions that lead to increased morbidity and increased mortality. Both the National Institutes of Health and the World Health Organization define obesity as a body mass index (BMI) ≥30 kg/m2 and overweight as a BMI 25–30. The most common conditions associated with obesity are insulin resistance, diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease, gallstones and cholecystitis, sleep apnea and other respiratory dysfunction, and the increased incidence of certain cancers. These are discussed below.
Similar content being viewed by others
References
National Heart Lung and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults — The Evidence Report. Obes Res 1998; 6 Suppl 2: 51S–210S.
Obesity (1997): Preventing and managing the global epidemic. Report of a WHO consultation on obesity. 1998. Geneva, World Health Organization.
Zumoff B, Strain G, Miller L. Plasma free and non-sex-hormone-binding-globulin-testosterone are decreased in obese men in proportion to their degree of obesity. J Clin Endo Metab 1990; 70: 929–31.
Flegal KM, Carroll MD, Kuczmarski RJ et al. Overweight and obesity in the United States: prevalence and trends. Int J Obes 1998; 22: 39–47.
Kuczmarski RJ, Flegal KM, Campbell SM et al. Increasing prevalence of overweight among U.S. adults. JAMA 1994; 272: 205–11.
Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat-Obesity, Institute of Medicine. Weighing the Options. Criteria for Evaluating Weight-Management Programs. Thomas PR. Washington, DC: National Academy Press 1995.
Chan JM, Rimm EB, Colditz GA et al. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diab Care 1994;17: 961–9.
Manson JE, Colditz GA, Stampfer MJ et al. A prospective study of obesity and risk of coronary heart disease in women. N Engl J Med 1990; 322: 882–9.
Olefsky J. Insulin resistance and insulin action: an in vivo and in vitro perspective. Diabetes 1981;38:148–62.
DeFronzo RA. The triumvirate: ß-cell, muscle, liver: a collusion responsible for NIDDM. Diabetes 1988; 37: 644–67.
Kolterman OG, Insel J, Saekow M et al. Mechanisms of insulin resistance in human obesity: evidence for receptor and postreceptor defects. J Clin Invest 1980; 65: 1272–84.
Polonsky KS, Given BD, Hirsch L et al. Quantitative study of insulin secretion and clearance in normal and obese subjects. J Clin Invest 1988; 81: 435–41.
McMahon SW, Blacket RB, McDonald GJ HW. Obesity, alcohol consumption and blood pressure in Australian men and women: National Heart Foundation of Australia Risk Factor Prevalence Study. J Hypertension 1984; 2: 85–91.
Bjerkedal T. Overweight and hypertension. Acta Med Scand 1957; 159: 13–26.
Kannel WB, Brand N, Skinner JJ Jr et al. The relation of adiposity to blood pressure and development of hypertension. The Framingham study. Ann Intern Med 1967; 67: 48–9.
Donahue RP, Abbott RD, Bloom E et al. Central obesity and coronary heart disease in men. Lancet 1987; 1: 821–4.
Haffner SM, Mitchell BD, Hazuda HP et al. Greater influence of central distribution of adipose tissue on incidence of non-insulin-dependent diabetes in women than men. Am J Clin Nutr 1991; 53: 1312–7.
Tuck M, Sowers J, Dornfield L et al. The effect of weight reduction on blood pressure plasma renin activity and plasma aldosterone level in obese patients. N Engl J Med 1981; 304: 930–3.
Rocchini A, Key J, Bondie D et al. The effect of weight loss on the sensitivity of blood pressure to sodium in obese adolescents. N Engl J Med 1989; 321: 580–5.
Landsberg L, Krieger DL. Obesity, metabolism, and the sympathetic nervous system. Am J Hypertens 1989; 2: 125S-32S.
Jacobs D, Sowers J, Hmeidan A et al. Effects of weight reduction on cellular cation metabolism and vascular resistance. Hypertension 1993; 21: 308–14.
Rexrode K, Henneken C, Willet W et al. A prospective study of body mass index, weight change, and risk of stroke in women. JAMA 1997; 277: 1539–45.
Walker SP, Rimm EB, Ascherio A et al. Body size and fat distribution as predictors of stroke among US men. Am J Epidemiol 1996; 144: 1143–50.
Hubert HB, Feinlieb M, McNamara PM et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67: 968–77.
Miller BD, Alderman EL, Haskell W et al. Predominance of dense low-density lipoprotein particles predicts angiograpic benefit of therapy in the Stanford coronary risk intervention study. Circulation 1996; 94: 2146–53.
