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Complications of obesity
Last reviewed: 06.07.2025
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Excess body weight contributes to a shorter life expectancy, increases the risk of developing cardiovascular diseases, atherosclerosis, and predisposes to the development of diabetes.
Hypertension occurs 4.5 times more often in obese individuals than in the general population. There is an undoubted relationship between the level of arterial pressure and the degree of excess body weight and the nature of the distribution of subcutaneous fat. Most often, hypertension develops with the android type of fat deposition. The pathogenetic mechanisms of hypertension syndrome in obesity are complex and have not been fully elucidated. Disturbances in central regulatory mechanisms, increased peripheral vascular resistance, increased functional activity of the adrenal cortex, hyperinsulinemia, and metabolic shifts are important.
Excess body weight is one of the important risk factors for the development of coronary heart disease. This is facilitated by hyperinsulinemia, dyslipidemia, arterial hypertension, and changes in the coagulating and fibrinolytic properties of blood that accompany insulin resistance.
Obese patients often have pathology of the hepatobiliary system - liver dysfunction, fatty infiltration, cholangitis, cholelithiasis. Cholesterol metabolism disorders, changes in the physicochemical properties of bile, and difficulties in bile secretion are of great importance for its development.
As body weight increases, the risk of developing cancer increases: in men - prostate cancer, rectal cancer, in women - breast cancer, endometrial cancer, ovarian cancer, gallbladder cancer.
With obesity, as a rule, there are symptoms of damage to the nervous system to varying degrees: sleep disturbance, increased appetite, thirst, astheno-neurotic manifestations.
A severe complication in patients with grade III-IV obesity is the development of hypoventilation syndrome of the obese (Pickwick syndrome), characterized by hypoventilation, impaired sensitivity of the respiratory center to hypoxia, hypercapnia in combination with pathology of the respiratory rhythm and frequent and prolonged periods of apnea (obstructive, central or mixed genesis), pulmonary hypertension, cardiopulmonary insufficiency, CNS damage in the form of sleep disturbance compensated by daytime sleepiness, depression, headaches. Changes in the mechanical properties of the chest, diaphragm, functional state of the respiratory center, neuromuscular conduction are important in the pathogenesis of this syndrome.
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