Complications of Obesity
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Complications of Obesity

Complications of Obesity
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Updated on December 17, 2024
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Obesity, or carrying excess weight, is associated with a variety of health complications, including high blood pressure, type 2 diabetes, gallbladder disease, and certain cancers.

 A person is defined as having obesity if their body mass index, or BMI, is over 30.


“Obesity affects every organ system in the body and causes negative effects on each of these systems,” says Mir Ali, MD, a bariatric surgeon and the medical director of Memorial Care Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California.

Read on to better understand the different complications of obesity.

High Blood Pressure

High blood pressure, referred to as hypertension, occurs when blood moves through arteries and veins at a higher pressure than normal.

People with high blood pressure can be at risk of the following conditions:

  • Heart disease
  • Heart attack
  • Stroke
  • Kidney disease
While genetics can contribute to high blood pressure, research has found that between 65 to 78 percent of high blood pressure cases are related to obesity.


Treating hypertension focuses on lifestyle factors (such as limiting alcohol and eating a healthy diet) and potentially medications to help lower blood pressure.


Liver Disease

Obesity is a well established risk factor for a type of liver disease called metabolic dysfunction–associated steatotic liver disease (MASLD). The condition was formerly known as nonalcoholic fatty liver disease (NAFLD).

The prevalence of MASLD in the general population is about 25 percent, and up to 60 percent in high-risk populations, which include individuals with obesity or type 2 diabetes. The prevalence increases with age, obesity, and lack of physical activity.


MASLD is largely asymptomatic until the liver becomes inflamed due to excess fat cells. This stage of disease is called metabolic dysfunction–associated steatohepatitis (MASH).

To treat MASLD, healthcare providers may focus on weight loss and treating other conditions, including diabetes, high cholesterol, and high blood pressure. Reducing excess fat may help calm inflammation that can worsen MASLD.

Common symptoms of MASH include:


  • Loss of appetite
  • Pain in the upper right quadrant of the abdomen
  • Weakness and fatigue
  • Unexplained weight loss
In the advanced stages of disease symptoms can include:

  • Jaundice (yellowing of the skin and the whites of your eyes)
  • Swelling in your legs and feet (edema)
  • Persistent itchiness
  • Confusion drowsiness and slurred speech

High Cholesterol

Cholesterol is a waxy, fatty substance your body produces. You need a certain amount of it to function, but too much can increase your risk of health issues, including heart disease, heart attack, and stroke. Your diet can also contribute to cholesterol levels.

People with any body size can have high cholesterol, though carrying extra body weight or having obesity can increase your likelihood of high cholesterol. If you have high cholesterol and carry excess weight, research has found that losing just 5 to 10 percent of your body weight can help reduce cholesterol numbers.


Type 2 Diabetes

Type 2 diabetes is a condition in which the body does not produce enough insulin, a hormone needed to move sugar into your cells. As a result, blood sugar levels rise, potentially leading to complications.

Type 2 diabetes is also related to insulin resistance, which develops when the body does not respond properly to insulin. This results in higher blood sugar levels, leading the pancreas to start making extra insulin to try to move that sugar into the cells. As the pancreas becomes more strained over time from the extra effort, it may start to make less insulin, leading to higher blood sugar levels and diabetes.


In addition to obesity, family history, age, and lifestyle factors can increase the chance of developing type 2 diabetes.

Research has found that losing even a small amount of weight (10 to 15 pounds, for example) can help you better manage your blood sugar levels.


Heart Disease

Heart disease encompasses multiple issues with the cardiac system and is often related to atherosclerosis, a condition where plaque builds up in the arteries. Having heart disease puts you at risk of a heart attack or heart failure.


Obesity is considered to be a contributing factor in the development of heart disease.


How people carry excess fat tissue can also increase their risk of developing heart disease. Abdominal obesity, meaning excess weight around the stomach and midsection, has been shown to contribute to heart disease.

To better understand a person’s heart disease risk, doctors may measure abdominal obesity by using an alternative weight measure to BMI, called waist circumference.


Having a waist circumference over 35 inches for women and over 40 inches for men could increase your risk of health conditions linked to obesity.


Losing just 5 to 10 percent of your weight can help reduce risk factors for heart disease.


Stroke

A stroke occurs when blood flow to the brain is blocked. This can be caused by a blocked blood vessel or a burst blood vessel.


People who are considered to be overweight have about a 22 percent increased risk of stroke. If people have obesity, that risk rises to 64 percent.


In addition, secondary complications linked to obesity, including high blood pressure, high cholesterol, and type 2 diabetes, can also increase the risk of stroke.


Gallbladder Disease

Obesity is associated with increased risk of gallbladder issues, including gallstones and an enlarged gallbladder.


People who carry excess weight are more likely to have insulin resistance and type 2 diabetes, both of which increase the risk of gallstones.

About 70 percent of gallstones are formed from cholesterol. These stones can block the bile duct in your biliary tract, leading to pain.


Osteoarthritis

When the body is carrying extra weight, it can put added stress on the joints. Obesity can increase the risk of developing osteoarthritis and having worse symptoms over time.

