Synonyms for morbid abound: bleak, grim, cheerless, dismal, foreboding, joyless, morose, ominous, and hopeless. No wonder people are offended to be diagnosed with a condition suggesting such grisly unwholesomeness.
Medically speaking, however, the word 'morbid' denotes a condition that has progressed to the level of unhealthiness or disease. Morbid obesity is defined as being 100 pounds over ideal body weight, or at least 200% of ideal body weight.
Just as alcoholism leads to liver damage and family disruption, morbid obesity is associated with predictable patterns of disease. While it's true, not every person who fits the definition will suffer from any of these, the following problems are common enough to be classified as dangers of morbid obesity:
1. Diabetes Type 2 . Obesity is associated with insulin resistance, a condition which may require greater insulin output than the pancreas can supply. When glucose levels outstrip insulin production, diabetes results, a risk factor for heart disease and a multitude of chronic problems.
2. High blood pressure . Just as weight loss can lower blood pressure, weight gain will increase both systolic and diastolic levels. Fairly often diabetes and hypertension are found in the same individual, thus multiplying the risk for cardiovascular problems, including heart attack and stroke.
3. High cholesterol . Both high food intake and high body weight contribute to elevated cholesterol levels, a third factor for cardiovascular disease.
4. Sleep apnea and breathing difficulties . When fat accumulates in the upper body, it may contribute to airway obstruction, especially during sleep, producing periods of decreased oxygenation and frequent awakening. This leads to daytime sleepiness and the feeling of never being refreshed. Additionally, breathing becomes more of an effort as the body must lift additional tissue to allow the lungs to expand. As exercise becomes more difficult, a person often becomes less active, leading to deconditioning and further difficulty breathing.
5. Degenerative joint and disc disease . The body is a machine, created with certain tolerances. Our knees, hips, and back were not designed to carry an extra hundred pounds all day long, year after year. Just like shocks on an overloaded truck, the weight-bearing joints give out with time, leading to pain and impaired movement.
6. Heart disease . The heart was designed with the ability to pump blood effectively, but only within a certain capacity. As the body expands, the heart must work harder. Eventually it can't keep up and congestive heart failure occurs. Additionally, obesity is a risk factor for accumulation of cholesterol within the coronary arteries, which may lead to angina or myocardial infarction (heart pain or heart attack).
7. Fatigue . Lugging around a spare tire day after day would make anyone tired. Carrying around a whole set seems impossible, yet many people carry this much weight and more every moment of their lives. It's no surprise that transporting the equivalent of a dozen bowling balls makes a person fatigued.
8. Venous stasis edema . Excess fat sometimes chokes off the circulation returning from the lower body. Just as sitting on a garden hose would limit water flow through the hose, compression of the large pelvic and abdominal veins by a large abdomen decreases flow through these blood vessels. It's easy enough for arterial blood to reach the feet – it's downhill all the way. But the return blood flow is uphill through the venous circulation. When venous circulation is compromised, swelling of the legs results. When this continues year after year, it causes chronic scarring and darkening of the stretched skin.
9. Blood clots . Obesity is associated with increased inflammation, which tends to make the blood stickier, thus clotting more easily. Sticky blood, in association with inactivity and slower venous blood flow, increases the risk for blood clots. Most commonly, these begin in the legs, then sometimes move to the heart or lungs where they can, indeed, be fatal.
Although the above list does appear bleak, grim, cheerless, dismal, foreboding, joyless, and ominous, it is far from hopeless. Weight loss can improve or reverse every one of these conditions. Start today and make a difference.
Copyright © 2010 Cynthia J. Koelker, MD
Morbid obesity. The very name suggests a sinister affliction.