Obesity – Widespread Disease

Adipositas - FettleibigkeitObesity Fatness Adiposity - disease
Obesity is a condition in which the natural energy reserve, stored in the fatty tissue of humans and other mammals, exceeds healthy limits. A person’s level of overweight can be calculated using the Body Mass Index (BMI). The BMI expresses the relationship between weight and height in a single figure.

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The excessive accumulation of fat that exceeds the body’s skeletal and physical standards. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk.
Obesity is steadily and inexorably increasing world wide and becoming the greatest health problem in the developed world. It has been recently estimated that 1.1 billion people are overfed and overweight, Today 127 million Americans are overweight, more than one-third of the adult population, are overweight, and 60 million are obese. An estimated 9 million of those are considered morbidly obese.

Extremely overweight people often have a negative self-image, which is frequently reinforced by their environment.Overweight children have particular difficulties: they are teased at school and often have difficulty making friends. It can be very difficult to find attractive clothing if you are severely overweight, and many institutions do not take the problems of overweight people into account.
Seats in public transport are too small and telephone boxes and cars often too confined. Sporting activities are almost impossible. Obese people cannot take part in activities requiring a certain level of mobility, or physical flexibility. Thus, many obese people gradually become very isolated. Even everyday activities can be difficult because obese people can tire quickly, or get out of breath easily. Physical flexibility can be reduced so much that even personal hygiene suffers.

Clinical problem of Obesity and Mortality

Multiple studies have described the exponential relation­ship between increasing BMI and the relative risk of dying prematurely. As a result of five prospective cohort studies, Allison and coworkers estimated that between 275,000 and 325,000 Americans die each year from obesity-related dis­eases.. It reaches nearly the estimated number of people, approximately 400,000, who die each year from smoking-related diseases.

Diabesity
Most patients with diabetes mellitus type 2 are overweight (BMI>25 and <30) and half of them are obese(BMI between 30 and 34)
The risk of developing Diabetes mellitus type 2 increases 5 times at BMI 25, 35 times greater at BMI 30, and 93 times greater at or above BMI 35. Given the morbidity and mortality that diabetes causes in young and middle-aged adults, this dis­ease alone should elicit a call for action against the rising epidemic of obesity.

Metabolic Syndrome
This includes a cluster of insulin resistance and hyperinsulinemia, dyslipidemia essential hypertension type 2 diabetes, increased risk of cardio­vascular events. polycystic ovary syndrome, which is characterized by ovulatory dysfunction, infertility, androgen excess, and reduced sex hormone binding globulin, nonalcoholic steatohepatitis, an increasingly common cause of abnormal liver function.

Respiratory diseases
As a result of intermittent pharyngeal obstruction due to soft tissue enlargement and reduced tone in the muscles controlling the tongue and soft palate is the obstructive sleep apnea(OSA), which is characterized by epi­sodes of apnea during sleep. Patients, whose BMI exceeds 40, have an incidence at least 10 times the norm of 2% to 4%.

Less common but more pathogenic than OSA is the obesity-hypoventilation syndrome, it leads through chronic hypoxia and hypercapnia to pulmonary hypertension and right heart fail­ure.

There is an increased preva­lence and severity of asthma in obese children.

Gastro esophageal reflux disease
There is a higher incidence of gastroesophageal reflux disease in obese patients, Objective measures of abnormal reflux by 24-hour pH monitoring and abnormal pressures at the lower esophageal sphincter on manometry support the clinical findings of increased prevalence. Cardiovascular Disease
Dyslipidemia is common in obese patient, it increases the incidence of atherosclerosis. The Car­diac output, stroke volume, and total blood volume increase. This leads to increase in systemic vascular resistance and hyper­tension,

The combination results in increased prevalence of myocardial infarction and stroke, two of the major causes of premature death in the obese.

Incontinence
A large, heavy abdomen and relaxation of the pelvic muscles, especially associated with the effects of childbirth, may cause the valve on the urinary bladder to be weakened, leading to leakage of urine with coughing, sneezing, or laughing, especially by female obese

Menstrual irregularities
Morbidly obese women often experience disruptions of the menstrual cycle, including interruption of the menstrual cycle, abnormal menstrual flow, and increased pain associated with the menstrual cycle.

Pregnancy
In obese women is associated with higher incidence of complication, this includes hy­pertension, preeclampsia, late fetal death, gestational diabetes and higher risk of induction of labor and cesarean section. There is also evidence that the infants of obese patient are at higher risk of developing abnormalities.

Osteoarthritis of weight-bearing joints
The additional weight placed on joints, particularly knees and hips, results in rapid wear and tear, along with pain caused by inflammation. Similarly, bones and muscles of the back are constantly strained, resulting in disk problems, pain and decreased mobility.

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