Obesity, or carrying excess weight, is associated with a variety of health complications. The Centers for Disease Control and Prevention (CDC) defines obesity using body mass index or BMI. If a person’s BMI is 30 or higher, they’re considered to have obesity.

“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.

This doesn’t mean everyone diagnosed with obesity will face these complications, but it does mean their risk factors for developing them are higher than for someone who doesn’t fall into the obesity category.

Dr. Ali says the conditions most commonly associated with obesity are:

• Diabetes
• High blood pressure
• Heart disease
• Sleep apnea
• Cancer

As the CDC notes, there are several other conditions associated with obesity.

Below, we’ll discuss some common complications of obesity. It’s important to note that genetics and lifestyle play a role in many of these conditions as well, so someone doesn’t have to be diagnosed with obesity to be diagnosed with one of these complications.

But if obesity is considered a key factor, many of these complications can be reduced or eliminated with weight loss.

High Blood Pressure

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

People with high blood pressure can also be at risk of the following, among other issues:

• Heart disease
• Heart attack
• Stroke
• Kidney disease

Genetics contribute, but obesity is also associated with high blood pressure. Prior research from the Framingham Offspring Study suggested that obesity accounts for 65 to 78 percent of primary high blood pressure cases.

MASLD

Obesity is a well established risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD). According to a summary of prior studies in a research article published in the journal Medicine (Baltimore), 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, and or type 2 diabetes. The prevalence increases with age, obesity, and lack of physical activity.

MASLD is largely asymptomatic until it becomes metabolic dysfunction-associated steatohepatitis (MASH), formerly known as non-alcoholic steatohepatitis (NASH), which is inflammation of the liver caused by excess fat cells in it.

According to the Cleveland Clinic, common symptoms of MASH include:

• Jaundice (yellowing of the skin and the whites of your eyes)
• Loss of appetite
• Pain in the upper right quadrant of the abdomen
• Weakness and fatigue
• Unexplained weight loss
• Swelling in your legs and feet (edema)

To date there is no cure for MASLD, and no way of reversing steatotic (fatty) liver disease. However, research shows that you can slow or stop the progression of fat accumulation in the liver by managing metabolic factors like weight, cholesterol (and other blood lipids), blood pressure, and blood sugar.

High Cholesterol

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

According to the American Heart Association (AHA), people with any body size can have high cholesterol, though carrying extra body weight or having obesity can increase your likelihood of high cholesterol. The AHA also states that people who lose 5 to 10 percent of their body weight may improve their cholesterol levels.

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, and the cells respond poorly to insulin, leading to increased levels of blood sugar, as the Mayo Clinic notes. Family history, age, and lifestyle factors all play a role in whether someone develops type 2 diabetes.

According to the American Diabetes Association, carrying excess weight increases the risk of type 2 diabetes, but losing even a small amount of weight (10 to 15 pounds, for example) can improve your health.

Research also shows a link between obesity and the development of prediabetes and type 2 diabetes.

Heart Disease

Heart disease involves several issues with the heart, including high blood pressure, high cholesterol, abnormal heart rhythm, and chest pain. It puts you at risk of a heart attack or heart failure.

The American Heart Association considers obesity to be a contributing factor in the development of heart disease. More recently, abdominal obesity, meaning excess weight around the stomach and midsection, has been shown to contribute to heart disease. Doctors may measure abdominal obesity by using an alternative weight measure to BMI, called waist circumference, according to a study published in Current Opinion in Nutrition and Metabolic Care in September 2018.

The National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) says losing 5 to 10 percent of your weight may reduce risk factors for heart disease. That means someone who weighs 200 pounds (lb) could lose as little as 10 lb, or 5 percent of their weight, and see a lower heart disease risk.

Stroke

When the blood supply gets suddenly cut off from the brain, it’s called a stroke. This can be caused by a blocked blood vessel or a burst blood vessel. High blood pressure, sleep apnea, and type 2 diabetes, which are also complications associated with obesity, can increase the risk of stroke.

A study published June 1, 2017, in the Lancet Public Health found that obesity more than doubled the risk of stroke. And compared with people with a normal BMI, people with a BMI suggesting severe obesity have a tenfold higher risk of stroke.

Gallbladder Disease

Obesity is associated with gallbladder issues, including gallstones and an enlarged gallbladder. This is because those with obesity are more likely to have higher levels of cholesterol in their bile, a factor that can cause gallstones.

A study published July 4, 2019, in BMC Gastroenterology found that obesity was a risk factor for gallstones.

Osteoarthritis

When the body is carrying extra weight, it can put added stress on the joints. Obesity can increase the risk of osteoarthritis, as well as the risk of this condition worsening over time. Osteoarthritis is caused when joint cartilage wears down, which can bring pain, swelling, and stiffness.

A study published February 27, 2020, in Scientific Reports linked obesity to osteoarthritis in the knee because of the stress placed on weight-bearing joints. Obesity may also play a role in the development of arthritis in other joints.

Sleep Apnea

Obstructive sleep apnea (OSA), often called sleep apnea for short, is a condition that causes breathing to be interrupted repeatedly during sleep. Whether someone develops OSA can depend on a variety of health 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.

Per the CDC, untreated sleep apnea can increase the risk of:

• Heart disease
• Stroke
• Type 2 diabetes
• Depression

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.

Asthma can be both a complication of obesity and an existing condition made more challenging to manage with obesity. People with obesity can have an increased risk of asthma, and those with asthma who become obese can see an increase in symptoms and symptom severity. This is true for both adults and children.

An article published in the Journal of Allergy and Clinical Immunology in April 2018 estimated that almost 60 percent of U.S. adults who had severe asthma also had obesity. 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.

Mental Health Disorders

Obesity may also play a role in mental health disorders. Research suggests that people with obesity have a higher likelihood of mood and anxiety disorders.

According to 2005–2010 data from the CDC, 43 percent of adults who had depression also had obesity. Adults with depression were also found more likely to have obesity than those without depression.

While researchers believe there’s a link, more research needs to be done in order to better understand why anxiety and mood disorders are 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.

According to the National Cancer Institute, people with obesity may have a larger risk of developing at least 13 types of cancer. These include:

• Endometrial
• Esophageal adenocarcinoma
• Gastric cardia
• Liver
• Kidney
• Multiple myeloma
• Meningioma
• Pancreatic
• Colorectal
• Gallbladder
• Breast
• Ovarian
• Thyroid

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 nonalcoholic fatty liver disease, 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.

Editorial Sources and Fact Checking:

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5. What Are Overweight and Obesity? National Heart, Lung, and Blood Institute. March 24, 2022.
6. Health Effects of Overweight and Obesity. CDC. September 24, 2022.
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Important Notice: This article was originally published at www.everydayhealth.com by Rena Goldman where all credits are due. Medically reviewed by Justin Laube, MD

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