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QJM Advance Access originally published online on August 17, 2006
QJM 2006 99(9):565-579; doi:10.1093/qjmed/hcl085
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Reviews

The medical complications of obesity

S.D.H. Malnick1, and H. Knobler2

From the 1Department of Internal Medicine C and 2Metabolic Unit, Kaplan Medical Centre, Rehovot, Israel

Address correspondence to Dr S.D.H. Malnick, Department of Internal Medicine C, Kaplan Medical Centre, Rehovot 76100, Israel. email: stevash@trendline.co.il

The first 150 words of the full text of this article appear below.


   Introduction
 
The prevalence of overweight and obesity is increasing worldwide.1 A comparison of data from 1976–802 with that from 1999–2000 shows that the prevalence of overweight (defined as body mass index, BMI, of 25–29.9 kg/m2) increased from 46% to 64.5%, and the prevalence of obesity (BMI >= 30 kg/m2) doubled to 30.5%. The epidemic of obesity is not just isolated to the US, but is worldwide,3,4 including less affluent countries.4

Obesity and overweight have many causes, including genetic, metabolic, behavioural and environmental. The rapid increase in prevalence suggests that behavioural and environmental influences predominate, rather than biological changes.

We summarize data from many studies evaluating the impact of obesity on mortality and morbidity, discuss some controversies and provide practical guidelines for managing obese patients.


   Relation between body weight and mortality
 
Direct associations between obesity and several diseases, including diabetes mellitus, hypertension, dyslipidaemia and ischaemic heart disease, are well recognized. Despite this, the relationship between body weight . . . [Full Text of this Article]


   Morbidity associated with obesity
 
Diabetes mellitus
Hypertension
Dyslipidaemia
Heart disease
Coronary artery disease
Heart failure
Atrial fibrillation
Cerebrovascular disease
Respiratory disease
Obstructive sleep apnoea
Asthma
Gastrointestinal system
Gastroesophageal reflux
Hepatobiliary disease
Non-alcoholic fatty liver disease (NAFLD)
Osteoarthritis
Cancer
Psychosocial function
Gynaecological and obstetric complications
Surgical and anaesthetic complications
Chronic kidney disease

   Are all obese patients at increased risk?
 
Physical fitness and activity
Insulin resistance and the metabolic syndrome
Fat distribution

   Genetics
 

   Conclusions
 

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