Abstract
Severe and complex obesity is associated with multiple medical problems. The lines of causality are often complex with (a) medical problems causing obesity and obesity causing medical problems as well as (b) ‘third’ factors (such as sedentary lifestyle or poor diet) causing both the medical problem and obesity.
The chapter seeks to outline the main medical and psychological comorbidities, to indicate the frequency and impact on morbidity and mortality of these comorbidities. The clinical rationale and financial justification for obesity treatment is very dependent on these comorbidities and the extent to which they are reversed by successful weight loss.
The major comorbidities include type 2 diabetes, increased vascular deaths, thromboembolism, sleep disordered breathing, and cancer. Comorbidities that contribute to poor quality of life include psychological, esophageal, gynecological, urological, and musculoskeletal problems.
Insulin resistance is an important mechanism for type 2 diabetes, dyslipidemia, and hypertension all of which lead to vascular disease. Aromatization of androgens is an important mechanism in gynecological problems and some neoplasia.
Obesity is currently the largest cause of lost quality adjusted life years (QALYs) in the United States of America and it is the only major risk factor from which the total loss of QALYs is currently increasing year on year.
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Emmanuel, J.J., Coppack, S.W. (2016). Health Consequences–Obesity Associated Comorbidities. In: Agrawal, S. (eds) Obesity, Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-04343-2_4
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DOI: https://doi.org/10.1007/978-3-319-04343-2_4
Publisher Name: Springer, Cham
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