Co-Morbid Diseases


What is a Co-Morbid Disease?
A co-morbid disease, or co-morbidity, is the presence of one or more disorder(s) or disease(s) in additional to a primary disease. When related to issues of weight, a co-morbid disease is any that is directly related to the condition of obesity. As mentioned in the Medical Candidacy and Insurance Candidacy sections of our website, the presence of one or more co-morbid disease(s) may qualify you for obesity surgery if your Body Mass Index (BMI) is between 35 and 39.9.

The significance of co-morbid disease(s) in obese or morbidly obese individuals is not exclusive to their potential ability to qualify for surgery; co-morbidities present significant additional health risks for those who are obese, morbidly obese, or even over weight. Weigh-related illness can significantly impact an individual’s quality of life and life expectancy; therefore, controlling obesity becomes even more critical.

Is Obesity Really a Disease?
Some may question the reference to obesity as a “disease”. Often, we think of a disease as an illness or affliction that is caused by a virus or bacteria that invades our bodies and disrupts our natural functions. Surely obesity, which is not caused by the introduction of an external organism into out bodies, cannot be classified as a “disease”. A disease is any disturbance or anomaly in the normal functioning of the body that probably has a specific cause and identifiable symptoms. Diseases are one of the factors threatening us from having a properly functional life. Today, more and more medical professionals recognize obesity as a chronic disorder that inflicts the same consequences on the human body as any disease caused by a microorganism. Consequently, in 2004, the American Academy of Family Physicians adopted a policy declaring obesity a ‘disease. Importantly, on a global scale, the World Health Organization has done likewise.

Health Risks Associated with Obesity
Not all obese individuals suffer from related medical issues; however, statistically, being overweight dramatically affects your likelihood of developing one or more additional health problems. This likelihood increases directly with an increase in BMI. For instance, individuals who are obese are:

  • 6 times more likely to develop gallbladder disease
  • 5.6 times more likely to develop high blood pressure
  • 3.8 times more likely to develop diabetes
  • Twice as likely to develop arthritis
  • More likely to develop some cancers, including prostate, and breast
  • More likely to have a stroke
  • More likely to suffer back problems
  • More likely to be infertile
  • More likely to suffer depression
  • More likely to snore and suffer sleep disorders

Life Expectancy
In addition, one’s life expectancy is found to be inversely related to BMI. In other words, the higher your BMI, the shorter your life expectancy. According to a team of scientists supported in part by the National Institute on Aging (NIA), a component of the National Institutes of Health (NIH) of the Department of Health and Human Services (DHHS), over the next few decades, life expectancy for the average American could decline by as much as 5 years unless aggressive efforts are made to slow rising rates of obesity. The U.S. could be facing its first sustained drop in life expectancy in the modern era.

According to a New England Journal of Medicine report, studies suggest that two-thirds of American adults are overweight (having a Body Mass Index (BMI) of 25 or more) or obese (having a BMI of 30 or more). Studies suggest that the prevalence of obesity in U.S. adults has increased about 50 percent per decade since 1980. Additional research has shown that people who are severely obese (with a BMI greater than 45) live up to 20 years less than people who are not overweight. A 6-year National Health and Nutrition Examination Survey (NHANES) indicated that someone who is 40% overweight is twice as likely to die prematurely than an individual of healthy weight. Some researchers have estimated that obesity causes about 300,000 deaths in the U.S. annually. In addition, obesity is fueling an epidemic of type 2 diabetes, which also reduces lifespan.

Reversible Effects
It is critical to realize; however, that just as health risks rise with an increase in BMI, the risks and presence of many of these same diseases decrease along with a decrease in BMI. Consequently, it is well worth the effort to control your weight and to explore your options, including that of obesity surgery, when looking for way to increase longevity and quality of life.

According to the American Obesity Association, there are over 30 medical conditions that are related to obesity.

Co-Morbid Diseases and/or Diseases/Disorders Related to Obesity

  • Insulin Resistance– Insulin is necessary for the transport of blood glucose (sugar) into the cells of muscle and fat (which is then used for energy). By transporting glucose into cells, insulin keeps the blood glucose levels in the normal range. Insulin resistance (IR) is the condition whereby the effectiveness of insulin in transporting glucose (sugar) into cells is diminished. Fat cells are more insulin resistant than muscle cells; therefore, one important cause of IR is obesity. The pancreas initially responds to IR by producing more insulin. As long as the pancreas can produce enough insulin to overcome this resistance, blood glucose levels remain normal. This IR state (characterized by normal blood glucose levels and high insulin levels) can last years. Once the pancreas can no longer keep up with producing high levels of insulin, blood glucose levels begin to rise, resulting in type 2 diabetes, thus IR is a pre-diabetes condition. In fact scientists now believe that the atherosclerosis (hardening of the arteries) associated with diabetes likely develops during this IR period.
  • Type 2 Diabetes– The risk of type 2 diabetes increases with the degree and duration of obesity. Type 2 diabetes is associated with central obesity; a person with central obesity has excess fat around his/her waist, so that the body is shaped like an apple. Type 2 diabetes reduces your body’s ability to control blood sugar. It is a major cause of early death, heart disease, stroke, and blindness. Overweight people are twice as likely to develop type 2 diabetes compared to normal weight people. You can reduce your risk of developing type 2 diabetes by losing weight and exercising more. If you have type 2 diabetes, losing weight and becoming more physically active can help control your blood sugar levels. Increasing your physical activity may also allow you to reduce the amount of diabetes medication you need.
  • Heart disease and Stroke– The Nurses Health Study found that the risk of developing coronary artery disease increased 3 to 4 times in women who had a BMI greater than 29. A Finnish study showed that for every one kilogram (2.2 pounds) increase in body weight, the risk of death from coronary artery disease increased by one percent. In patients who have already had a heart attack, obesity is associated with an increased likelihood of a second heart attack. Heart disease and stroke are the leading causes of death and disability for people in the U.S. Overweight people are more likely to have high blood pressure, a major risk factor for heart disease and stroke, than people who are not overweight. Very high blood levels of cholesterol can also lead to heart disease and often are linked to being overweight. Being overweight also contributes to angina (chest pain caused by decreased oxygen to the heart) and sudden death from heart disease or stroke without any signs or symptoms.
  • Cancer– Several types of cancer are associated with being overweight. In women, these include cancer of the uterus, gallbladder, cervix, ovary, breast, and colon. Overweight men are at higher risk for developing colorectal cancer and prostate cancer. For some types of cancer, such as colon or breast, it is not clear whether the increased risk is due to the extra weight or to a high-fat, high-calorie diet. While not conclusively proven, some observational studies have linked obesity to cancer of the colon in men and women, cancer of the rectum and prostate in men, and cancer of the gallbladder and uterus in women. Obesity may also be associated with breast cancer, particularly in postmenopausal women. Fat tissue is important in the production of estrogen, and prolonged exposure to high levels of estrogen increases the risk of breast cancer.
  • Gallbladder Disease– Gallbladder disease and gallstones are more common if you are overweight. Your risk of disease increases as your weight increases. It is not clear how being overweight may cause gallbladder disease. Ironically, weight loss itself, particularly rapid weight loss or loss of a large amount of weight, can actually increase your chances of developing gallstones. Modest, slow weight loss of about 1 pound a week is less likely to cause gallstones.
  • Osteoarthritis– Osteoarthritis is a common joint condition that most often affects the joints in your knees, hips, and lower back. Carrying extra pounds increases the risk of osteoarthritis by placing extra pressure on these joints and wearing away the cartilage (tissue that cushions the joints) that normally protects them. Weight loss can decrease stress on the knees, hips, and lower back and may improve the symptoms of osteoarthritis
  • Gout– Gout is a disease that affects the joints that is caused by high levels of a substance called uric acid in the blood. The large amount of uric acid can form into solid or crystal-like masses that deposit in the joints. Gout is more common in overweight people and the risk of developing the disorder increases with higher body weights. Over the short term, certain dietary changes may lead to an attack of gout in people who have high levels of uric acid or who have had gout before. If you have a history of gout, check with your doctor before trying to lose weight.
  • Sleep Apnea– Sleep apnea is a serious breathing condition that is associated with being overweight. Sleep apnea can cause a person to snore heavily and to stop breathing for short periods during sleep. Sleep apnea may cause daytime sleepiness and even heart failure. The risk for sleep apnea increases as body weight increases. Weight loss usually improves sleep apnea.
  • Congestive Heart Failure-In this condition heart is unable to pump sufficient volume of blood to various body organs. Various research studies show that obesity increases the risk of Congestive Heart Failure (CHF).
  • Heart Enlargement– In case of overweight people the heart muscles need to overwork so as to pump blood to all the body parts. This excess work done by heart muscles results in heart enlargement.
  • Polycystic Ovarian Syndrome– Due to abnormal production of follicle stimulating hormone and luteinizing hormone the ovary tends to form many benign cysts. Being overweight can stimulate abnormal secretion of 2 hormones hence leading to polycystic ovarian syndrome.
  • Pulmonary Embolism-Pulmonary embolism can be defined as fatal blockage of arteries. It is observed that many overweight people tend to be inactive hence it results in accumulation of fat in arteries.
  • Gastro– esophageal Reflux or Heartburn- This disease is highly common among overweight people. In this condition the stomach juices and acid reverts back to esophagus causing discomfort and burning sensation.
  • Fatty Liver Disease– This condition can be defined as excess accumulation of fat in liver cells. This condition is irreversible.
  • Erectile Dysfunction– This condition can be defined as regular failure to maintain or achieve erection. Obesity or overweight increases the risk of erectile dysfunction development.
  • Chronic Renal Failure– Obese or overweight persons are at higher risk of chronic renal failure. In chronic renal failure the kidney completely fail to work.
  • Lymph Edema– This disease is caused due to dysfunction or damage of lymphatic nodes. The risk of developing lymph edema is greater in case of obese persons as accumulated fat tends to crush its own lymphatic nodes.
  • Urinary Incontinence– The inability to control urination is called as urinary incontinence. Obese person is at higher risk as they tend to have weak pelvic floor muscles and bladder.
  • Depression– Depression is common problem faced by obese person. In some cases it might even lead to suicide attempts.
  • Cellulitis– This condition is characterized by spreading of infection in subcutaneous and dermis skin tissues. This condition is caused due to improper lymph flow resulted due to obesity.
  • Pickwickian Syndrome– Excess weight adds pressure on the pulmonary system hence leading to pickwickian syndrome characterized by sleep apnea.
  • Hernia– This condition is caused to weak and enlarged diaphragm.