By Elizabeth M. Whelan, Sc.D., M.P.H.
Posted: Saturday, April 4, 2009

ARTICLES
Publication Date: April 4, 2009

This piece first appeared in April 2009 on the Consumer Guide to Bariatric Surgery (at YourBariatricSurgeryGuide.com):

There is an old adage that more weight reduction diets begin in the fitting room of a clothing store than in a physician's office.

The downside of obesity has typically been associated with having an "unattractive" appearance. Gradually, over the past two decades, this view has been replaced by something more substantive, with data showing that being obese or overweight raises the risk of heart disease and diabetes.

But that is not the full extent of the problem.

As obesity, its effects and its consequences become more widely recognized and understood, the list of maladies associated with excess weight grows exponentially.

Obesity adversely affects almost every system in the human body.

For example, obesity:

• Shortens your life expectancy by six to seven years.
• Dramatically increases the odds of developing hypertension (high blood pressure), a leading cause of coronary heart disease and stroke.
• Impairs breathing because of fat tissue around the ribs and abdomen. (Obese people have a lower capacity for exercise than normal-weight people.)
• Increases your risk of developing asthma.
• Causes sleep apnea, a condition in which people stop breathing repeatedly while they are asleep, usually for ten to thirty seconds at a time.
• Is strongly associated with the risk of developing endometrial (uterine), colon, esophogeal, and male and female breast cancer, as well as kidney stones and gallstones. (Preliminary evidence shows that obesity may also increase the risk of prostate, ovarian, liver, thyroid and stomach cancers, as well as multiple myeloma and non-Hodgkin's lymphoma.)
• Leads to increased risk of complications in patients who have surgery or who undergo anesthesia or sedation, even for something as routine as sedation dentistry.
• Leads to increased risk of post-surgical infection, sometimes because the surgery takes more time in obese people.
• Increases the risk of needing gallbladder surgery.
• Causes pancreatitis (an inflammation of the pancreas) and nonalcoholic liver disease.
• Triggers complications of pregnancy including gestational diabetes and high blood pressure.
• Leads to delays in becoming pregnant; may cause infertility.
• Causes urinary incontinence, erectile dysfunction, and is likely to decrease male fertility and viable sperm production.
• Increases the risk of Parkinson's disease in both men and women.
• Increases the risk of developing psoriasis, an inflammatory skin disease.
• Raises the risk of unintentional injury. (Overweight people are far more prone to falls and other accidents.)

And when dealing with the negative health effects of obesity, you can't choose one from column A and one from column B. Obesity subjects you to all these risks at once. The list of known effects is likely to expand significantly in the near future. Unlike the health consequences of cigarette smoking, which have been studied for almost sixty years, we are just now confirming the risks of being overweight and obese.

What can you do about it?

• Determine your BMI. If it is over 25, you are overweight. If it is over 30, you are obese.
• Speak to your physician about your weight. Get his or her advice, perhaps even a recommendation for assistance.
• Accept the fact that the number of calories you consume daily -- and the amount of exercise you do to burn those calories -- determines weight gain and loss.
• Learn what your ideal daily caloric intake is and by how much you should cutcalories to accelerate weight loss.
• Be patient. It takes time to lose weight.
• Consider joining a self-help weight loss group for support. Find an online support site on the Internet if you can't find one offline.
• And recognize that to maintain your weight loss it is necessary to make permanent changes in your lifestyle.


Elizabeth M. Whelan, ScD, MPH, is president of the American Council on Science and Health, a New York City-based non-profit consumer education group. This group recently published Obesity and Its Health Effects. For more information on ACSH and this publication, visit ACSH.org.