A NIH study in 2004, which calculated preventable causes of death, concluded that Obesity was responsible for 400,000 early deaths in the US per year. The only other factor more deadly was Tobacco exposure, only after adding in second-hand smoke. Based on the rate of increase in the death rate from Obesity it is now likely that it is responsible for more early death in Americans than any other factor – more than HIV, more than motor vehicle accidents, more than interpersonal violence or suicide, more than SARS, or Bird-Flu, or any other new infectious epidemic in the news.
Why is Morbid Obesity so dangerous? The answer is that severe Obesity causes disease in almost every major organ system over time. The derangements are dependent upon the degree of obesity, its duration, and the individual’s vulnerability to those derangements. The degree of Obesity that leads to these derangements is termed “Morbid Obesity.” This is a medical term. Morbid Obesity is responsible for the following medical problems:
|Organ System||Primary Problem||Secondary Problem|
|Cardiovascular||High Blood Pressure||heart attack, heart failure, stroke|
|High Cholesterol||heart attack, heart failure, stroke|
|High Fats in Blood||heart attack, heart failure, stroke, pancreatitis|
|Neurological||Pseudotumor Cerebrii||seizure, stroke|
|Respiratory||Obstructive Sleep Apnea||high blood pressure|
|Endocrine||Diabetes||kidney failure, heart attack, blindness, infections|
|Fatty Liver||liver failure|
|Gastric Reflux||Barrett’s esophagus, esophageal cancer|
|Urinary||Stress Urinary Incontinence|
|Polycystic Ovaries||high blood pressure, diabetes, high cholesterol|
|Musculoskeletal||Arthritis / Joint pain||joint replacement|
|Chronic Back Pain|
If a person remains morbidly obese it is likely that a combination of the above listed conditions will eventually be fatal. Conversely, the only way to arrest or reverse most of them is for the person to significantly reduce his or her weight to a lower, and safer, BMI. Not only must the BMI be reduced, but the reduction must be long term for there to be lasting reduction of risk.
The ability of Anti-Obesity operations to cure or improve the conditions listed above has been well documented. The reversal of the caloric balance with weight loss – and the redirection of nutrients with a myriad of hormonal effects (Gastric Bypass) – has an almost magical effect in causing these conditions to fade away. A meta-analysis (a study combining information from all published studies on a subject) appeared in the Journal of the American Medical Association in 2004. Observing the outcomes for the most common obesity related co-morbidities, depending on the type of operation done, the following cure and improvement rates were noted1.
Weight reduction surgery – as opposed to physician supervised diets – has been proven to maintain weight loss for the long run. Furthermore, most patients with these associated conditions will be cured or greatly improved. This is the great, underappreciated benefit of weight reduction surgery. Because in many patients who have multiple associated medical problems have a resultant cure or reduction in the severity of their problems, there is a subsequent reduction in preventable mortality. Weight reduction surgery has been shown to extend people lives. Very few treatments or surgeries in Medicine can make similar claims.
1. Buchwald H, Avidor Y, Braunwald E, et al. JAMA oct 2004; (292)1724-1737