The Effects of Obesity on The Body

What exactly are the effects of obesity on the body? There are about 2.8 million adults per year that die from being overweight or obese globally. Shocking studies have revealed that being overweight and obese is the fifth risk of global death.

Most of this burden really comes from diabetes that's out there or from ischemic heart disease associated with being overweight and obese and of course increased risk of cancer associated with this condition.

There is a study called the Framingham Heart Study and this shows that if you are obese and a nonsmoker women lose seven years of life and men lose about six years of life.

Obesity increases your risk of cardiovascular disease including coronary artery disease the risk of strokes, heart attacks abnormalities with cholesterol an increased risk of heart failure.

It's also associated with an increased risk of gallstones, the fatty liver which can progress to fibrosis and cirrhosis and of course, may then lead to the need for liver transplants.

Currently, alcoholic liver disease is the major cause for a liver transplant but obesity or fatty liver disease in progression with that is set to be probably the most common cause for a liver transplant. We also see effects in respiratory disease, increased rates of obstructive sleep apnea, also exacerbation of asthma.

But if you are obese and a smoker both women and men lose at least 13 years of life that's quite significant. So obesity can virtually affect every organ of your body. We can try and look at the complications of obesity by splitting them up into three sections.

These are metabolic, mechanical, and mental. If we start with metabolic complications then obesity is associated of course with a very high risk of type 2 diabetes which leads to other complications.

Metabolic

Moving on to metabolic problems, of course, the increased risk of cancer is also increased, this increases the risk of cancer such as breast cancers such as rectal, ovarian, pancreatic, amongst many others.

Mechanical

If we then move on to the mechanical complications of obesity, of course, we know that increased weight is associated with problems with lower back pain and osteoarthritis.

And finally thinking about the mental disease which of course is a really important part of this. Many people with obesity have depression and anxiety and of course, this burden of disease really needs to be tackled and sometimes it's very much
ignored.

There are many options available for weight loss but the cornerstone of all these options, of course, is lifestyle interventions. Dietary changes and increase exercise within one's lifestyle. 

For some patients lifestyle alone is not enough and then one needs to look at other options including pharmacotherapy and bariatric surgery.

Pharmacotherapy

Pharmacotherapy can be very useful in achieving weight loss some of these mimic some of our natural hormones or our satiety hormones that speak to our brain to say that we're full. And these interventions can be effective in achieving and maintaining weight loss.

Moving on from pharmacotherapy there are some endoscopic options such as the gastric balloon and the endo barrier which are endoscopically placed into your gut. These have been found to be useful in maintaining weight loss. Although these procedures are temporary once the device is removed then the satiety signal is removed and not sustained. 

Bariatric Surgery

Finally, we have bariatric surgery which has been shown to be an effective way to both lose weight and maintain weight with time studies show weight loss after 20 years and beyond.

The three most common procedures worldwide are the gastric band the sleeve gastrectomy and the Roux-en-Y gastric bypass these procedures will require lifelong follow up especially nutritional supplementation.

It is very important that if patients are considering bariatric surgery which of course has been shown to be very successful in remission of many of the comorbidities that we have discussed so far.

You should get assessed by an obesity physician to discuss the pros and cons of surgery and whether it is suitable for you.

Our bodies are designed in such a way as to preserve energy and defend us from times of famine so when we lose weight through a diet, for example, our gut hormones change in such a way as to increase our hunger hormones (Karelin) and to decrease our satiety hormones thus making us feel more hungry.

What's really interesting is that even one year after we finished a diet plan our hormones still remember that we've lost calories and our hunger hormones remain high and the satiety home will remain low.

Our basal metabolic rate after weight loss is lower that is the energy required for all our metabolic processes is less than it used to be. So when we lose weight because of the changes in the gut hormones and the fact that we require fewer calories to maintain our basal metabolic processes which means that it's that much harder to keep the weight off over time.