Medical consequences of obesity

Obesity now represents one of the most important global public health issues through its rapidly increasing prevalence and association with a wide range of diseases. Mortality is increased with increasing BMI and a 40-year old with a BMI >30 kg/m2 might expect to die 6–7 years earlier than a normal weight individual. There is a strong link of type 2 diabetes with obesity – a 25% increase in risk for every 1 kg/m2 increase in BMI above 22. Obesity has a particular impact on the cardiovascular system including an increased prevalence of heart failure, hypertension and coronary heart disease. Sleep apnoea syndrome, symptoms of breathlessness and asthma are all more common in the obese. An increasingly recognized consequence of excess adiposity is the development of fatty liver and its transition to non-alcoholic steatohepatosis, which threatens to become the leading cause of liver failure. Many cancers are more common in the obese and the outcome of treatment is often less successful. Psychosocial and psychiatric consequences of obesity are also increasingly recognized. This increasing health burden poses considerable economic costs and challenges, making prevention and effective management imperative.