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Obesity
Health effects of morbid obesity that can be improved with gastric
bypass surgery
Severe obesity damages the body by its mechanical, metabolic and physiological
adverse effects on normal bodily function. These "co-morbidities"
affect nearly every organ in the body in some way and produce serious
secondary illnesses which may also be life-threatening. The cumulative
effect of these co-morbidities can interfere with a normal and productive
life, cause endless frustration and can seriously shorten life as
well.
Heart Disease
People who suffer from morbid obesity are approximately 6 times as
likely to develop heart disease as those who are normal-weighted.
Coronary disease is predisposed by increased levels of blood fats
and the metabolic effects of obesity. Increased load on the heart
leads to early development of congestive heart failure. People with
morbid obesity are 40 times as likely to suffer sudden death, in many
cases due to cardiac rhythm disturbances.
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High Blood Pressure
Essential hypertension, the progressive elevation of blood pressure,
is much more common in people with morbid obesity, and leads to development
of heart disease and damage to the blood vessels throughout the body,
causing susceptibility to strokes, kidney damage, and hardening of
the arteries.
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High Blood Cholesterol
Cholesterol levels are commonly elevated in the severely obese –
another factor predisposing to development of heart and blood vessel
disease.
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Diabetes Mellitus
Overweight people are 10 times as likely to develop Type II, Adult-Onset,
Diabetes. Elevation of the blood sugar leads to damage to tissues
throughout the body: Diabetes is the leading cause of adult-onset
blindness, a major cause of kidney failure, and the cause of more
than one half of all amputations. It is the third leading cause of
death in the United States.
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Sleep Apnea Syndrome
Sleep apnea – the stoppage of breathing during sleep –
is commonly caused in the obese by compression of the neck, causing
loud snoring interspersed with periods of complete obstruction during
which no air gets in at all. The sleeping person sounds to an observer
like he is holding his breath, but he is, himself, usually unaware
that the problem is occurring at all, or only notices that he sleeps
poorly, and awakens repeatedly during the night. The health effects
of this condition may be severe – high blood pressure, cardiac
rhythm disturbances, and sudden death. Affected persons awaken exhausted
and often fall asleep during the day, sometimes even at the wheel
of their car. This condition has a high mortality rate, and is a life-threatening
problem.
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Obesity Hypoventilation Syndrome
This condition occurs primarily in the very severely obese –
over 350 pounds. It is characterized by episodes of drowsiness, or
narcosis, occurring during awake hours and is caused by abnormalities
of breathing and accumulation of toxic levels of carbon dioxide in
the blood. It is often associated with sleep apnea and may be difficult
to distinguish from it.
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Respiratory Insufficiency
Obese people find that exercise causes them to be out of breath very
quickly. The lungs are decreased in size, and the chest wall is very
heavy and difficult to lift. At the same time, the demand for oxygen
is greater with any physical activity. This condition prevents normal
physical activities and exercise, often interferes with usual daily
activities like shopping, yard-work or stair climbing, and can be
completely disabling.
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Heartburn – Reflux Disease &
Reflux Nocturnal Aspiration
Acid belongs in the stomach, and seldom causes any problem when it
stays there. When it escapes into the esophagus through a weak or
overloaded valve at the top of the stomach, the result is called "heartburn,"
or "acid indigestion." The real problem is not with digestion,
but with the burning of the esophagus by the powerful stomach acid.
When one belches, the acid may bubble up into the back of the throat
causing a fiery feeling there as well. Often this occurs at night,
especially after a large or late meal, and if one is asleep when the
acid regurgitates it may actually be inhaled, causing a searing of
the airway and violent coughing and gasping.
This condition is dangerous because of the possibility of pneumonia
or lung injury. The esophagus may become scarred and constricted,
causing trouble with swallowing. Approximately 10 - 15% of patients
with even mild sporadic symptoms of heartburn will develop a condition
called Barrett's esophagus, which is a pre-malignant change in the
lining membrane of the esophagus, a cause of esophageal cancer.
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Asthma and Bronchitis
Obesity does not directly cause asthma or bronchitis. However, it
does interfere with breathing, aggravating any attack of asthma. Gastroesophageal
reflux caused by obesity may seriously aggravate asthma and may cause
severe bronchitis.
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Gallbladder Disease
Gallbladder disease occurs several times as frequently in the obese,
in part due to repeated efforts at dieting which predispose to this
problem. When stones form in the gallbladder, and cause abdominal
pain or jaundice the gallbladder must be removed.
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Stress Urinary Incontinence
A large heavy abdomen and relaxation of the pelvic muscles, especially
associated with the effects of childbirth, may cause the valve on
the urinary bladder to be weakened which can lead to leakage of urine
with coughing, sneezing, or laughing. This condition is strongly associated
with being overweight and is usually relieved by weight loss.
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Degenerative Disease of Lumbo-Sacral
Spine
The entire weight of the upper body falls on the base of the spine,
and overweight causes it to wear out or to fail. The consequence may
be accelerated arthritis of the spine or "slipped disk,"
when the cartilage between the vertebrae squeezes out. Either of these
conditions can cause irritation or compression of the nerve roots
and lead to sciatica – a dull, intense pain down the outside
of the leg.
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Degenerative Arthritis of Weight-Bearing Joints
The hips, knees, ankles and feet have to bear most of the weight of
the body. These joints tend to wear out more quickly or develop degenerative
arthritis much earlier and more frequently than in the normal-weighted
person. Eventually, joint replacement surgery may be needed to relieve
the severe pain. Unfortunately, the obese person faces a disadvantage
there too – joint replacement has much poorer results in the
obese. Many orthopedic surgeons refuse to perform the surgery in severely
overweight patients.
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Venous Stasis Disease
The veins of the lower legs carry blood back to the heart, and they
are equipped with an elaborate system of delicate one-way valves,
to allow them to carry blood "uphill." The pressure of a
large abdomen may increase the load on these valves, eventually causing
damage or destruction. The blood pressure in the lower legs then increases,
causing swelling, thickening of the skin, and sometimes ulceration
of the skin.
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Emotional/Psychological Disease
Seriously overweight persons face constant challenges to their emotions:
repeated failure with dieting, disapproval from family and friends,
sneers and remarks from strangers. They often experience discrimination
at work and cannot enjoy theater seats or a ride on an airplane. It's
no wonder that anxiety and depression might accompany years of suffering
from the effects of a genetic condition – one which many people
believe should be controlled easily by will power.
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Social Effects
Seriously obese people can't qualify for many types of employment
and suffer from discrimination in employment opportunities as well.
They tend to have higher rates of unemployment and a lower socioeconomic
status. Ignorant people often make rude and disparaging comments and
there is a general societal belief that obesity is a consequence of
moral weakness or a lack of self-discipline. Many severely obese persons
find it preferable to avoid social interactions or public places,
choosing to limit their own freedom rather than suffer embarrassment.
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