Obesity and Related Diseases/Conditions

In addition to the conditions listed in the Complications of Obesity section of this handbook, obesity adversely impacts existing endocrine and metabolic disorders. In fact, one out of every five overweight people is affected by the metabolic syndrome, or “Syndrome X²⁶.” The metabolic syndrome, one of the fastest growing health concerns among both doctors and patients, is a disorder characterized by a cluster of health problems including obesity, high blood pressure, abnormal lipid levels and high blood sugar. Patients with polycystic ovary syndrome (PCOS), Cushing’s syndrome and other conditions have an increased risk of developing the metabolic syndrome. According to the Centers for Disease Control and Prevention (CDC), the metabolic syndrome affects almost a quarter (22 percent) of the American population – an estimated 47 million people. The assemblage of problems characterized as comprising the metabolic syndrome can raise a patient’s risk for developing more serious health problems, such as heart disease, diabetes and stroke.

Obesity and Cardiovascular Health
Overweight and obese people have an increased incidence of cardiovascular disease (CVD), including heart attack, congestive heart failure, sudden cardiac death, angina and abnormal heart rhythm²⁷. Obesity often increases CVD risk because of its negative effect on blood lipid levels, including increasing triglyceride levels and decreasing high-density lipoprotein (HDL) levels. As a corollary, people with an excessive amount of body fat have higher levels of triglycerides and low-density lipoprotein (LDL) cholesterol, and lower levels of HDL cholesterol in the blood, which may cause inflammation, and an increased risk for developing CVD²⁸.

Obesity and Type 2 Diabetes
More than 80 percent of people with the most common form of diabetes, Type 2, are obese or overweight. Data from the CDC’s National Health and Nutrition Examination Survey III shows that two-thirds of adult men and women in the U.S. diagnosed with Type 2 diabetes have a BMI of 27 or greater, which is classified as overweight and unhealthy²⁹. Type 2 diabetes develops when either the body does not produce enough insulin in the blood or cells ignore the insulin³⁰. As obesity alters the body’s ability to control blood sugar using insulin, there is an increased risk of developing diabetes. The body begins overproducing insulin to regulate blood sugar levels and over time the body can no longer keep these levels in a normal range. Eventually this inability to achieve balance results in higher, unhealthy blood sugar levels, and ultimately leads to the development of Type 2 diabetes³¹. Obesity complicates the management of Type 2 diabetes by increasing insulin resistance and glucose intolerance, which makes drug treatment for the disease less effective³².

Obesity and Dyslipidemia
Obesity has a negative effect on lipid levels in the blood, which often leads to the development of a condition known as dyslipidemia. Dyslipidemia, a primary risk factor for coronary artery disease, occurs when LDL cholesterol and triglyceride levels are high and HDL cholesterol is low, or any combination of these factors³³. Physicians often attribute this abnormal shift in lipid levels to weight gain. Losing weight, conversely, has an opposite effect. Weight loss of about 20 pounds has been shown to:

• Reduce LDL levels by 15 percent;
• Reduce triglyceride levels by 30 percent;
• Increase HDL by eight percent ; and
• Reduce total cholesterol levels by 10 percent³⁴.

Obesity and Polycystic Ovary Syndrome (PCOS)
The majority of patients diagnosed with PCOS, the most common hormonal disorder in reproductive-age women, are either overweight or obese³⁵. The syndrome is associated with an accumulation of incompletely developed follicles in the ovaries and is characterized by irregular menstrual cycles, multiple ovarian cysts and excessive hair growth³⁶. PCOS is a leading cause of infertility³⁷. In addition, PCOS causes significant insulin resistance, thereby increasing the woman’s risk of developing diabetes³⁸.

Overweight adolescent girls are also susceptible to developing PCOS. Hyperinsulinemia (excess insulin in the blood), insulin resistance and overweight are associated with PCOS in adolescents. Common characteristics among postpubertal adolescents and adults with PCOS include excessive hair growth, irregular menses and cystic or
non-cystic acne³⁹.