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Obesity is common in populations that are overnourished and can become a significant public health problem. Obesity predisposes to non-insulin dependent diabetes mellitus, hypertension, dyslipidemia, cholelithiasis, some malignancies and osteoarthritis. These consequences that most directly affect the cardiovascular system are dyslipidemia and hypertension. Nations in which obesity is rare should learn from the experience of the countries where it is prevalent, that prevention of obesity is a public health measure rather than weight reduction.
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PMID:Cardiovascular consequences of obesity. 149 63

Weight loss reduces many of the health hazards associated with obesity including insulin resistance, diabetes mellitus, hypertension, dyslipidemia, sleep apnea, hypoxemia and hypercarbia, and osteoarthritis. Potential adverse effects of weight loss include a greater risk for gallstone formation and cholecystitis, excessive loss of lean body mass, water and electrolyte problems, mild liver dysfunction, and elevated uric acid levels. Less consequential problems such as diarrhea, constipation, hair loss, and cold intolerance may also occur. The short-term adverse effects are not severe enough to contraindicate weight loss, nor do they outweigh its short-term benefits.
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PMID:Short-term medical benefits and adverse effects of weight loss. 836 5

Obesity leads to and exacerbates many serious disorders, including hypertension, dyslipidemia, cardiovascular disease, non-insulin-dependent diabetes mellitus, gallbladder disease, respiratory dysfunction, gout, and osteoarthritis. Many short-term studies have shown that weight loss can ameliorate or, in some cases, reverse such disorders. Fewer long-term studies-defined as those whose combined acute intervention and follow-up phases extend for at least 1 year-of the therapeutic benefits of weight loss on specific disorders have been undertaken. Those long-term studies that have been performed tend to confirm the results of briefer studies. Even when weight loss has been comparatively modest or some degree of weight regain has occurred, weight loss is generally associated with a decrease in risk factors and the alleviation of clinical symptoms.
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PMID:A review of long-term studies evaluating the efficacy of weight loss in ameliorating disorders associated with obesity. 900 21

An estimated 97 million adults in the United States are overweight or obese, a condition that substantially raises their risk of morbidity from hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, and endometrial, breast, prostate, and colon cancers. Higher body weights are also associated with increases in all-cause mortality. Obese individuals may also suffer from social stigmatization and discrimination. As a major contributor to preventive death in the United States today, overweight and obesity pose a major public health challenge.
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PMID:Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. 975 81

Obese patients are at an increased risk for developing many medical problems, including insulin resistance and type 2 diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease, stroke, sleep apnea, gallbladder disease, hyperuricemia and gout, and osteoarthritis. Certain cancers are also associated with obesity, including colorectal and prostate cancer in men and endometrial, breast, and gallbladder cancer in women (1-6). Excess body weight is also associated with substantial increases in mortality from all causes, in particular, cardiovascular disease. More than 5% of the national health expenditure in the United States is directed at medical costs associated with obesity (7). In addition, certain psychologic problems, including binge-eating disorder and depression, are more common among obese persons than they are in the general population (8.9). Finally, obese individuals may suffer from social stigmatization and discrimination, and severely obese people may experience greater risk of impaired psychosocial and physical functioning, causing a negative impact on their quality of life (10).
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PMID:Obesity and its comorbid conditions. 1069 82

Obesity increases the risk of metabolic complications such as diabetes, dyslipidemia, systemic hypertension and cardiovascular disease. These are mainly responsible for the increased mortality of obese people. Other metabolic consequences of obesity are: gallstones, steatosis of the liver and the polycystic ovary syndrome. Beside the body mass index the distribution of body fat is important. Centralized obesity, as measured by the waist-to-hip circumference ratio (WHR), is associated with increased mortality and morbidity. Insulin resistance and hyperinsulinaemia seem to play a central role in the pathogenesis of this association. Obesity has not only metabolic complications. There is a relationship between obesity and impaired respiratory function. Furthermore is obesity a risk factor for osteoarthrosis of the knee, the hip and even the hand and for pulmonary embolism and venous thrombosis. Obesity can also lead to psycho-social problems such as depression, social discrimination and isolation.
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PMID:[Consequences and complications of obesity]. 1102 85

