Friday, June 29, 2012

What does it mean to be morbidly obese?


Excessive accumulation of body fat is called obesity. This is a common condition in the modern world. Prevalence of obesity has increased drastically due to sedentary life style and high fat diet. Accumulation of fat is a major cause of many non communicable diseases. Several types of measurements are used to identify people with high level of fat. BMI (Body Mass Index) is one such measurement. It is calculated by dividing the weight of the person by square of his or her height. According to WHO Body Mass Index (BMI) of obese people is above 30. BMI of morbidly obese persons is above 40. A person is also considered morbidly obese if he or she is 100 over his or her ideal body weight. People with a BMI more than 35 kg/m2 along with obesity related health conditions are also considered as morbidly obese. As the name implies, these people are at a higher risk of getting diseases.

Morbid obesity  affects the person’s physical, psychological and social health. There are several physical illnesses that result from morbid obesity. They are type 2 diabetes mellitus, cardiac disorders, hypertension, hypercholesterolemia, osteoarthritis, gastro-esophageal reflux disease, gallstones, cancer and asthma. Some of theses diseases are collectively known as metabolic syndrome. It is also known as insulin resistant syndrome and syndrome X.  Apart form these serious health conditions, morbid obesity can affect the day to day activities of a person. Morbidly obese people find it difficult to move. They even find it hard to sleep because they develop sleep apnea.

Metabolic Syndrome

Metabolic syndrome  is a collection of conditions that increases the risk of diabetes mellitus, coronary artery disease and stroke. People with central obesity are more likely to get this syndrome. Fat tissues secrete several types of chemicals. Leptin and resistin  are two such chemicals that cause insulin resistant. These chemicals interfere with carbohydrate and fat metabolism in the body. These actions finally lead type 2 diabetes mellitus, hypercholesterolemia and atherosclerosis, coronary artery disease, hypertension and strokes.   

Osteoarthritis and other joint problems

Osteoarthritis is inflammation of the joints. It occurs as a result of wear and tear. When there is more stress on the joint, it gets damaged. When a person is morbidly obese, his or her weight is transmitted through the joint. Increased weight increases the resistance between two joints. This ultimately damages the joint and initiates an inflammatory process. The person starts to experience swelling, redness and impaired function of the joint. The increased weight on vertebral column causes the vertebral bodies to collapse. It also causes displacement of the intervertebral disks. It is called spondylolisthesis.

Sleep Apnea

 The excessive fat deposits in various places in human body. They can deposit in the tongue and neck. This leads to narrowing of the throat. So the person experiences difficulty in breathing. The effects are more when the person is sleeping. During sleep, especially when the person is sleeping on his or her back, the obese tongue falls back. This obstructs the respiratory passage. Sometimes it produces a noise. This is why many obese people snore when sleeping. These people accumulate carbon dioxide in their blood. It causes the dilatation of the vessels in the brain. When the blood vessels in the brain dilate, the intra-cranial pressure rises. Raised intracranial pressure causes nausea and drowsiness. That is why many morbidly obese people develop nausea and drowsiness in the morning.

Gastroesophageal Reflux Disease

Morbid obesity causes gastroesophageal reflux disease  due to several reasons. It causes esophageal motor disorders and decreases the lower esophageal sphincter pressure. There is also increased risk of development of hiatal hernia and intragastric pressure. All these effects finally lead to gastroesophageal reflux.
 
Infertility

Infertility  is a well known outcome of obesity. It is mainly seen in women. Polycystic ovarian syndrome is the commonest cause of infertility associated with obesity. It causes menstrual irregularities and chronic oligo-anovulation. Morbid obesity is a risk factor for miscarriages. Morbidly obese males have low testosterone levels, reduced spermatogenesis and erectile dysfunction. All these finally lead to infertility.

Depression

As mentioned earlier, morbid obesity affects not only the physical health but also the psychological and social health of a person. These people constantly face problems with their diet. They often feel uncomfortable among people due to their obesity. They often get offended with other peoples’ comments regarding their obesity. Above mentioned morbidities also put a great strain on them. All these things make them depressed.
Above mentioned are only several of morbidities associated with morbid obesity. Being morbidly obese is like living in a jungle of diseases. Morbid obesity is a huge burden to the person as well as to the country. Therefore, it is very important to prevent and treat obesity.   http://endo.endojournals.org/content/149/2/443.full 

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