Lamarche B, Tchernof A, Moorjani S et al. Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men. Prospective results from the Quebec Cardiovascular Study. Circulation 1997; 95: 69–75.
Reaven GM, Chen YDI, Jeppesen J et al. Insulin resistance and hyperinsulinemia in individuals with small, dense, low density lipoprotein particles. J Clin Invest 1993; 92: 141–6.
Bjorntorp P. “Portal” adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arteriosclerosis 1990; 10: 493–6.
Després JP. Lipoprotein metabolism in visceral obesity. Int J Obes 1991; 15 Suppl 2: 45–52.
Pi-Sunyer FX. Medical hazards of obesity. Ann Intern Med 1993; 119: 655–60.
Alexander JK. Obesity and the heart. Curr Probl Cardiol 1980; 5: 1–41.
Alexander JK. The cardiomyopathy of obesity. Prog Cardiovasc Dis 1985; 27: 325–34.
Burnett W. The epidemiology of gallstones. Tijdschr Gastroenterol 1971; 14: 79–89.
Friedman GD, Kannel WB, Dawber TR. The epidemiology of gallbladder disease: observations in the Framingham Study. J Chronic Dis 1966; 19: 273–92.
Grundy SM, Metzer Al, Adler RD. Mechanisms of lithogenic bile formation in American Indian women with cholesterol gallstones. J Clin Invest 1971; 51: 652–8.
Liddle RA. Gallstone formation during weight-reduction dieting. Arch Intern Med 1989; 149: 1750–3.
Remmers JE, deGroot WJ, Sauerland EK et al. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol 1978; 44: 931–8.
Barrocas M, Chokroverty S, Baum GL, Schwartz A, Sharp JT. Hypoventilation-obesity syndrome: central origin of a ventilatory dysrythmia. Chest 1975; 68 (Suppl): 401 (abstr).
Sharp JT, Barrocas M, Chokroverty S. The cardiorespiratory effects of obesity. Clin Chest Med 1980; 1: 103–18.
Giovannucci E. Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr 2001; 131: 3109S-20S.
Lehrer S, Diamond EJ, Stagger S, Stone NN, Stock RG. Increased serum insulin associated with increased risk of prostate cancer recurrence. Prostate 2002; 50: 1–3.
Goodwin PJ, Ennis M, Pritchard KI et al. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol 2002; 20: 42–51.
Garfinkel L. Overweight and cancer. Ann Intern Med 1985; 103: 1034–6.
Paffenberger RSJr, Kampert JB, Chang HG. Characteristics that predict risk of breast cancer before and after menopause. Am J Epidem 1980; 112: 258–68.
Lubin F, Ruder AM, Wax Y et al. Overweight and changes in weight throughout adult life in breast cancer etiology. A case-control study. Am J Epidemiol 1985; 122: 579–88.
Rimm AA, Werner LH, Yserloo BV et al. Relationship of obesity and disease in 73,532 weight-conscious women. Public Health Rep 1975; 90: 44–54.
Leach R, Baumgard S, Broom J. Obesity: its relationship to osteoarthritis of the knee. Clin Orthop 1973; 93: 271–3.
Goldin RH, McAdam L, Louie JS et al. Clinical and radiological survey of the incidence of osteoarthritis among obese patients. Ann Rheum Dis 1976; 35: 349–53.
Larsson B, Svärdsudd K, Welin L et al. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. BMJ 1984; 288: 1401–4.
Donahue RP, Abbott RD, Bloom E et al. Central obesity and coronary heart disease in men. Lancet 1987; 1: 821–4.
Lapidus L, Bengtsson C, Larsson B et al. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12-year follow-up of participants in the population study of women in Gothenburg, Sweden. BMJ 1984; 289: 1257–61.
Kissebah A, Peiris AN, Evans D. Mechanisms associating body fat distribution to glucose intolerance and diabetes mellitus: window with a view. Acta Med Scand 1988; 723 (Suppl): 79–89.
Boden G, Lebed B, Schatz M et al. Effects of acute changes of plasma free fatty acids on intramyocellular fat content and insulin resistance in healthy subjects. Diabetes 2001; 50: 1612–7.
Colditz GA, Willett WC, Rotnitzky A et al. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 1995; 122: 481–6.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pi-Sunyer, F.X. The Medical Risks of Obesity. OBES SURG 12 (Suppl 1), S6–S11 (2002). https://doi.org/10.1007/BF03342140
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03342140