Obesity and Type 2 Diabetes: What’s So Bad About Being Overweight?

In my last entry, I discussed the high prevalences of obesity and diabetes in the U.S. I did not mention that the problems are now world-wide. This should not come as much of a surprise to anyone. Now, it is one thing to have a “problem” such as an obesity epidemic. It is quite another thing if the problem has serious consequences. I can assure you that both obesity and diabetes are serious matters.

Short-term Consequences

Short-term consequences of obesity include: poor self-esteem and other psychological problems; orthopedic disorders, particularly hip and knee problems; pulmonary and airway problems (more asthma and sleep disorders); abnormal lipids (e.g., high triglycerides and cholesterol); gastrointestinal disorders (e.g., gall stones); skin disorders (e.g., a condition called acanthosis nigricans and yeast infections); and type 2 diabetes.

Long-term Consequences

Long-term consequences include: everything in the short-term category plus increased risks for cardiovascular diseases (heart disease and stroke); hypertension; increased risk for cancer (especially colon, breast, and prostate); and the Metabolic Syndrome, often called the Polycystic Ovary Syndrome in women). I could go on and on but you get the point. The consequences of obesity are big time serious. If you don’t believe me, check out an excellent study on the relationship between weight and the risk of heart failure (Kenchaiah et. al., New England Journal of Medicine 347:305-313, 2002). In some instances, it is not entirely clear wheter it is the obesity itself that causes the complication risks, or some other associated factor. For example, the fact that obesity is associated with hypertension and abnormal lipids, may explain the increased risk for cardiovascular disorders. It has been hard to find a large group of overweight people without hypertension and abnormal lipids to study if those patients have the same risks as normal weight people. This is actually a very important question since we do have effective ways to treat hypertension and lipid abnormalities. Maybe we do not need to work so hard to “fight” the obesity, only the consequences? I’m not really sure that argument makes any sense, but it’s a thought. The reasons for the increased risks of developing of cancer are unknown.

The Consequences of Developing Diabetes

I believe it is appropriate to consider the complications of type 2 diabetes also as consequences of obesity since type 2 diabetes is very uncommon without concomitant obesity. The complications include eye disease, kidney disease, nerve disease (all specific to diabetes), and cardiovascular disease (heart disease, peripheral vascular disease, and stroke).

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