Osteoarthritis is caused when joint cartilage wears down, which can bring pain, swelling, and stiffness. Excess fat can also cause inflammation, which can damage joints over time.


Sleep Apnea

Obstructive sleep apnea (OSA), often called sleep apnea for short, is a condition that causes breathing to be interrupted repeatedly during sleep.

OSA can be due to multiple factors, including age and genetics, but obesity is a common risk factor.


Obesity can lead to excess fat deposits in the neck that then block the upper airway during sleep. The airway blockage can cause or worsen snoring, gasping, or snorting while sleeping.

Untreated sleep apnea can increase the risk of:


  • Heart disease
  • Stroke
  • Type 2 diabetes

Asthma

People with obesity have an increased risk for asthma. Asthma is a condition that affects the lungs. It causes inflammation and tightening of the airways, making breathing harder, and it can lead to a life-threatening emergency if left untreated.

Obesity can cause changes to lung function when excess weight puts pressure on the lungs, limiting their capacity to take in air, as well as increasing inflammation that may worsen the condition.


Additionally, people already living with asthma who develop obesity can see an increase in symptoms and symptom severity.


A study published in 2019 found that among people with asthma, 39 percent had obesity and 31 percent were overweight.


Mental Health Disorders

Research has found a connection between obesity and mood disorders including anxiety and depression.


Depression and obesity have been observed to be closely linked and being diagnosed with either condition increases the likelihood of developing the other.


Past research found that people with obesity had a 55 percent increased risk of developing depression. Comparatively, people with depression had a 58 percent increased risk of developing obesity.

Experts haven’t untangled fully the mechanism of why that relationship occurs, but people with people with obesity can face issues that impact their quality of life, including stigma, difficulty doing physical activities, social isolation, and disability.


If you are dealing with obesity and depression, a physician may refer you to receive mental health counseling. There are many different types of counseling that can help with depression symptoms, including:

  • Cognitive behavioral therapy
  • Motivational interviewing
  • Dialectical behavioral therapy
  • Interpersonal psychotherapy
Medications that can affect key neurotransmitters in the brain, including serotonin, norepinephrine, and dopamine, may also be recommended for people dealing with depression. These medications include:

  • SSRIs, selective serotonin reuptake inhibitors
  • SNRIs, serotonin-norepinephrine reuptake inhibitors
  • NDRIs, norepinephrine-dopamine reuptake inhibitors

More research needs to be done in order to better understand why depression is a complication of obesity.

Cancer

Cancer forms when cells in an area of the body grow out of control and take over healthy cells and tissue. Although many factors can contribute to cancer risk, obesity can increase your chances of developing some cancers.

People with obesity may have a larger risk of developing at least 13 types of cancer. These include:


While more research is needed to explain exactly how obesity plays a role in the development of cancer, current theories include:

  • Fat tissue creates extra estrogen, which is the hormone associated with cancers such as breast, endometrial, and ovarian cancer.
  • High levels of insulin and the development of type 2 diabetes, risk factors for some cancers, are common in people with obesity.
  • Inflammatory conditions, such as gallstones or MASLD, which are often complications of obesity, can increase cancer risk.
  • The hormones that fat cells produce can increase or block cell growth, which might promote cancer cell growth in certain cancers.

The Takeaway

  • Obesity is linked to increased risk of a variety of health conditions.
  • Carrying excess weight can lead to inflammation and other health issues that can affect multiple organ systems.
  • For many conditions, including high cholesterol, losing just 5 to 10 percent of body weight can significantly lower your risk.

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Sean Hashmi, MD

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Castle Connolly Top Doctor, Member of American College of Lifestyle Medicine

Sean Hashmi, MD, is an experienced nephrologist and obesity medicine specialist based in Southern California. As the regional director for clinical nutrition and weight management at a prominent healthcare organization in Southern California, Dr. Hashmi oversees the development and implementation of cutting-edge nutritional programs and weight management strategies. With his innovative approach and unwavering commitment to providing evidence-based solutions, he is a highly sought-after speaker and a leader in his field.

Hashmi founded the nonprofit organization SelfPrinciple.org to provide accessible and accurate health, nutrition, and wellness information to the public. Through this platform, he shares the latest research findings, empowering individuals to make informed decisions about their well-being. Self Principle also supports children's education by providing scholarships, books, and supplies, so that students have the resources necessary to succeed academically and build a brighter future.

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Rena Goldman

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Rena Goldman is a journalist, editor, and content strategist with over a decade of media experience covering health, wellness, mental health, and small business. She has written on a variety of topics, including clinical conditions, lifestyle changes, fitness, new products, food, trends, and sleep.

Curious about what it takes to live your healthiest life in a modern society, Goldman is passionate about empowering readers with the information to make educated decisions about their health. She has spent years interviewing clinicians and working with them to ensure content is medically accurate. This experience has helped her build in-depth knowledge in the health and wellness space.

Goldman's work has been featured in numerous online health and lifestyle publications, including Everyday Health, Health.com, Healthline, Business Insider, Psych Central, and U.S. News & World Report.

She's based in Los Angeles, where she enjoys good vegan food, trying new workout trends, and hiking with her dachshund, Charlie.
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