The national health objectives for 2010 rank obesity among the top ten leading health indicators. Obesity increases the risk for type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, respiratory problems, certain cancers, gallstones, osteoarthritis, and lowered life expectancy. The estimated annual cost attributable to obesity-related diseases is approximately $100 billion. Obesity among adults in the general U. S. population increased from 12.0% in 1991 to 17.9% in 1998. Little is known about the national or state prevalence of obesity among persons with disabilities. Obesity is not measured routinely or reported among persons with disabilities. To determine the prevalence of obesity among persons with and without disabilities, CDC analyzed data from the 1998 and 1999 Behavioral Risk Factor Surveillance System (BRFSS) for eight states and the District of Columbia (DC). The findings indicate that obesity rates are significantly higher among persons with disabilities, especially among blacks and persons aged 45-64 years. The findings suggest that public health messages and interventions should be targeted to persons with disabilities who are likely to become obese and to obese persons who are likely to become disabled.
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PMID:State-specific prevalence of obesity among adults with disabilities--eight states and the District of Columbia, 1998-1999. 1226 68

The prevalence of obesity is increasing worldwide. In the United States, in 1999, 27% of adults had a body mass index >30 kg/m(2), almost double the prevalence of 20 years earlier. The estimated mortality from obesity-related diseases in the United States is approximately 300,000 annually and growing. In the future, mortality related to obesity is expected to exceed that of smoking. Numerous diseases are caused or made worse by obesity. These include type 2 diabetes; hypertension; dyslipidemia; ischemic heart disease; stroke; obstructive sleep apnea; asthma; nonalcoholic steatohepatitis; gastroesophageal reflux disease; degenerative joint disease of the back, hips, knees, and feet; infertility and polycystic ovary syndrome; various malignancies; and depression. Type 2 diabetes is perhaps the most visible obesity-related problem. Present in at least 14 million Americans, it leads to serious complications and premature death. It is largely caused by obesity, and is generally cured by weight loss. The quality of life of the obese is markedly reduced, and the costs to health care systems are great. Preventive programs have yet to affect the rising prevalence. An effective solution is needed.
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PMID:The extent of the problem of obesity. 1252 43

Every month new clinical trials are published that provide relevant insight into medical care. Health care professionals are expected to review the results of these trials to update their knowledge and clinical practice. Although it is impossible to review every clinical trial, it is important to evaluate study findings in one's area of interest or practice. For nurses and other practitioners in the field of geriatrics, clinical trials involving drug therapy can be particularly valuable. This article is a review of clinical trials published in the past year that provide new information about drug therapy used by elderly patients. It reviews recent clinical trials in the areas of cardiology (hypertension, dyslipidemia, antioxidants for cardiovascular disease, hormone replacement therapy, atrial fibrillation, systolic heart failure), hematology (venous thromboembolic disease), neurology (Parkinson's disease, post-herpetic neuralgia), and rheumatology (osteoarthritis). Major findings and implications for geriatric clinical practice are included.
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PMID:What's new about old drugs. 1475 53

Obesity is the most common nutritional disorder in the Western world. Actually, 250 million adults are obese, and 500 million adults and 22 million children under 5 years of age are overweight. Obesity is a complex trait, depending upon interactions between multiple genes and the environment, but its recent rise and "epidemic proportions" are, above all, the consequences of dramatic changes in lifestyle, socioeconomic progress, and political and cultural trends. Eating behavior has strong extraphysiological determinants, being influenced by neuroendocrine, nutritional, environmental, and cognitive stimuli, able to modify the body weight set-point. Health care professionals should be concerned about obesity, because of the well-established relations between excess body weight and pathologies such as type II diabetes, hypertension, atherosclerosis, osteoarthritis, dyslipidemia, and cancer, which afflict more and more people in the Western world--sort of "well-being syndromes." An overview of modern Western diets--the American, Mediterranean, Atkins, and Zone diets--reveals the contradictions existing about the correct and healthy approach to human nutrition and suggests a "return to Nature." From the actual artificial nutrition systems, based on cereals, milk, and their products, irrespective of our genome and metabolic attitudes, a simple diet based on natural food can be an ally in health maintenance and restoration.
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PMID:A natural diet versus modern Western diets? A new approach to prevent "well-being syndromes". 1571 28


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