27 November 2019
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Complications of Obesity
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Obesity is a chronic, progressive pathology with a poor prognosis of weight loss, which has no cure, requires specific treatment for weight loss and continuous follow-up to avoid weight regain. The early onset of obesity (childhood and youth) is a poor prognostic factor since obesity tends to be more severe, more resistant to treatment, and is more frequently associated with emotional disorders than adult-onset obesity.
In adulthood obesity is associated with decreased life expectancy and increased early mortality.
Chronic complications
Obesity is not only important because of its high prevalence, but also because it is a multisystem disease. In general, obesity is associated with increased overall and cardiovascular mortality.
At endocrine level, the most common diseases associated with obesity are intolerance to carbohydrates and type 2 diabetes. It also forms part of the polycystic ovary syndrome, is associated with infertility, and with complications during pregnancy and childbirth.
At circulatory system level, obesity is associated with arterial hypertension, dyslipidaemia, ischaemic heart disease, heart failure, and venous insufficiency.
At gastrointestinal level, it is associated with gastroesophageal reflux disease and cholelithiasis (gallstones).
At neurological level, with cerebrovascular accidents, dementia, and endocranial hypertension.
At dermatological level, it is associated with acanthosis nigricans (skin becomes thick or dark), intertrigo (skin folds disease due to friction or friction), cellulitis and hirsutism.
At respiratory level, with sleep apnoea syndrome and with respiratory problems during the induction of anaesthesia.
At a urological and nephrological level, it is associated with urinary incontinence, chronic renal failure, hypogonadism, and erectile dysfunction.
At osteoarticular level, it is associated with back pain, joint pain, and gout.
With various types of cancer: breast cancer, endometrial cancer, ovarian cancer, kidney cancer, pancreas cancer, oesophagus cancer and colorectal cancer.
At psychiatric level, it is associated with depressive disorder, anxiety disorder and eating behavior disorders.
It affects the quality of life, it can cause problems of self-esteem and social stigmatization.
Complications of surgical treatment of Obesity
Bariatric surgery, on being major gastrointestinal surgery, entails the possibility of complications and secondary effects. The complications due to the surgery or surgical comorbidity are around 10%.
Among the early and serious complications are rupture of the stapled line, suture dehiscence, ulcers, bleeding, stenosis of the gastric stoma, and pulmonary thromboembolism.
The long-term complications included nutritional deficiencies, among the most common are, iron deficiency (anaemia), vitamin B12 (pernicious anaemia), calcium, vitamin D (osteoporosis), and proteins, which require oral supplements, or intravenous ones if the oral route fails. Other less frequent complications are diarrhoea, protein-calorie malnutrition, low blood glucose, gallstones, and gastroesophageal reflux disease.
General symptoms are also very common, like the feeling of cold caused by the lower amount of fat covering the body surface. Weakness or tiredness is associated with loss of muscle mass and nutritional deficiencies, as well as hair loss associated with a deficiency of proteins and vitamins.
Finally, the excess of skin and cutaneous flaccidity that appear after the weight loss occasionally requires to be corrected with plastic surgery.
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Substantiated information by:
Alba Andreu Martí
Nutritionist
Endocrinology and Dietetics Department
Lilliam Flores Meneses
Endocrinologist
Endocrinology Department
Silvia Cañizares Alejos
Psychologist
Psychiatry and Psychology Department
Published: 17 August 2018
Updated: 20 January 2022
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