What concomitant and secondary diseases can be associated with obesity?

According to a report by the World Health Organization (WHO), people with obesity have a more than 3-fold increased risk of developing metabolic diseases such as type 2 diabetes and/or a fatty liver compared to people of normal weight. In addition, obesity is often associated with breathing disorders during sleep, known as sleep apnea syndrome.

People with obesity have a 2 to 3 times higher risk of also developing high blood pressure and other cardiovascular diseases as well as lipometabolic disorders. If high blood pressure, increased blood sugar levels and elevated blood lipid levels are present in combination with obesity, the risk of further illnesses or cardiovascular events such as heart attack and stroke increases.

People with obesity have a 1 to 2 times higher risk of tumor, gastrointestinal, kidney and lung diseases. In addition, obesity is associated with hormonal disorders in women and men, for example polycystic ovary syndrome or infertility.

Furthermore, an increased body weight is associated with an increased risk of osteoarthritis in the hip or knee and leads more frequently to back problems. Older people in particular are at an increased risk of accidents and injuries due to their limited mobility.

People with obesity experience more complications during operations and anesthesia than people of normal weight. On the one hand, this is attributed to technical reasons owing to the increased body weight. On the other hand, metabolic conditions, existing cardiovascular stress and pre-existing organ damage or a diminished effect of medication can increase the risk in people with obesity.

In addition to the medical health risks, psychosocial aspects also play an important role in obesity. Obesity still often leads to social exclusion. The consequences can be depressive illnesses and anxiety disorders, reduced participation in social events and diminished self-esteem. Restricted physical mobility can also impair quality of life.

In general: The longer obesity persists and the more pronounced it is, the more difficult it is to treat obesity-associated secondary diseases and obesity itself. In some cases, it is no longer possible to reverse secondary diseases.

Obesity is one of the most important risk factors for type 2 diabetes. Body weight, especially waist circumference, is closely linked to the risk of type 2 diabetes. The duration and severity of the obesity play a decisive role: Each 1 kg/m² that the body mass index (BMI) is higher corresponds to a 25 percent increased risk of type 2 diabetes.

Researchers suspect that obesity promotes the development of insulin resistance due to a persistent lack of exercise, an oversupply of energy- and sugar-rich foods and an altered release of messenger substances from the fatty tissue. In addition, not only the quantity but also the quality of the diet is a key factor in the development of obesity. This applies in particular to abdominal obesity, which is associated with a high risk of concomitant diseases. It has recently been shown that around 70 percent of new cases of type 2 diabetes can be attributed to reduced dietary quality.

People who are overweight or obese are often judged negatively by society and held solely responsible for their increased body weight. This greatly simplifies the understanding of how obesity develops. It is wrongly assumed that obesity can only be avoided by increasing exercise and reducing calorie intake. More complex correlations such as genetic predisposition and environmental factors as well as the poor long-term feasibility are usually ignored. Due to this stigmatization, affected people are discriminated in many areas of life. Obesity is often a barrier to professional success.

The transfer of the negative social image to one’s own body image is referred to as self-stigma. This further reduces self-esteem and can lead to anxiety disorders and depression. Eating disorders can further intensify obesity or make treatment more difficult.

The stress caused by stigmatization can in turn have an impact on health: Stress is associated with the development of cardiovascular disease, type 2 diabetes and inflammation. In the short term, stress can increase blood pressure and trigger an increased release of cortisol. In the long term, this leads to an increased risk of body weight continuing to rise and obesity persisting or worsening.

Studies show that intensive behavioral therapy can reduce self-stigma and thus improve mental health and quality of life.

Behavioral therapy aims at

• strengthening self-esteem regardless of body weight,
• breaking negative thought spirals, for example through mindfulness,
• learning to defend oneself against prejudices by others, and
• deepening one’s knowledge of the various causes of obesity and thus being able to better assess one’s own responsibility.

The risk of developing obesity-associated concomitant and secondary diseases increases with the severity and duration of obesity. It is therefore important to take countermeasures at an early stage and reduce body weight. This should be done in consultation with a doctor.

Doctors determine the health risk based on the individual overall picture of the person affected. In addition to pure measurements such as BMI and waist circumference, existing diseases such as type 2 diabetes, cardiovascular diseases and orthopedic diseases as well as psychosocial aspects are also taken into account. The possible treatment options can then be discussed together and the appropriate steps towards weight loss can be planned.

A weight reduction of just 3 to 5 percent has a positive effect on existing risk factors and obesity-associated secondary diseases such as cardiovascular disease and type 2 diabetes.