Obesity has a substantial adverse impact on health via its association with a number of serious illnesses and risk factors for disease. Obesity-related conditions include hypertension, dyslipidemia, type 2 diabetes mellitus, coronary heart disease (CHD), stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and cancers of the endometrium, breast, prostate and colon.
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Hypertension

The prevalence of high blood pressure in adults is twice as high for individuals with BMI > 30 than for those with normal weight. Mechanisms for increased blood pressure appear to be related to increases in blood volume, vascular resistance, and cardiac output. Hypertension is a risk factor for both CHD and stroke.
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Dyslipidemia

Obesity is associated with lipid profilles that increase risk for CHD, including elevated levels of total cholesterol, triglycerides, and low-density lipoprotein (bad) cholesterol, as well as low levels of highdensity lipoprotein (good) cholesterol.
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Type 2 Diabetes Mellitus

Data from international studies consistently show that obesity is a robust predictor of the development of diabetes. A 14- year prospective study concluded that obesewomenwere at 40 times greater risk for developing diabetes than normalweight, age-matched counterparts.

Current estimates suggest that 27% of new cases of type 2 diabetes are attributable to weight gain of 5 kg or more in adulthood. Moreover, abdominal obesity is a speci“c major risk factor for type 2 diabetes.
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Coronary Heart Disease

Overweight, obesity, and abdominal adiposity are associated with increased morbidity and mortality due to CHD. These conditions are directly related to elevated levels of cholesterol, blood pressure, and insulin, all of which are specific risk factors for cardiovascular disease. Recent studies suggest that, compared to a BMI in the normal range, the relative risk for CHD is twice as high at a BMI of 25 to 29, and three times as high for BMI > 29. Moreover, a weight gain of 5 to 8 kg increases CHD risk by 25%.
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Stroke

The Framingham Heart Study suggested that overweight may contribute to stroke risk, independent of hypertension and diabetes. Later research established that the relationship between obesity and stroke is clearer for ischemic stroke versus hemorrhagic stroke. Recent prospective studies show a graduated increase in risk for ischemic stroke with increasing BMI (i.e., risk is 75% higher with BMIs > 27; 137% higher with BMIs > 32).
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Gallstones

Obesity is a risk factor across both age and ethnicity for gallbladder disease. The risk of gallstones is 4 to 6 times higher for women with BMIs > 40 compared to women with BMIs 24.
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Sleep Apnea

Sleep apnea is a serious and potentially lifethreatening breathing disorder, characterized by repeated arousal from sleep due to temporary cessation of breathing. Both the presence and severity of sleep apnea, is associated with obesity, and sleep apnea occurs disproportionately in people with BMIs > 30. Large neck circumference ( # 17 inches in men and # 16 inches in women) is highly predictive of sleep apnea.
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Women’s Reproductive Health

Menstrual irregularity and amenorrhea are observed with greater frequency in overweight and obese women. Polycystic ovary syndrome, which often includes infertility, menstrual disturbances, hirsutism, and anovulation, is associated with abdominal obesity, hyperinsulinemia, and insulin resistance.