Physical Manifestations of Obesity

  • Jeffrey Sicat


The accumulation of excess fat mass results in progressively higher degrees of adiposity. Adiposity leads to numerous complications related to the effects of this increasing fat mass. Whereas bariatric endocrinology deals with adiposopathy (pathological changes that occur in adipose tissue), and with concomitant derangements of metabolism and hormones, it is imperative to have awareness of all aspects of a patient’s health.

The physical complications of obesity include obstructive sleep apnea, fatigue from having to expend energy moving excess body mass, gastroesophageal reflux disease (worsened by increased intra-abdominal pressure), gallbladder disease, skin changes (especially under skin folds), urinary incontinence, and degenerative osteoarthritis (OA), among others.

There is a bidirectional relationship between many of the physical complications of obesity, and adiposity itself. Two examples of this are sleep apnea and osteoarthritis. As fat mass increases, sleep apnea becomes progressively worse. This in turn causes sleep disturbance, daytime fatigue, and excessive somnolence. And this in turn causes a more sedentary lifestyle that promotes weight gain. Similarly, as the fat mass increases, weight-bearing joints are strained and wear down. With progressive arthritis comes increasing joint pain. This makes movement increasingly difficult. And with inactivity comes more weight gain.

The treatment of obesity, with effective weight loss, effectively treats many of the complications of increasing fat mass. For many patients, effective treatment of overweight or obesity involves treating the physical complications. For example, providing analgesia for painful joints allows for better movement. Institution of continuous positive airway pressure allows for better sleep and more energy to have a healthier lifestyle. A bariatric endocrinology practice should either provide or refer for the diagnostic and treatment needs of individual patients. The goals of achieving weight loss, treating adiposopathy, and reversing metabolic derangements, all need addressing the physical complications of obesity.


Obesity Adiposity Sleep apnea Gastroesophageal reflux disease Osteoarthritis Urinary tract infection Myocardial infarction 

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jeffrey Sicat
    • 1
  1. 1.Virginia Weight and WellnessGlen AllenUSA

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