Psychological Effects of Obesity

Being severely obese has serious psychological and social repercussions. Many people who are overweight are subject to disapproval, even lectures, from family and friends and to sneers and remarks from strangers. Such behavior is propagated by the general societal belief that obesity is caused by a lack of self-discipline or moral weakness. These attitudes carry over into the work world, where a job or a promotion is often denied simply because of how much one weighs. Not surprising, many obese people prefer not to go out in public because they feel selfconscious or they simply cannot enjoy activities that most people take for granted, like going to the movies, taking the subway, or going on vacation - because the seats are too small, the turnstiles are too narrow, or the accommodations are too uncomfortable. All these experiences, repeated day after day for years, can lead to depression, anxiety, or low self-esteem. In one study, severely obese persons were asked to choose between being obese or having some other infirmity. The results were astounding. By and large, the respondents said that they would rather be blind or have one leg amputated than be at their present weight. Most interestingly, everyone said they would rather be poor and thin than rich and overweight. A 1991 study showed that 80 percent of severely obese people:

perceive themselves as physically unattractive believe that others make disparaging comments about their weight dislike being seen in public feel discrimination when applying for jobs feel that they are treated disrespectfully by their physician

Indeed, several studies suggest that many physicians do treat obese patients disrespectfully. In a 1969 survey of physicians, obese patients were described as "weak-willed," "ugly," "awkward," and "self-indulgent." In a more recent physician survey, one of three doctors said they respond negatively to obesity, behind three other diagnostic/social categories: drug addiction, alcoholism, and mental illness. A comparable study found that two-thirds of doctors believe obese patients lack self-control, and 39 percent feel they are lazy. Two studies of nurses showed similar results. The truth of the matter is that morbid obesity is a chronic medical illness, although a good portion of society and the health-care establishment does not seem to agree. At NYU, we strive to educate the professionals and laypeople alike of the seriousness of this disease and the need to change the way it is viewed and treated.

The Effects of Obesity

The effects of obesity extend far beyond physical weight and related health problems. Obesity side effects can include a greater risk of mental health problems and low self-esteem. Social attitudes on obesity range from avoidance to outright discrimination and bullying. For those suffering from childhood obesity, effects of this condition can last a lifetime.

Obesity Health Effects

The effects of obesity on physical health are well documented. The Stanford Hospital (2010) reports obesity causes up to 300,000 premature deaths a year in the United States alone. Obesity health effects range from backaches and joint pain to life-threatening conditions. The following is a list of health conditions attributed to obesity. This list is by no means exhaustive; the effects of obesity on physical health are, unfortunately, many and varied. Obesity side effects include:

Angina (chest pain) Atherosclerosis (hardening of the arteries) Cancer Diabetes Heart attack High blood pressure Joint pain Metabolic syndrome Mobility impairment Osteoarthritis Stroke.

Mental Health Effects of Obesity

Obesity side effects can include mental health disorders. The mental effects of obesity have not been studied as extensively as physical obesity side effects. Evidence suggests, however, that being obese negatively affects mental health. Low self-esteem is common among the severely obese. Rates of depression and anxiety appear to be higher; a Swedish study found that severely obese people are three to four times more likely to exhibit symptoms of anxiety and depression, as compared to those with a healthy weight.

Obesity Side Effects and Social Stigma

A long history of mocking and discriminating against the obese runs through many cultures. Many people assume the obese are to blame for their condition, and that obesity is a sign of low willpower, overindulgence or slovenliness.

Obese people may have fewer social and romantic relationships compared to the non-obese. College admission, careers and earning power may be negatively affected by weight, particularly for obese women. While it may not be generally acceptable to discriminate based on gender, religion or ethnicity, many people continue to ridicule, mock or even abuse the obese.

Childhood Obesity Effects

According to the Centers for Disease Control and Prevention (2010), childhood obesity rates have tripled since the 1980s. Almost 20 percent of U.S. children aged 6 to 11 are now obese. Childhood obesity effects include a heightened risk of early-onset hypertension and heart disease, and an increased risk of problems such as stroke, heart disease and diabetes as adults. Socially, childhood obesity effects include an increased risk of bullying and teasing. Although long-term effects of childhood obesity on self-esteem and relationships continue to be studied, obese children and teens report lower levels of self-esteem than their non-obese counterparts.

