June 20, 2023
Treating Patients with Diseases Related to Obesity
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Two hundred diseases are associated with the disease of obesity. Obesity is a complex disease that directly and indirectly affects many body systems. Some diseases are commonly recognized for their links to obesity, such as type two diabetes, obstructive sleep apnea, hypertension, and polycystic ovarian syndrome. However, cancers associated with obesity aren’t discussed often. Understanding the impact of obesity care on many other diseases is beneficial for both clinicians and patients. In this article, we will review the association between obesity and four diseases: Cancers, Diabetes Type II, Sleep Apnea, & COVID-19.
What to Know About Obesity and Cancer
Biological Factors: It was once thought that adipose tissue (“fat cells”) was inactive in the body, but we now know adipose tissue is very active. Fat cells produce harmful chemicals that cause inflammation in our body; over time, this can lead to damage to healthy cells. Fat cells also produce high hormone levels that can trigger cancer genes in people with an increased risk for certain types of cancer. For example, in post-menopausal women, most estrogen is made outside of the ovaries. Studies show that as BMI increases, estrogen levels also increase. This increased level of estrogen has been implicated in breast cancer.
Lifestyle Factors: Several lifestyle factors play a key role in obesity and cancer risk. Proper nutrition and physical activity are critical to obesity and cancer prevention. For example, a high intake of red meat and processed foods can lead to obesity, and several processed meats and foods have been recognized by the World Health Organization and other researchers as carcinogens (agents that cause cancer). Participating in regular physical activity is not only helpful in reducing obesity risk, but it can also decrease cancer risk. Exercise helps reduce inflammation in the body and balance the negative effects of harmful hormone levels in the body.
While we know that weight gain is associated with cancer risk, ongoing research is being done to investigate how weight loss may help to reduce cancer risk and prevent re-occurrence in survivors. The National Cancer Institute has ongoing trials, such as the Breast Cancer Weight Loss (BWEL) Study, to evaluate cancer re-occurrence rates in women who are overweight and have obesity after they have participated in a weight loss program post-diagnosis compared to those who do not participate in a weight loss program.
The Relationship Between Obesity and Diabetes
Obesity is a significant risk factor for developing type 2 diabetes, the most common form of diabetes. Excess weight, especially around the abdomen, can lead to insulin resistance, where the body’s cells become less responsive to the hormone insulin. As a result, glucose cannot enter the cells effectively, leading to elevated blood sugar levels. Over time, this insulin resistance can progress to type 2 diabetes, which further increases the risk of cardiovascular diseases, kidney problems, and other complications.
Managing both obesity and type 2 diabetes requires a comprehensive approach that begins with lifestyle changes. Promoting healthy eating habits, regular physical activity, and weight management are crucial in preventing both conditions. Public health initiatives and education campaigns play a vital role in raising awareness and providing individuals with the knowledge and tools to make informed choices about their lifestyles. Additionally, healthcare systems must prioritize early screening and diagnosis of diabetes and offer effective treatment options, including lifestyle interventions and medication, to mitigate the long-term consequences of these conditions.
Sleep Apnea and Obesity
Sleep apnea and obesity are closely linked health conditions that can have a significant impact on an individual’s overall well-being. Sleep apnea is a sleep disorder characterized by pauses in breathing or shallow breaths during sleep, which can lead to disrupted sleep patterns and insufficient oxygen supply to the body. Obesity is a known risk factor for sleep apnea, as excess weight can contribute to the narrowing of the airways, making it more difficult for air to flow freely during sleep.
Managing sleep apnea in patients with obesity requires a combination of weight loss interventions and targeted treatments to address breathing disturbances during sleep. By adopting a holistic approach that addresses both obesity and sleep apnea, individuals can experience improved sleep quality, reduced daytime symptoms, and better overall health outcomes.
Understanding Obesity and COVID-19
COVID-19 and obesity have been found to have a significant relationship, with obesity being recognized as a risk factor for severe outcomes and complications related to viral infection. Studies have shown that individuals with obesity are more likely to experience severe COVID-19 symptoms, require hospitalization, and face an increased risk of mortality. The underlying mechanisms linking obesity and COVID-19 severity are multifaceted and complex. Obesity, defined as a body mass index (BMI) of 30 or greater, has become a well-recognized risk factor for severe COVID-19-related illness. This has dramatic public health implications considering that over 42% of the US population is affected by obesity.
Early and aggressive management is crucial in this population. Treatment strategies for COVID-19 in patients with obesity often involve a combination of medical interventions and supportive care. Healthcare providers may also closely monitor and manage other comorbidities commonly associated with obesity, such as hypertension and diabetes, as these conditions can further complicate the management of COVID-19. Supportive care measures, such as oxygen therapy, mechanical ventilation, and fluid management, are provided as needed to support respiratory function and overall health during the course of the illness.
For more up-to-date information on obesity and COVID-19, learn more from the CDC at https://www.cdc.gov/obesity/data/obesity-and-covid-19.html
Obesity represents a significant risk factor for the development and progression of various diseases, particularly different types of cancer. Understanding the complex relationship between obesity and diseases like cancer is crucial in implementing effective prevention strategies, early detection protocols, and comprehensive treatment plans. Public health efforts should prioritize educating individuals about the importance of weight management, healthy lifestyles, and regular cancer screenings. By addressing obesity as a modifiable risk factor, we can make significant strides in reducing the burden of cancer and improving the overall health and well-being of individuals worldwide.
Listen to our two-part podcast episode on cancer and obesity:
Article written by:
Sylvia Gonsahn-Bollie, MD
Sylvia Gonsahn-Bollie, MD, DABOM, FOMA, is an integrative obesity specialist, bestselling author, and founder of Embrace You Weight & Wellness. Dr. Bollie works with individuals and organizations to transform evidence-based medicine into customized solutions. However, Dr. Bollie is more than a doctor. She is also a consultant and wellness mindset coach who leads by example. In 2015, she was overweight and overworked, so she started her weight loss wellness journey. Dr. Bollie has maintained her weight loss for over eight years through a consistent wellness lifestyle.
Dr. Sylvia is a sought-after health consultant, program designer, and freelance writer. She is a regular contributor to Medscape.com. Her work has been published in Obesity Pillars, Forbes, Scientific America, Livestrong.com, and more. In March 2021, Dr. Bollie co-founded the Overcoming Obesity Club on Clubhouse. In these weekly, highly engaging discussion rooms, Dr. Bollie organizes and shares evidence-based obesity facts with the help of six featured moderators from various professional backgrounds.
Dr. Bollie is a consultant for organizations such as Black Health's Obesity Education Outreach program. At Black Health, she’s helped create culturally relevant videos and written obesity content. Connect with Dr. Bollie on her website and all social media platforms. In 2022 she received the Black Physician Healthcare Network Wellness Initiative grant to implement the ENHANCE Black Healthy Weight & Wellness obesity education & healthy goals program. Dr. Bollie and her husband of 15 years, Rodney Bollie, enjoy giving back to their communities. In addition to being active in the PTA and local Chamber of Commerce, in 2017, Rodney and Dr. Sylvia founded the Institute of Basic Technology, Liberia's only non-profit STEM lab for high school students. The Bollie family resides in the DC Metro area and frequently escapes the DC hustle on the beautiful walking trails.