Understanding the Comorbidities and Complications of Obesity

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Obesity puts people at risk of developing various other medical conditions. These conditions are known as comorbidities. There are also a number of other health problems linked to obesity, known as complications.1

Understanding the health conditions related to obesity is crucial for detecting, treating, and preventing them. Weight loss through healthy lifestyle changes is an important way to reduce your risk for obesity and obesity-related conditions.1

Here are some of the most common health complications associated with obesity.

Type 2 diabetes

Obesity and type 2 diabetes often go hand in hand. People with obesity are 6 times more likely to develop type 2 diabetes.2

Excessive weight gain and a sedentary lifestyle can lead to insulin resistance. Insulin resistance is when the body becomes less responsive to insulin. This can result in increased blood sugar levels and may lead to type 2 diabetes. If left uncontrolled, type 2 diabetes can cause great harm to your body and overall health.1,2

Not everyone with obesity will go on to develop type 2 diabetes. Several factors come into play, like:2

  • Family history
  • Diet and exercise
  • Stress

Losing even 5 to 10 percent of your total body weight can reduce your risk of developing type 2 diabetes.2

High blood pressure

Obesity is strongly linked to high blood pressure, also known as hypertension. Excess weight puts more strain on the heart. This forces the heart to work harder to pump blood throughout your body, which can lead to high blood pressure. Over time, this can damage your blood vessels and increase your risk of heart disease or stroke.1,3-6

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Heart disease and stroke

Obesity also increases the risk of heart disease and stroke because it is linked with high cholesterol and triglyceride levels. Cholesterol and triglycerides are fatty deposits, or plaques. The buildup of fatty deposits in your arteries and blood vessels restricts blood flow to your heart and brain. This can lead to heart attacks and strokes.1,7

Sleep apnea and breathing problems

Obesity is the most common risk factor for developing obstructive sleep apnea. Sleep apnea is a disorder in which breathing stops and starts over and over again during sleep. This can be quite dangerous.7

Excess weight can cause a narrowing, or obstruction, in your airways. Because sleep apnea disrupts sleep, it can lead to daytime fatigue and an increased risk of heart problems. Poor sleep has also been shown to increase appetite, which contributes to obesity.7

Osteoarthritis

Excess weight puts immense pressure on the joints, especially the ankles, knees, and hips. This can quicken the wear and tear of the bone and joint cartilage, leading to osteoarthritis. Osteoarthritis can cause chronic pain and affect how well you can move around. This can affect your overall quality of life and lead to more weight gain.1,7

Digestive problems

Obesity can contribute to many digestive problems. These can include:1,7,8

  • Gallbladder disease – Gallstones, which form in the gallbladder from too much cholesterol, are more common in people with obesity.
  • Heartburn (acid reflux) – Excess abdominal fat can increase the pressure on the stomach, leading to heartburn.
  • Gastroesophageal reflux disease (GERD) – GERD occurs after a prolonged period of constant heartburn or reflux of stomach contents. It can cause damage to the stomach lining and the esophagus.
  • Non-alcoholic fatty liver disease (NAFLD) – NAFLD occurs when excess fat collects in the liver. It can lead to inflammation and liver damage.

Certain cancers

Experts have found a link between obesity and an increased risk for certain types of cancer. These cancers include:1,3,7

  • Uterine
  • Cervical
  • Endometrial
  • Ovarian
  • Breast
  • Colorectal
  • Esophageal
  • Liver
  • Gallbladder
  • Pancreatic
  • Kidney
  • Prostate

Many complex factors affect whether a person will develop both obesity and cancer. For example, hormonal changes, chronic inflammation, and insulin resistance all play a role in cancer development. But weight loss and lifestyle changes can reduce the risk of both obesity and obesity-related cancers.7

Gout

Obesity has also been closely linked with gout. Gout occurs when uric acid builds up in the body. This buildup causes crystals to form in the joints, which are very painful. Typically the kidneys filter out uric acid, but obesity can make it harder for kidneys to do their jobs.7,9

Studies have shown that the risk of gout nearly doubles in people with a body mass index (BMI) over 30. And those with fat that collects around the belly (visceral fat) are more at risk of developing gout.7,9

Severe COVID-19 symptoms

Emerging evidence suggests that obesity may worsen COVID-19 symptoms and create serious complications. People with obesity are more likely to have respiratory distress and need hospitalization when infected with the COVID-19 virus. They also face a higher death rate from the virus.10

Obesity-related factors such as reduced lung function, chronic inflammation, and weakened immune response add to the increased risk of severe illness from COVID-19. If you have tested positive for COVID-19 and have obesity, talk with your doctor as soon as possible.10

Mental health issues

Obesity can affect not only your physical health but also your mental health. Obesity can cause:11

  • Low self-esteem
  • Depression
  • Anxiety
  • Social isolation
  • Negative body image

The emotional toll of obesity can lead to disordered eating. And weight stigma and discrimination against people with larger bodies can add fuel to the fire.11

People with obesity who are seeking weight loss should consider talking with a counselor or therapist. Meeting with a mental health professional is also important if you are facing emotional problems, disordered eating, or discrimination.11

Weight loss can reduce these risks

Obesity is a complex health condition that can lead to a range of comorbidities and complications. But by working toward a healthy weight, you can reduce these risks to your health. Get regular physical activity, eat a balanced and nutritious diet, and seek medical help if you need it. Small steps toward a healthier lifestyle can lead to big positive changes in the long run.2,3,7

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