Understanding the Impact of Obesity on Health and longevity. The role GLP1 analogues Semaglutide and Tirzapetide in Weight Loss Management.
The medical community has been aware of the health risks associated with being overweight or obese for over 2000 years. Overweight is defined by a Body Mass Index (BMI) of 25 to 29.9 kg/m², obesity by a BMI of 30 kg/m² or higher, and severe obesity by a BMI exceeding 40 kg/m².
The impact of Obesity on lifespan.
Obesity in adults significantly reduces life expectancy, particularly for those who become obese at a younger age (under 40 years old). The combination of obesity and smoking drastically lowers life expectancy compared to individuals who either smoke or are obese but not both.
In 2015, excess body weight was responsible for four million deaths globally and over 320,000 deaths in the United States in 2014. Both general obesity (measured by BMI) and central obesity (measured by waist-hip ratio, or WHR) are linked to increased morbidity and mortality from all causes.
A higher BMI is generally associated with increased mortality from all causes, including cardiovascular diseases. A study found that for non-smokers, life expectancy from age 40 was reduced by 4.2 years for males and 3.5 years for females with obesity (BMI ≥30 kg/m²) compared to those of a healthy weight.
Central obesity’s impact on mortality appears to be independent of BMI. A meta-analysis of 72 cohort studies with over 2.5 million participants found that a higher WHR was linked to increased mortality, even after adjusting for BMI.
The Role of Exercise and Fitness
Fitness plays a crucial role in mitigating the health risks associated with obesity. Physical activity and cardiorespiratory fitness are linked to reduced risks of cardiovascular diseases, including heart failure and coronary heart disease. Fitness also influences the relationship between fat accumulation and major cardiovascular outcomes.
Metabolic Risks
Diabetes Mellitus
Losing 5 to 7 percent of body weight can significantly lower the risk of developing type 2 diabetes in people with prediabetes.
Dyslipidemia
Central obesity is closely linked to abnormalities in serum lipid levels.
Cardiovascular Conditions
Obesity is associated with various cardiovascular issues, including coronary heart disease, heart failure, myocardial steatosis, atrial fibrillation, and increased risk of stroke and venous thromboembolism.
Cancer Risks
Obesity and overweight increase the risk of dying from cancer. This is likely due to changes in sex hormone metabolism, insulin and insulin-like growth factor levels, and adipokine pathways. The cancer risk related to excess weight is higher in females than males. Numerous studies and meta-analyses have found strong links between obesity and cancers such as endometrial, kidney, gastric cardia, colon, rectum, biliary tract, pancreas, breast, esophageal adenocarcinoma, ovarian, multiple myeloma, hepatocellular carcinoma, and meningioma.
Musculoskeletal Disorders
Obesity increases the risk of musculoskeletal issues such as osteoarthritis and gout.
Gastrointestinal and Hepatobiliary Diseases
Obesity is linked to gastrointestinal conditions like gastroesophageal reflux disease (GERD) and gastrointestinal cancers.
Reproductive Health
In females, obesity is associated with various reproductive disorders including infertility, abnormal uterine bleeding, endometrial hyperplasia or carcinoma, anovulatory cycles, polycystic ovarian syndrome, uterine fibroids, endometriosis, and sexual dysfunction. In males, obesity is a risk factor for infertility and erectile dysfunction.
Genitourinary Issues
Obesity increases the risk of chronic kidney disease, kidney stones, urinary incontinence, and complications requiring dialysis or kidney transplantation.
Psychosocial Impact
Individuals with obesity often face social stigma, which affects their mental health, leading to issues such as depression and dementia.
Respiratory Complications
Obesity is linked to respiratory conditions like obstructive sleep apnea, asthma, and obesity hypoventilation syndrome.
Infection Risks
Obesity increases the risk of severe outcomes from infections like influenza and COVID-19. It is also a risk factor for long COVID.
Economic Impact of Obesity
The treatment of obesity and related conditions imposes a significant economic burden. In 2017, the cost of obesity in the United States was estimated at $1.4 trillion. These costs include direct healthcare expenses and indirect costs such as lost productivity and reduced household income.
Summary and Recommendations
Obesity is linked to increased morbidity and mortality. While BMI is an imperfect measure, it is widely used to categorize underweight, normal weight, overweight, and obesity. Greater BMI is generally associated with higher all-cause and cardiovascular mortality.
Obesity and increased central fat are linked to various chronic conditions such as type 2 diabetes, hypertension, heart disease, stroke, sleep apnea, cancer, osteoarthritis, hepatobiliary disease, GERD, asthma, and chronic kidney disease. Even modest weight loss can improve these conditions.
Obesity affects mental and social well-being, as individuals with obesity often face discrimination in various areas, including education, employment, and healthcare.
The cost of treating obesity-related conditions is substantial, encompassing direct healthcare costs and other expenses like lost work productivity.
At Aesthetics and Medical Laser of Colorado, our board-certified Internal Medicine physician, Dr. Roland Kafuuma, utilizes cutting-edge, FDA-approved GLP-1 analogues, including Semaglutide and Tirzepatide, for weight loss treatment. For more information, call us at 720-818-0533 or visit our website at aestheticsandmedicallasers.com.