Resources
Marcus, M. (2002). Effects of obesity on the quality of life. Retrieved June 2, 2010, from http://www.endotext.org/obesity/obesity14/obesity14.htm. Mocan, N.
Effects of obesity What are the dangers in being obese? If you are overweight, it is important to understand the health effects of obesity. Obesity is associated with more than thirty medical conditions and scientific evidence has established a strong relationship with at least fifteen of those conditions.1 Obesity is associated with the development of osteoarthritis of the hand, hip, back, and knees. Obesity increases the risk of breast cancer in men and women. It is strongly associated with cancer of the esophagus. Obese women have three to four times the risk of endometrial cancer than women with lower BMI. Obesity increases cardiovascular disease risk because of its effect on blood lipid levels. Obesity is a major risk factor for heart attack. Gallstones are common in overweight and obese persons. Obesity decreases the bodys resistance to harmful organisms. Obesity is the most common factor of nonalcoholic steatophepatitis, a major cause of liver disease.

These are just some examples of how obesity negatively affects the health of a person.

Even more concerning is that approximately 15 percent of children and adolescents are overweight, compared to just 4 percent a few decades ago, and another 15 percent are at risk for being overweight. Childhood obesity is a growing concern in today's world. An alarming number of children are obese and developing diseases normally seen in adulthood. Overweight adolescents have a greatly increased risk of dying from heart disease in

adulthood. Even our youngest citizens are at risk. About 10 percent of preschoolers weigh more than is healthy for them. Weighing too much may increase your risk for developing many health problems. If your body mass index (BMI) indicates that you are overweight or obese, you may be at risk for many of obesity's health effects. These include:

Type 2 diabetes Heart disease Stroke High blood pressure (hypertension) High cholesterol (hypercholesterolemia) Certain cancers Sleep apnea Osteoarthritis Gallbladder disease and gallstones Fatty liver disease (also called nonalcoholic steatohepatitis or NASH) Gastroesophageal reflux disease (GERD) Gout Psychological and emotional effects.

Defining Overweight

When people eat more calories than they burn off, their bodies store the extra calories as fat. A couple of pounds of extra body fat are not a health risk for most people. But when people keep up a pattern of eating more calories than they burn, more and more fat builds up in their bodies. Eventually, the body gets to a point where the amount of body fat can have a negative effect on a person's health. Doctors use the terms "overweight" or "obese" to describe when someone is at greatest risk of developing weight-related health problems. As you've probably heard, more people are overweight today than ever before. Experts are calling this an "obesity epidemic." This health problem affects young people as well as adults one third of all kids between the ages of 2 and 19 are overweight or obese. So younger people are now developing health problems that used to affect only adults, like high blood pressure, high cholesterol, and type 2 diabetes.
Why Do People Become Overweight?

Obesity tends to run in families. Some people have a genetic tendency to gain weight more easily than others because they burn calories more slowly. During times when food was scarce, this was a real advantage. But now that food is available 24/7 in most industrialized countries, an efficient metabolism that once ensured our survival now works to our disadvantage.

Although genes strongly influence body type and size, the environment also plays a role. People today may be gaining weight because of unhealthy food choices (like fast food) and family habits (like eating in front of the television instead of around a table). High-calorie, low-nutrient snacks and beverages, bigger portions of food, and less-active lifestyles are all contributing to the obesity epidemic. Sometimes people turn to food for emotional reasons, such as when they feel upset, anxious, sad, stressed out, or even bored. When this happens, they often eat more than they need.
Measuring Weight

Figuring out if a teen is overweight can be more complicated than it is for adults. That's because teens are still growing and developing. Doctors and other health care professionals often use a measurement called body mass index (BMI) to determine if someone is overweight. After calculating BMI, a doctor will plot the result on a BMI growth chart. A BMI at or above the "95th percentile" line on the chart is considered in the obese range. A BMI number that is equal to or greater than the 85th percentile line but less than the 95th is considered overweight.

