Skip to main content
×
Home
    • Aa
    • Aa

Pathophysiology of obesity

  • M. E. J. Lean (a1)
Abstract

The rapidly rising prevalence of obesity, worldwide, has prompted re-evaluations of the definitions and diagnostic criteria, and of the extent of the burden it contributes to health care services. Although categorized arbitrarily for epidemiological purposes according to BMI > 25 kg/m2 (‘overweight’) and BMI > 30 kg/m2 (‘obese’), the disease itself (ICD code E.66) is the process of excess fat accumulation. It leads to multiple organ-specific pathological consequences, particularly if there is a tendency to intra-abdominal fat accumulation. The simplest field method to identify obesity and risk of medical problems is the waist circumference, and this method has found a special role in health promotion. Risks begin with waist > 80 cm (women) or > 94 cm (men). As a broad generalization, obesity produces few symptoms below the age of 40 years, but then several symptoms often develop; tiredness, breathlessness, back pain, arthritis, sweatiness, poor sleeping, depression and menstrual disorders all being common. The symptoms are often attributed to diseases in other body systems. Metabolic diseases like diabetes, hyperlipidaemia and, hypertension develop later, but the mean BMI at diagnosis of diabetes is 28 kg/m2. Ultimately, obesity increases the likelihood of myocardial infarction, stroke and several major cancers, but its biggest impact on health, especially in the elderly, is probably the multiplicity of effects on other body systems. The greatest challenge for public health is to develop effective preventive measures, recognizing that BMI > 25 kg/m2 before the age of 20 years is a very strong predictor of obesity and ill health in adulthood.

    • Send article to Kindle

      To send this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Pathophysiology of obesity
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Pathophysiology of obesity
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Pathophysiology of obesity
      Available formats
      ×
Copyright
Corresponding author
Corresponding author: Professor M. E. J. Lean, fax + 44 (0)141 211 4844, email mej.lean@clinmed.gla.ac.uk
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

B Bahadori , E Neuer , M Schumacher , F Fruhwald , B Eber , W Klein , H Toplak & TC Wascher (1996) Prevalence of coronary-artery disease in obese versus lean men with angina-pectoris and positive exercise stress test. American Journal of Cardiology 77, 10001001.

JP Bastard & L Pieroni (1999) Plasma plasminogen activator inhibitor 1, insulin resistance and android obesity. Biomedicine and Pharmacotherapy 53, 455461.

GA Colditz , WC Willett , A Rotnitzky & JE Manson (1995) Weight gain as a risk factor for clinical diabetes mellitus in women. Annals of Internal Medicine 122, 481486.

MA Denke , CT Sempos & SM Grundy (1993) Excess body weight. An under recognised contributor to high blood cholesterol levels in white American men. Archives of Internal Medicine 153, 10931103.

MA Denke , CT Sempos & SM Grundy (1994) Excess body weight. An under recognised contributor to dyslipidaemia in white American women. Archives of Internal Medicine 154, 401410.

AR Dyer , P Elliott , M Shipley , R Stamler & J Stamler (1994) Body mass index and associations of sodium and potassium with blood pressure in INTERSALT. Hypertension 23, 729736.

SZ Goldhaber , DD Savage , RJ Garrison , WP Castelli , WB Kannel , PM McNamara , C Gherardi & M Feinleib (1983) Risk factors for pulmonary embolism. The Framingham Study. American Journal of Medicine 74, 10231028.

TS Han , EJM Feskens , MEJ Lean & JC Seidell (1998) Associations of body composition with non-insulin dependent diabetes mellitus. Diabetic Medicine 15, 129135.

CR Hankey , A Rumley , GDO Lowe , M Woodward & MEJ Lean (1997) Moderate weight reduction improves red cell aggregation and factor VII activity in overweight subjects. International Journal of Obesity 21, 644650.

MEJ Lean , TS Han & JC Seidell (1998) Impairment of health and quality of life in people with large waist circumference. Lancet 351, 853856.

MEJ Lean , TS Han & JC Seidell (1999) Impairment of health and quality of life using new US Federal guidelines for the identification of obesity. Archives of Internal Medicine 159, 837843.

MEJ Lean , JK Powrie , AS Anderson & PH Garthwaite (1990) Obesity, weight loss and prognosis in type 2 diabetes. Diabetic Medicine 7, 228233.

JE Manson , GA Colditz , J Meir , MJ Stampfer , WC Willett , B Rosner , RC Monson , FE Speizer & CH Hennekens (1990) A prospective study of obesity and risk of coronary heart disease in women. New England Journal of Medicine 322, 882889.

JE Manson , WC Willett , MJ Stampfer , GA Colditz , DJ Hunter , SE Hankinson , CH Hennekens & FE Speizer (1995) Body weight and mortality among women. New England Journal of Medicine 333, 677685.

N Sattar , A Gaw , CJ Packard & IA Greer (1996) Potential pathogenic roles of aberrant lipoprotein and fatty acid metabolism in pre-eclampsia. British Journal of Obstetrics and Gynaecology 103, 614620.

CD Sjostrom , L Lissner , H Wedel & L Sjostrom (1999) Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study. Obesity Research 7, 477484.

DF Williamson , E Pamuk , M Thun , D Flanders , T Byers & C Heath (1999) Prospective study of intentional weight loss and mortality in overweight white men aged 40–64 years. American Journal of Epidemiology 149, 491503.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Proceedings of the Nutrition Society
  • ISSN: 0029-6651
  • EISSN: 1475-2719
  • URL: /core/journals/proceedings-of-the-nutrition-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: