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Health Effects of Obesity

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Photo: Shot of someone's feet on a bathroom scale.
Photo: Weight and height are used in
computing body mass index, an indicator of risk
for developing obesity-associated diseases.

Credit: Bill Branson, NIH


“...obesity is essentially an inflammatory disease”, according to Gökhan Hotamisligil, professor of genetics and metabolism at the Harvard School of Public Health. “Excess calories affect the fat cells in such a way that they mount an immune response. You’re activating the immune system without a legitimate pathogen. You’re constantly activating your immune system at a low level in such a way that it releases chemicals that start contributing to inflammation.” (Quoted in “Fat chance: the biology of obesity” on the web site of the Whitehead Institute for Biomedical Research, June 22, 2005. Original article written by David Cameron in the Spring 2005 issue of the magazine Paradigm)

More than one third of U.S. adults and 16% of U.S. children are obese. Being obese, whether by genetic factors, metabolism, hormonal imbalances or changes (e.g., menopause), body type (most likely endomorph), medical conditions, such as hypothyroidism or Cushing’s disease, side effects of medication, smoking cessation, or poor lifestyle habits, can lead to early mortality. Obesity can contribute to a multitude of health effects, including problems with:

  • the respiratory system and sleep (sleep apnea; asthma; breathlessness)
  • the digestive system (GERD; gallbladder disease & gallstones; eating disorders)
  • the reproductive system (menstrual problems; pregnancy complications; infertility; impotence; birth defects; PCOS-polycystic ovary syndrome)
  • the endocrine system (pancreatitis; fatty pancreas)
  • the cardiovascular system (heart attack; elevated cholesterol/atherosclerosis; abnormal heart rhythms; hypertension; peripheral vascular disease; stroke)
  • mental health (depression)
  • liver (nonalcoholic fatty liver disease-NALD; nonalcoholic steatohepatitis-NASH)
  • kidneys (kidney stones; chronic kidney disease-CKD)
  • the musculoskeletal system (osteoarthritis in the back, hips, knees; gout)
  • the immune system (inflammation; lowered immunity)

Obesity can cause complications in surgery and with anesthesia. It has been implicated in Alzheimer’s. It often leads to metabolic syndrome and type 2 diabetes. It is a factor in cancers, such as ovarian, endometrial, postmenopausal breast cancer, colorectal, prostate, and others. A link has been found between migraine and obesity. And, of course, obesity affects an individual’s general quality of life, self-esteem and self-image.

A person is considered obese if the body mass index, which is based on height and weight, is 30 or greater (40 or greater is morbidly obese; 25-29 signifies overweight).

Waist measurement is a good indicator of abdominal fat. Men with a waist circumference of 40 inches or more and women with 35 inches or more are at increased risk of adverse health effects, such as heart disease. Another indicator of health risks is the waist-to-hip ratio, which indicates if you have an apple or a pear shaped body (those with a pear shape are less prone to health problems):



Encyclopedia of obesity. Kathleen Keller, general editor. Thousand Oaks, CA, Sage, c2008. 2v., various pagings.
   Includes bibliographical references.
   RC628.E53 2008<SciRR>

Handbook of obesity : clinical applications. Edited by George A. Bray, Claude Bouchard. 3rd ed. New York, Informa Healthcare, c2008. 659 p.
   Includes bibliographical references.
   RC628.H289 2008<SciRR>

Handbook of obesity: etiology and pathophysiology. Edited by George A. Bray, Claude Bouchard. 2nd ed. New York, Marcel Dekker, c2004. 1046 p.
   See: Part III: Pathophysiology. Covers most of the complications noted in the introduction.
   Includes bibliographical references.
   RC628.H29 2004<SciRR>

Obesity: epidemiology, pathophysiology, and prevention. Edited by Debasis Bagchi, Harry G. Preuss. Boca Raton, FL, CRC Press, c2007. 569 p.
   Includes bibliographical references.
   RC645.O23O2465 2007<SciRR>

Obesity: science to practice. Edited by Gareth Williams, Gema Frubeck. Chichester, West Sussex, UK, Hoboken, NJ, Wiley, 2009. 585 p.
   See: Chapter 1: History of obesity. Traces obesity from early human history. Table 1.1 lists landmarks in the history of obesity since the seventeenth century (1679-1st dissection of an obese cadaver; 1780-disease classification included obesity).
   Includes bibliographical references.
   RC628.O296 2009

Power, Michael. L., and Jay Schulkin. The evolution of obesity. Baltimore, Johns Hopkins University Press, 2009. 392 p.
   Bibliography: p. 331-382.
   RC628.P65 2009<SciRR>

Stern, Judith S., and Alexandra Kazaks. Obesity: a reference handbook. Santa Barbara, CA, ABC-CLIO, c2009. 323 p.
   Comprehensive: includes background, history, problems & controversies, global issues, chronology, biographical sketches, agencies & organizations, databases, web sites.
   Series: Contemporary world issues.
   Includes bibliographical references.
   RC645.O23S74 2009<SciRR>

Wolin, Kathleen Y., and Jennifer M. Petrelli. Obesity. Santa Barbara, CA, Greenwood Press, c2009. 160 p.
   A book that is less technical.
   Series: Biographies of disease.
   Includes bibliographical references.
   RC628.W57 2009



Adipose Tissue and Visceral Fat
Adipose tissue is an endocrine organ. Visceral fat (belly fat around the organs) is “toxic fat.”

Abdominal obesity and the endocannabinoid system: from basic aspects to clinical management of related cardiometabolic risk. Edited by Jean-Pierre Despres, Vincenzo Di Marzo. New York, Informa Healthcare, c2009. 265 p.
   Includes bibliographical references.
   RC628.A233 2009

Adipose tissue and adipokines in health and disease. Edited by Giamila Fantuzzi, and Theodore Mazzone. Totowa, NJ, Humana Press, c2007. 397 p.
   Series: Nutrition and health.
   Bibliography: p. 381-383.
   QP88.23.A35 2007

Adipose tissue and inflammation. Editors, Atif B. Awad, Peter G. Bradford. Boca Raton, FL, Taylor & Francis, c2010. 306 p. (Oxidative stress and disease, 28)
   Includes bibliographical references.
   RC628.A335 2010

Sears, Barry. Toxic fat: when good fat turns bad. Nashville, Thomas Nelson, c2008. 355 p.
   Discusses the inflammation caused by visceral fat. Good book for the layperson.
   Bibliography: p. 316-355
   RC628.S412 2008

Metabolic Syndrome (syndrome X, insulin resistance)
Metabolic syndrome is having 3 of 5 risk factors--high blood pressure, abdominal obesity, high triglycerides, low HDL cholesterol, fasting glucose greater than 110---that increase the chances of developing heart disease, stroke, and diabetes.

Bray, George A. The metabolic syndrome and obesity. Totowa, NJ, Humana Press, c2007. 303 p.
   Includes bibliographical references.
   RA645.O23 B73 2007

The Metabolic syndrome: epidemiology, clinical treatment, and underlying mechanisms. Edited by Barbara Caleen Hansen and George A. Bray. Totowa, NJ, Humana Press, c2008. 401 p.
   Series: Contemporary endocrinology.
   Includes bibliographical references.
   RC662.4.M47 2008

Overweight and the metabolic syndrome: from bench to bedside. Edited by George A. Bray, Donna H. Ryan. New York, Springer, c2006. 335 p. ( Endocrine updates, 26)
   Includes bibliographical references.
   RA645. O23 O95 2006

Diseases, Disorders, Other Conditions and Complications

Bellamy, Mark C., and Michel Struys. Anaesthesia for the overweight and obese patient. Oxford, New York, Oxford University Press, 2007. 108 p.
   Also covers disorders of sleep and respiratory control in obesity; perioperative assessment and management; and obesity and the airway.
   Includes bibliographical references.
   RD87.3.O23 B45 2007

Body mass index and health. Linda A. Ferrara, editor. New York, Nova Biomedical Books, c2005. 144 p.
   Includes bibliographical references.
   RC628.B57 2005

Cassell, Dana K., and David H. Gleaves. The Encyclopedia of obesity and eating disorders. 3rd ed. New York, Facts on File, c2006. 362 p.
   Bibliography: p. 341-346.
   RC552.E18C37 2006<SciRR>

The Johns Hopkins textbook of dyslipidemia. Editor, Peter O. Kwiterovich, Jr. Philadelphia, Wolters Kluwer Health/Lippincott Williams & Wilkins, c2010. 303 p.
   Dyslipidemia: a condition marked by abnormal concentrations of lipids or lipoproteins in the blood.
   See: Chapter 24: Therapeutic options for modifying obesity and cardiometabolic risk factors, p. 277-291.
   Includes bibliographical references.
   RC632.L5J64 2010<SciRR>

Obesity and binge eating disorder. Volume editors, Simone Munsch, Christoph Beglinger. Basel, New York, Karger, c2005. 222 p. (Bibliotheca psychiatrica, 171)
   Includes bibliographical references.
   RC552.C65O24 2005

Obesity and cancer research. Pauline R. Ramonde and Eva H. Fochas, editors. New York, Nova Biomedical Books, c2009. 187 p.
   Includes bibliographical references.
   RC268.45.O24 2009

Obesity and cardiovascular disease. Edited by Malcolm K. Robinson, Abraham Thomas. New York, Taylor & Francis, 2006. 453 p. (Fundamental and clinical cardiology, v.58)
   Includes bibliographical references.
   RC628.O2262 2006

Obesity and diabetes. Editors, Anthony H. Barnett, Sudhesh Kumar. 2nd ed. Chichester, West Sussex, UK, Hoboken, NJ, Wiley-Blackwell, c2009. 328 p.
   Includes bibliographical references.
   RC628.O2263 2009

Obesity and mental disorders. Edited by Susan L. McElroy, David B. Allison, George A. Bray. New York, Taylor & Francis, 2006. 462 p. (Medical psychiatry, 33)
   Includes bibliographical references.
   RC455.4.N8O24 2006

Obesity and metabolism. Volume editor, Marta Korbonits. Basel, New York, Karger, c2008. 294 p. (Frontiers of hormone research, v. 36)
   Includes bibliographical references.
   RC628.O2272 2008

Obesity and the kidney. Volume editor, Gunter Wolf. Basel, New York, Karger, c2006. 260 p. (Contributions to nephrology, v. 151)
   Includes bibliographical references.
   RC628.O2285 2006

Obesity: genomics and postgenomics. Edited by Karine Clement, Throkild I.A. Sorensen. New York, Informa Healthcare, c2008. 576 p.
   Includes bibliographical references.
   RC628.G47 2007

Sleep medicine essentials. Edited by Teofilo L. Lee-Chiong. Hoboken, NJ, Wiley-Blackwell, c2009. 280 p.
   In index see “obesity.”
   Includes bibliographical references.
   RC547.S54737 2009

Treatment of the obese patient. Edited by Robert F. Kushner, Daniel H. Bessesen. Totowa, NJ, Humana Press, c2007. 440 p.
   See: Part I: Physiology and Pathophysiology. Covers neuroregulation of appetite, gut peptides, endocannabinoids, adipokines.
   Series: Contemporary endocrinology.
   Includes bibliographical references.
   RC628.T696 2007



Hu, Frank B. Obesity epidemiology. Oxford, New York, Oxford University Press, c2008. 498 p.
   See: Part II: Epidemiologic studies of consequences of obesity, p. 140-271.
   Covers metabolic, cardiovascular disease, cancer, mortality, quality of life.
   Includes bibliographical references.
   RA645.O23 H8 2008

Levin, Judith. Obesity and self-image. New York, Rosen, 2009. 64 p.
   Series: Understanding obesity.
   Bibliography: p. 60-61.
   RC552.O25L478 2009

Neurobiology of obesity. Edited by Jenni Harvey, Dominic J. Withers. Cambridge, New York, Cambridge University Press, 2008. 324 p.
   Includes bibliographical references.
   RC628.N387 2008

Obesity in perspective: a conference/sponsored by the John E. Fogarty International Center for Advanced Study in the Health Sciences, National Institutes of Health, Bethesda, Maryland, October 1-3, 1973. George A. Bray, editor. Washington, U.S. Govt. Print. Off., 1975. 2 v.
   The Fogarty Conference on Obesity led to a series of international congresses on obesity and to the publication of the International journal of obesity. (DHEW publication, no. (NIH) 75-708. Fogarty International Center series on preventive medicine, v.2)
   Includes bibliographical references.

Segrave, Kerry. Obesity in America, 1850-1939: A history of social attitudes and treatment. Jefferson, NC, McFarland & Co., c2008. 202 p.
   For historical perspective: "This study concentrates on how the condition of obesity was viewed, studied, and treated from 1850 to 1939. It examines the images and stereotypes that were associated with fatness, the various remedies that were proposed for the condition, and the often bizarre theories that were proposed to explain obesity."
   Includes bibliographical references
   RC628.S438 2008



PubMed Central (PMC) (NLM/NIH)
   (Provides free access to full-text journal articles)

   Some particular journals of interest in PMC include: Diabetes, obesity & metabolism; International journal of obesity; International journal of obesity and related metabolic disorders; Journal of nutrition and metabolism; Journal of obesity; Obesity management; Obesity research; Obesity research and clinical practice; Obesity reviews.