Health Problems of Being Overweight

Obesity is bad news for both body and mind. Not only can it make someone feel tired and uncomfortable, carrying extra weight puts added stress on the body, especially the bones and joints of the legs. As they get older, kids and teens who are overweight are more likely to develop diabetes and heart disease. The health problems that affect overweight teens include:

Blount disease. Excess weight on growing bones can lead to this bone deformity of the lower legs. Arthritis. Wear and tear on the joints from carrying extra weight can cause this painful joint problem at a young age. Slipped capital femoral epiphyses (SCFE). Obese children and teens are at greater risk for this painful hip problem. SCFE requires immediate attention and surgery to prevent further damage to the joint. Asthma. Obesity is associated with breathing problems that can make it harder to keep up with friends, play sports, or just walk from class to class. Sleep apnea. This condition (where a person temporarily stops breathing during sleep) is a serious problem for many overweight kids and adults. Not only does it interrupt sleep, sleep apnea can leave people feeling tired and affect their ability to concentrate and learn. It also may lead to heart problems. High blood pressure. When blood pressure is high, the heart must pump harder and the arteries must carry blood that's moving under greater pressure. If the problem continues for

a long time, the heart and arteries may no longer work as well as they should. Although rare in most teens, high blood pressure, or hypertension, is more common in overweight or obese teens. High cholesterol. Long before getting sick, obese teens may have abnormal blood lipid levels, including high cholesterol, low HDL ("good") cholesterol, and high triglyceride levels. These increase the risk of heart attack and stroke when a person gets older. Gallstones. An accumulation of bile that hardens in the gallbladder forms gallstones. These may be painful and require surgery. Fatty liver. When fat accumulates in the liver, it can cause inflammation, scarring, and permanent liver damage. Pseudotumor cerebri. This is a rare cause of severe headaches in obese teens and adults. There is no tumor, but pressure builds in the brain. In addition to headaches, symptoms may include vomiting, unsteady walking, and vision problems that might become permanent if not treated. Polycystic ovary syndrome (PCOS). Girls who are overweight may miss periods or not get their periods at all and might have elevated testosterone (the male hormone) levels in the blood. Although it's normal for girls to have some testosterone in their blood, too much can interfere with normal ovulation and can cause excess hair growth, worsening acne, and male-type baldness. PCOS is associated with insulin resistance, a precursor to developing type 2 diabetes. Overweight women also might have fertility problems. Insulin resistance and diabetes. When there is excess body fat, insulin is less effective at getting glucose, the body's main source of energy, into cells. More insulin becomes needed to maintain a normal blood sugar. For some overweight teens, insulin resistance may progress to diabetes (high blood sugar). Depression. People who are obese are more likely to be depressed and have lower selfesteem.

Luckily, it's never too late to make changes that can effectively control weight and the health problems it causes. Those changes don't have to be big. For a start, make a plan to cut back on sugary beverages, pass up on seconds, and get more exercise, even if it's just 5-10 minutes a day. Build your way up to big changes by making a series of small ones. And don't be afraid to ask for help!

Obesity is an epidemic disease that threatens to inundate health care resources by increasing the incidence of diabetes, heart disease, hypertension, and cancer. These effects of obesity result from two factors: the increased mass of adipose tissue and the increased secretion of pathogenetic products from enlarged fat cells. This concept of the pathogenesis of obesity as a disease allows an easy division of disadvantages of obesity into those produced by the mass of fat and those produced by the metabolic effects of fat cells. In the former category are the social disabilities resulting from the stigma associated with obesity, sleep apnea that results in part from increased parapharyngeal fat deposits, and osteoarthritis resulting from the wear and tear on joints from carrying an increased mass of fat. The second category includes the metabolic factors associated with distant effects of products released from enlarged fat cells. The insulin-resistant state that is so common in obesity probably reflects the effects of increased release of fatty acids from fat cells that are then stored in the liver or muscle. When the secretory capacity of the pancreas is overwhelmed by battling insulin resistance, diabetes develops. The strong association of increased fat, especially visceral fat, with diabetes makes this consequence particularly ominous for health care costs. The release of cytokines, particularly IL-6, from the fat cell may stimulate the proinflammatory state that characterizes obesity. The increased secretion of prothrombin activator inhibitor-1 from fat cells may play a role in the procoagulant state of obesity and, along with changes in endothelial function, may be responsible for the increased risk of cardiovascular disease and hypertension. For cancer, the production of estrogens by the enlarged stromal mass plays a role in the risk for breast cancer. Increased cytokine release may play a role in other forms of proliferative growth. The combined effect of these pathogenetic consequences of increased fat stores is an increased risk of shortened life expectancy.