RELATIVE RISK OF INDIVIDUAL COMPLICATIONS: (BMI 25-30)

Hirsutism 2

Stroke 1.6

Breathlessness 3.5

Gall stones 2.7 (7 fold at BMI > 40)

Colon cancer 1.5

Pancreas Cancer 1.6

Uterine Cancer 4.6

Breast Cancer 1.3

Pregnancy problems 2

Menorrhagia 1.8

Hypertension 2.9

Coronary disease 2.5

Thromboembolism 1.5

Heart failure 1.5

Osteoarthritis 2

Gout 3

Diabetes mellitus 10

Dyslipidaemia 1.5

Pancreatitis

Cataracts

Asthma

Non alcoholic steatohepatitis

Phlebitis

Depression

Benign Intracranial Hypertension

Gall stones are more common due to increased cholesterol synthesis, reduce bile acids, reduced responsiveness of the GB to Cholecystokinin, and changes in cholesterol/bile acid ratio.

Obesity increases the risk of Cancers of the esophagus, colon, rectum, liver, gall bladder, pancreas, kidney, stomach,  prostate, breast, uterus, cervix and ovary as well as lymphomas and multiple myeloma. N Engl J Med. 2003 Apr 24;348(17):1625-38.

In the woman, obesity increases the chances of

           infertility

           heart defects in fetus by 2 fold

           neural tube defects by 3 fold

           miscarriage by 3 fold

           gestational diabetes by 4 fold

           pre eclampsia by 2-3 fold

           venous thromboembolism by 10 fold in the presence of the ocp

           caesarean section

           intrapartum complications

           fetal macrosomia

           wound dehiscence post caesarean

Diabetes is an independent predictor of mortality from cancer of the colon, pancreas, breast (women) , liver and bladder (men).   Am J Epidemiol. 2004 Jun 15;159(12):1160-7.

Relative risk of Diabetes in Obesity:

The relative risk of developing diabetes increases by 25% for every 1kg/m2 increase above 22 kg/m2

Data from the 1998 BRFSS indicates that for every kilogram increase in self-reported weight, the risk for diabetes increased by approximately 9%.

Data from the Nurses' Health Study indicated that compared to women with a BMI < 22, the relative risk of diabetes increased

        5-fold in women with a BMI of about 25

        28-fold for those with a BMI of approximately 32, and

        58-fold for those with a BMI greater than 35.

Illness                            Level Of evidence:

T2DM                                                                  A

Hypertension                                                      A

Metabolic syndrome                                          B

Coronary Heart Disease                                    A

Obstructive Sleep apnea                                   C

Gout                                                                      A

Gall stones                                                           A

Fatty liver                                                            B

Asthma                                                                 B

Osteoarthritis knees                                           A

Breast cancer                                                       A

Uterine cancer                                                     A

Large intestine cancer                                        B

Other diseases shown to be associated with obesity

Multiple Myeloma   Epidemiology. 2005 Sep;16(5):691-4.

Kidney Stones    JAMA. 2005 Jan 26;293(4):455-62

BENEFITS OF WEIGHT LOSS

Loss of approximately 5% to 10% of body weight -- is also associated with significant improvements in cardiovascular risk factors including:

-reductions in blood pressure ( N Engl J Med. 1978 Jan 5;298(1):1-6. ;  Arch Intern Med. 1997 Mar 24;157(6):657-67. ; Hypertension. 2000 Feb;35(2):544-9. ;  Ann Intern Med. 2001 Jan 2;134(1):1-11)

-lipid levels (Am J Clin Nutr. 1992 Aug;56(2):320-8 ;  Arch Intern Med. 2000 Jul 24;160(14):2150-8.)

-inflammatory cytokines and markers (Circulation. 2002 Feb 19;105(7):804-9. ; Circulation. 2002 Feb 5;105(5):564-9.),

as well as an improvement in glycaemia Ann Intern Med. 1993 Oct 1;119(7 Pt 2):722-6. ;    and a decrease in the need for diabetic medications Diabetes Obes Metab. 2000 Jun;2(3):121-9.   and mortality.

A 7% weight loss in the DPP study was associated with a 58% reduction in the 4-year incidence of Type 2 diabetes. N Engl J Med. 2002 Feb 7;346(6):393-403.

Improvement in fasting glucose is directly related to the relative amount of weight lost. Metabolism. 1990 Sep;39(9):905-12.

In women with obesity-related conditions, intentional weight loss of any amount was associated with a 20% reduction in all-cause mortality and a 30% to 40% reduction in diabetes-associated mortality

For individuals with type 2 diabetes, an average intentional weight loss of 11% of initial body weight was associated with a 25% reduction in total mortality and a 28% reduction in cardiovascular and diabetes mortality

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    This page was last updated on: 07/03/2007

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