Berrington de Gonzalez, Amy, and others. Body-mass index and mortality among 1.46 million white adults. New England journal of medicine, v. 363, no. 23, Dec. 2, 2010: 2211-2219.

Bertola, Adeline, and others. Hepatic expression patterns of inflammatory and immune response genes associated with obesity and NASH in morbidly obese patients. (liver inflammation in obesity) PLoS one, v. 5, Oct. 2010, 11 p.

Davy, Kevin P., and Jeb S. Orr. Sympathetic nervous system behavior in human obesity. Neuroscience & biobehavioral reviews, vol. 33, Feb. 2009: 116-124.

Fawcett, Katherine A., and Ines Barroso. The genetics of obesity: FTO leads the way. Trends in genetics, vol. 26, June 2010: 266-274.

Guh, Daphne P., and others. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC public health, published Mar. 25, 2009, 20 p.

Kershaw, Erin E., and Jeffrey S. Flier. Adipose tissue as an endocrine organ. Journal of clinical endocrinology & metabolism, vol. 89, June 2004: 2548-2556.

Kirk, Erik P., and Samuel Klein. Pathogenesis and pathophysiology of the cardio-metabolic syndrome. Journal of clinical hypertension, vol. 11, Dec. 2009: 761-765.

Murugan, A. T., and G. Sharma. Obesity and respiratory diseases. Chronic respiratory disease, v. 5, Nov. 2008: 233-242.

Nedeltcheva, Arlet V., and others. Insufficient sleep undermines dietary efforts to reduce adiposity. Annals of internal medicine, vol. 153, no. 7, Oct. 5, 2010: 435-441.

Needham, Belinda L., and others. Trajectories of change in obesity and symptoms of depression: the CARDIA study. American journal of public health, vol. 100, June 2010: 1040-1046.

Rasouli, Neda, and Philip A. Kern. Adipocytokines and the metabolic complications of obesity. Journal of clinical endocrinology & metabolism, vol. 93, 11 Suppl 1, Nov, 2008: S64-S73.

Reilly, J. J., and J. Kelly. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. International journal of obesity, published online Oct. 26, 2010.

Stothard, Katherine J., and others. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA, vol. 301, no. 6, Feb. 11, 2009: 636-650.

Yamaji, Taiki., and others. Visceral fat volume and the prevalence of colorectal adenoma. American journal of epidemiology, vol. 170, Dec. 15, 2009: 1502-1511.



Federal Government--US Department of Health & Human Services

Centers for Disease Control and Prevention (CDC)

MedlinePlus (National Library of Medicine--NIH)

National Institutes of Health Obesity Research
(Includes NIH Obesity Research Task Force and Strategic Plan for NIH Obesity Research, updated December 2010). You can click on the various member institutes and others on the task force and search “obesity” on their web sites.

National Institutes of Health (NIH) Institutes:
The following are examples of information available from the various other NIH Institutes. For complete list of institutes see

National Cancer Institute:
Obesity and Cancer: Questions and Answers
(91 references)

National Heart Lung and Blood Institute:
Enhancing Obesity Research at NHLBI
(References: pages 65-73)

National Human Genome Research Institute:
New Genetic Findings Explain Some Obesity Risk and Body Types

National Institute of Diabetes and Digestive and Kidney Diseases:
Research at NIDDK

NIDDK’s Weight-control Information Network (WIN) publications:
Understanding Adult Obesity
Do You Know the Health Risks of Being Overweight?
Statistics Related to Overweight and Obesity

National Institute on Aging:
Link Between Obesity & Alzheimer’s
   URL: NNA_Conferences/obesity.htm
Body Fat & Dementia (Alzheimer’s Education and Referral Center--ADEAR)



International Association for the Study of Obesity (IASO)
Publishes the journals International journal of obesity; International journal of pediatric obesity; Obesity reviews; and beginning in 2011, Clinical obesity. Web site has obesity news. Holds the annual International Congress on Obesity (ICO).
   Under Policy & Projects, see Health Impact of Obesity

International Obesity Task Force (IOTA)
Advocacy arm of IASO.

Obesity Action Coalition (OAC)
Education and advocacy organization. Your weight matters magazine published for members.
   See: All about obesity: related conditions
A creation of The Endocrine Society and the Hormone Foundation. Serves as a clearinghouse for information on scientific trends and advancements.

The Obesity Society (TOS)
Publishes the journal Obesity. Has consumer information, fact sheets, links.

Rudd Center for Food Policy and Obesity (Yale)

Society for Women’s Health Research (Washington, DC)
   See: Education/Scientific factsheets: obesity

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