VIDEO: Mental health, other complications associated with obesity

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So the most common complications of obesity that we treat routinely in our patients, you wanna start from the top and work our way down the body, I mean, 'cause there are over 200 complications that are associated with obesity, but I'll hit a few.

So at the top, thinking about mental health, we see that there's a common association of increased depression, anxiety, those types of symptoms with obesity, and there's questions around, like, chicken or the egg and that relationship because we know that, in our society, people with obesity face stigma and bias and that that has a negative impact on mental health and wellbeing, and so we can see sort of a negative cycle happening where people who are dealing with obesity experience bias and stigma, and then, they internalize that and they think more poorly of themselves and that leads to increase depressive symptoms or anxiety as people are engaging in public, so there's definitely a relationship there.

If we go down a little bit further, we look at obstructive sleep apnea, so this is a result of excess weight, often in the head and neck area as well as in the chest area, and so you can have an impact on airflow, especially when people relax and they lay down, you get a collapsing of the airways that makes it difficult to breath when people are trying to sleep, and that leads to reduction in oxygen levels at night when people are sleeping, so that's an really important issue. Certainly heart disease, we know that, you know, increased risk of coronary artery disease and stroke, other vascular disease, we see that association with obesity.

Fatty liver disease, we call it metabolically associated, liver disease, and this fatty liver disease is really just a manifestation of when we have excess fat in the body, the preferable place to put it is under the skin, but sometimes we put it around the organs, especially when those fat stores under the skin actually are full, and so we call this ectopic fat deposition going into the organs and so being in the liver is a bad thing and increases the size of the liver if untreated or in lots of... In some percentage of cases, it progresses all the way even to cirrhosis of the liver, so we know that that's a real, you know, challenge.

Type 2 diabetes is another significant complication of obesity, and we see that the rise in type 2 diabetes in the U.S. and elsewhere parallels the rise in the prevalence of obesity, and so we know that type 2 diabetes is really a, you know, manifestation of untreated obesity where we continue to see excess energy balance, and then, you get insulin resistance, and, ultimately, you can end up with a situation where your body just can't keep up with glucose loads and you start to get hyperglycemia and into frank type 2 diabetes.

Further on, we see a number of other risk factors or issues, complications from obesity, including polycystic ovarian syndrome. We see issues around knee and hip osteoarthritis, lower back osteoarthritis. Those are not only mechanical but also inflammatory-related complications of obesity. You have a number of issues there that I've highlighted and, you know, it's also important to think about cancer risk as a complication of obesity, so cancer of multiple sites for both men and women seeing increased risk associated with obesity, so obesity is one of those disease states that affects individuals from head to toe, in and out, and can have a negative impact on a lot of areas in terms of quality of life.