Body Basics

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Weight Management

"A man too busy to take care his health is like a mechanic too busy to take care of his tools"


Being overweight or obese is an established risk factor for several diseases. What follows is a discussion of some of the most common disorders linked to excess body weight. In other words, these are diseases that you are less likely to have if you maintain a healthy weight.

Heart disease
Heart disease is actually a collection of diseases that make it difficult for the heart to pump blood through the body. Heart disease includes such conditions as coronary artery disease and heart failure and can lead to a heart attack. Heart disease is the leading cause of death for both men and women in the United States and so accounts for much of the health risk associated with being overweight. Excess weight, especially around the waist, increases the risk the of coronary artery disease and heart failure by increasing blood cholesterol, blood triglycerides, blood pressure, and insulin resistance. All of these things independently are also risk factors for heart disease and when they both occur in someone who is overweight, the risk of heart disease skyrockets.
High blood cholesterol
Being overweight or obese increases the risk that you will have high cholesterol. Cholesterol is a molecule necessary for the proper functioning of all body cells. However, when its levels are too high in the blood, it contributes to artery disease (atherosclerosis) by helping to form plaques inside the blood vessels. These plaques are a major cause of heart disease and stroke. Having more body fat can cause cholesterol to stay in the blood longer, leading to higher blood cholesterol levels.
Hypertension is high blood pressure. While it is hard to determine exactly what causes most cases of hypertension, many people with high blood pressure are overweight or obese. Excess weight increases the force that the heart must generate to pump blood throughout the body, which increases the blood pressure. Hypertension is a major risk factor for heart attack and stroke.

Type 2 diabetes
Type 2 diabetes is a disease of high blood sugar caused by insufficient production of or response to the hormone insulin. The most important risk factor in the development of type 2 diabetes is obesity, especially when the weight is carried centrally (an apple body shape, as opposed to a pear body shape). Researchers don’t know exactly why excess weight leads to diabetes but they do know that fat, especially central fat, makes the body less responsive to insulin.

A stroke is a “brain attack.” When a blood vessel that normally supplies nourishment to brain tissue becomes blocked, the brain tissue that depends on that blood vessel for oxygen and nutrients begins to starve and subsequently dies. Carrying excess weight is associated with an increased risk of stroke and also causes independent risk factors for stroke including hypertension and high blood cholesterol.
Osteoarthritis is degeneration of the cartilage and bone in the joints. Osteoarthritis occurs as a normal consequence of aging in many people. However, heavier people are at greater risk for osteoarthritis especially in the weight bearing joints found in the legs and back. The more weight a person has, the more stress there is on the joints and over time this can lead the bones and cartilage to wear away.
Several types of cancer are more likely to occur in people who are overweight and obese. These include breast, uterine, and cervical cancers in women; prostate cancer in men; and colon, kidney, and esophageal cancer in both sexes. Researchers don’t know why excess weight increases cancer risk - and the factors may be different for each cancer - but it might have to do with changes in the levels of hormones such as insulin and sex hormones. Fat tissue releases small amounts of estrogen which could upset the normal balance of sex hormones in the body and increase risk of some cancers. Excess weight also makes cells more resistant to insulin, so levels of this hormone tend to be higher than in average-weight people. Some studies have also reported links between obesity and cancers of the gallbladder, ovaries, and pancreas though these associations are not as well established.
Sleep apnea
Sleep apnea is a condition in which a person stops breathing during sleep several times each night. More than 90% of people with sleep apnea are obese. Most sleep apnea cases are called “obstructive” because they are caused by the structures of the neck and throat losing muscle tone which collapses the upper airway; when the airway is collapsed no air can get in or out. This forces the person to wake up in order to restore normal breathing. Having excess fat in the neck region increases the likelihood that the upper airway will collapse during sleep. Sleep apnea is itself associated with a higher incidence of cardiac arrhythmias, heart attacks, and strokes.

Breathing problems
Carrying extra weight can also cause respiratory problems. When you have more fat in the abdomen and thorax, the lungs cannot expand as much as normal and the chest wall becomes heavy and hard to move. This can make normal activities such as yard work, stair climbing, and exercise difficult. Asthma and bronchitis can also be aggravated by excess weight. While obesity does not cause asthma or bronchitis, it interferes with breathing and may aggravate an attack.
Gastroesophageal reflux disease (GERD)
GERD occurs when acid from the stomach seeps up (refluxes) into the base of the esophagus and causes severe heartburn. It is a chronic condition that is more likely to occur in individuals who are overweight or obese. Excess weight in the abdominal region may disrupt the normal anatomical relationship between the stomach and esophagus and make acid reflux more common.
The gallbladder is a small abdominal organ that stores bile produced in the liver. Bile is released into the digestive tract to help digest the fat in food. When the bile in the gallbladder becomes too concentrated, it forms solid masses called gallstones. Gallstones can cause inflammation of the gallbladder which causes abdominal pain and may require surgery to remove the gallbladder. Obesity increases the risk of gallstones, perhaps because the gallbladder does not empty its contents as well in obese people so it can build up and become too concentrated.

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