The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health 9:88

Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, BC, Canada.
BMC Public Health (Impact Factor: 2.26). 04/2009; 9(1):88. DOI: 10.1186/1471-2458-9-88
Source: PubMed


Overweight and obese persons are at risk of a number of medical conditions which can lead to further morbidity and mortality. The primary objective of this study is to provide an estimate of the incidence of each co-morbidity related to obesity and overweight using a meta-analysis.
A literature search for the twenty co-morbidities identified in a preliminary search was conducted in Medline and Embase (Jan 2007). Studies meeting the inclusion criteria (prospective cohort studies of sufficient size reporting risk estimate based on the incidence of disease) were extracted. Study-specific unadjusted relative risks (RRs) on the log scale comparing overweight with normal and obese with normal were weighted by the inverse of their corresponding variances to obtain a pooled RR with 95% confidence intervals (CI).
A total of 89 relevant studies were identified. The review found evidence for 18 co-morbidities which met the inclusion criteria. The meta-analysis determined statistically significant associations for overweight with the incidence of type II diabetes, all cancers except esophageal (female), pancreatic and prostate cancer, all cardiovascular diseases (except congestive heart failure), asthma, gallbladder disease, osteoarthritis and chronic back pain. We noted the strongest association between overweight defined by body mass index (BMI) and the incidence of type II diabetes in females (RR = 3.92 (95% CI: 3.10-4.97)). Statistically significant associations with obesity were found with the incidence of type II diabetes, all cancers except esophageal and prostate cancer, all cardiovascular diseases, asthma, gallbladder disease, osteoarthritis and chronic back pain. Obesity defined by BMI was also most strongly associated with the incidence of type II diabetes in females (12.41 (9.03-17.06)).
Both overweight and obesity are associated with the incidence of multiple co-morbidities including type II diabetes, cancer and cardiovascular diseases. Maintenance of a healthy weight could be important in the prevention of the large disease burden in the future. Further studies are needed to explore the biological mechanisms that link overweight and obesity with these co-morbidities.

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Available from: Laird Birmingham, Jun 03, 2014
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    • "L'obésité, définie par un Indice de Masse Corporelle (IMC) supérieur ou égal à 30 kg/m², est une pathologie chronique qui constitue une problème majeur de santé publique, tant par sa prévalence que par sa gravité [1]. L'obésité s'accompagne en effet d'un risque accru de mortalité [2], d'un risque accru de comorbidités somatiques et psychiatriques [3] [4], et d'une altération de la qualité de vie physique, psychologique et sociale [5]. Parmi les stratégies de prise en charge de l'obésité, la prise en charge chirurgicale de l'obésité, qui est apparue en France depuis une quinzaine d'années, constitue actuellement une option thérapeutique à part entière, en permettant une amélioration de la mortalité et de la qualité de vie [1] [6], bien qu'il faille rappeler la persistance de certaines difficultés, comme par exemple une plus forte prévalence du risque suicidaire et des troubles anxieux et dépressifs après chirurgie comparativement à la population générale [7] [8]. "
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    ABSTRACT: Bariatric surgery is indicated in obese patients with a BMI ≥ 40kg/m(2) or ≥ 35kg/m(2) with serious comorbidities, in second intention in patients who failed to achieve significant weight loss after a well-managed medical, nutritional and psychotherapeutic treatment for 6 to 12 months, and in patients who are aware of the consequences of bariatric surgery and who agree with a long term medical and surgical follow-up. Such a treatment requires a preoperative multidisciplinary assessment and management, which includes a mandatory consultation with a psychiatrist or a psychologist that should be member of the multidisciplinary staff and participate in these staffs. Although one of this consultation's aim is to screen for the few patients who for which surgery is contra-indicated, in most cases, the main aim of this assessment is to screen for and manage psychiatric and psychopathologic disorders that could be temporary contra-indication, because these disorders could lead to poorer postoperative outcome when untreated. By explaining to the patient how these disorders could affect postoperative outcome and which benefits he could retrieve from their management, the patient will increase his motivation for change and he will be more likely to seek professional help for these disorders. In all cases, a systematic examination of the patient's personality and his/her ability to understand the postoperative instructions is essential before surgery because clinicians should check that the patient is able to be adherent to postoperative instructions. In addition to clinical interview, use of self-administered questionnaires before the consultation might help to determine which psychiatric or psychopathologic factors should be more closely screened during the consultation. Psychiatric disorders and addictions are highly prevalent in this population (e.g., mood and anxiety disorders, binge eating disorder, attention deficit hyperactivity disorder, addictions, personality disorders, pathological personality traits and dimensions), and when untreated, they can lead to poorer postoperative outcome (postoperative occurrence of psychiatric disorders, poorer quality of life, and sometimes to poorer weight loss or excessive weight rebound when the disorder is present during the postoperative period). A complementary training in addiction medicine is helpful given the higher risk for addictions in this population. Given that this evaluation is often the first meeting with a psychiatrist, an empathic and motivational approach is helpful to improve the patient's ability to request for a future psychiatric consultation during the follow-up. Some conditions are required for a high quality assessment: the objectives and expectations of the consultation should be systematically explained to the patient prior to the consultation by the physician who enquires for the assessment; it needs time; the psychiatrist should systematically be member of the multidisciplinary staff and should take part in regular multisciplinary staff meetings; patients should be seen alone to assess his/her readiness to change. After the consultation, a contact with the physician who enquires for the assessment should be systematic (e.g., use of a medical letter that sum up the main conclusions of the consultation; participation in regular multisciplinary staff meetings).
    La Presse Médicale 10/2015; DOI:10.1016/j.lpm.2015.09.013 · 1.08 Impact Factor
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    • "The enormous health and economic tolls of obesity and its profound adverse effects on quality of life underscore the need for both increased prevention and effective treatment [3] [4]. Obesity has been linked to more than 65 comorbidities, including coronary artery disease, type 2 diabetes mellitus, hypertension , hypercholesterolemia, more than a dozen cancers, and a host of other disease processes [5]. Although obesity has a substantial impact on patient care in all disciplines in medicine, physician and medical student education about obesity is limited [6] [7]. "
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    09/2015; 2015(82):841249. DOI:10.1155/2015/841249
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    • "The prevalence of obesity is rising at an alarming rate throughout the world, particularly in developing countries. Obesity is an established risk factor for cardiovascular disease, diabetes mellitus, certain cancers, and osteoarthritis among other conditions [1] [2]. There is also a growing body of epidemiological data linking obesity and asthma [3e5]. "
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