Secondary diseases and complications
Nowadays the disease criterion for adiposity is well known and unchallenged. With an increasing degree of morbid obesity (morbid adiposity BMI 40) up to super-obesity (BMI> 50kg/m2) the rate of secondary, concomitant or co-morbidities rises.
Commonly known, for example, is the coincidence of adiposity with heart- and circulatory diseases (high blood pressure, coronary vessel diseases, common weakness of the heart), diabetes mellitus (glucose intolerance), and disorder of the lipid metabolism (dislipidaemia, hypertriglyceridaemia, hypercholesteraemia). Other frequent comorbidities include reduced lung-functions with respiratory distress (dyspnoea at the smallest effort), lung diseases, sleep apnoea syndrome (snoring and temporarily halted breathing), Pickwick-Syndrome (breathing stops, prolonged night-sleep, increased daytime sleep, polycytaemia, pulmonary hypertonia, right ventricular load), metabolic syndrome with insulin resistance, uricaemia, bile stone diseases, skeletal diseases caused by abrasion and overloading (intervertebral disc prolapses, arthrosis, tendonitis), varicosis (stretching of the superficial veins by permeable venous valves, hernias (breaking of the abdominal wall), gastroesophageal reflux disease (acid reflux with oesophagus changes), axial hiatus hernia (diaphragmatic hernia in the area of the transition from oesophagus to the stomach caused by a part of the stomach slipping through the diaphragmatic gap), thromboembolic events (vein thrombosis in the "deep" system, pulmonary embolism), pregnancy complications (gestosis), infertility, and not least malignant emphyma (gynaecological tumors (carcinoma of endometrium, cervix, ovary, mamma), prostate carcinoma, tumors of the gastro-intestinal tract (carcinoma of colon, rectum, gallbladder, pancreas, as well as hepatocellular carcinoma), renal cell carcinoma).
The risk of developing secondary diseases is higher in the truncal obesity type than in the gynoide form of adiposity (see also Tab. 2 and 3).
Aside from physical limitations with increased morbidity, morbid adiposity also causes a increased mortality. The relative mortality risk in males is doubled compared to normal weight people in the age group 25 – 34 years, and six times as high in the 35 – 44 year olds (Drenick, 1980). Finally, there is also a severe impairment in the psycho-sociological environment (see also Behavior and Psyche).
Complications
It is not until a patient suffers severe damage resulting directly or indirectly from adiposity – e.g. sudden cardiac death or massive impairment of physical or mental capabilities, which may cause invalidity – that the term"complication" is used. For example, the artereosclerosis caused by adiposity in itself is not considered a complication, though it increases the risk many times over. Obese smokers suffer from heart attacks 3-4 times more often than smokers of normal weight.
The risk of complications during surgeries like pulmonary embolism and pneumonia increases proportionally to a person’s excess weight.