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Harrison's Principles of Internal Medicine, 17e
| Part 5. Oncology and Hematology > |
Pathologic Consequences of Obesity
Sections: Pathologic Consequences of Obesity , Insulin Resistance
and Type 2 Diabetes Mellitus, Reproductive
Disorders, Cardiovascular
Disease, Pulmonary Disease, Gallstones, Cancer, Bone, Joint,
and Cutaneous Disease.
Topics Discussed: acanthosis nigricans; biliary calculi; cancer; cardiovascular disease in women; cardiovascular disorders; congestive heart failure; coronary heart disease; diabetes mellitus; glucose intolerance; high density lipoprotein cholesterol; hyperinsulinism; hypertension; insulin resistance; intracranial hemorrhages; ischemic stroke; lipoproteins, vldl; low density lipoprotein increased; lung diseases; male hypogonadism; menstruation-related disorders; obesity; obesity hypoventilation syndrome; obstructive sleep apnea; oligomenorrhea; osteoarthritis; overweight; polycystic ovary syndrome; sleep apnea syndromes; stroke; triglycerides; venous stasis syndrome; waist-hip ratio.
Excerpt:
"(See also Chap. 75) Obesity has major adverse effects on health. Obesity is associated with an increase in mortality, with a 50–100% increased risk of death from all causes compared to normal-weight individuals, mostly due to cardiovascular causes. Obesity and overweight together are the second leading cause of preventable death in the United States, accounting for 300,000 deaths per year. Mortality rates rise as obesity increases, particularly when obesity is associated with increased intraabdominal fat (see above). Life expectancy of a moderately obese individual could be shortened by 2–5 years, and a 20- to 30-year-old male with a BMI > 45 may lose 13 years of life. It is also apparent that the degree to which obesity affects particular organ systems is influenced by susceptibility genes that vary in the population.Hyperinsulinemia and insulin resistance are pervasive features of obesity, increasing with weight gain and diminishing with weight loss (Chap. 236). Insulin resistance is more strongly linked to intraabdominal fat than to fat in other depots. The molecular link between obesity and insulin resistance in tissues..."
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