Overweight and obesity are associated with chronic diseases such as diabetes, Diabetes signi cantly increases the risk. for heart disease and stroke, and is the …
Chapter Two: Overweight and Obesity and Co-Existing Chronic Diseases
Chapter Two: Overweight and Obesity and Co-Existing Chronic Diseases
Overweight and obesity are associated with chronic diseases such as diabetes, hypertension, stroke, heart disease, arthritis, asthma, and some cancers In addition, overweight or obese people are at increased risk for illness and death due to violence and injury
d diabetes
Type 2 diabetes, once considered Diabetes significantly increases the risk an adult disease, is now also seen in for heart disease and stroke, and is the children leading cause of new cases of blindness It is estimated that almost one-half of among working age adults In 2000-2001 all new childhood diabetes cases are about 82,000 nontraumatic lower-limb classified as type 226 Evidence suggests this increase is a result of the emerging amputations were performed annually childhood obesity epidemic Children among people with diabetes24,25 with diabetes will potentially be affected The prevalence of diabetes and obesity by the burden of diabetes for a greater increased dramatically from 1989-2004, in proportion of thier lives compared to adults with Figure 6 Percentage of Adults
With Diabetes by Weight Category, diabetes These Utah 2004 diabetic children will require expensive, potent, and sometimes complicating medication for most of thier lives The impacts on their health and on the health care system, will be Source: Utah BRFSS 2004; Age-adjusted to 2000 population significant26
Overweight is defined as a BMI of 250-299 and obese is defined as a BMI of 30
Obesity can lead to type 2 diabetes Obesity is a major risk factor for developing type 2 diabetes previously called noninsulin-dependent diabetes mellitus or maturity-onset diabetes Type 2 diabetes is often considered a lifestyle disease and is associated with overweight and obesity, physical inactivity, and poor dietary habits The prevalence of diabetes is dramatically higher in obese and overweight people See Figure 6 In fact, nationally 80 percent of people with diabetes are overweight22,23
part due to the increase in obesity during the same time period See Figure 7 Several factors are contributing to the increased prevalence of diabetes: an increase in the precentage of people who are obese, an increase in the number of people being screened, and diagnosis earlier in life Additionally, the
increase in the proportion of racial and ethnic minorities in the population who are at higher risk for diabetes leads to a higher overall incidence of diabetes
Tipping the Scales Toward a Healthier Population in Utah Page 9
Chapter Two: Overweight and Obesity and Co-Existing Chronic Diseases Figure 7
Adult Diabetes and Obesity Prevalence Over Time, Utah and US 1989-2004
Source: BRFSS 1989 to 2004; Age-adjusted to the 2000 population Obese is defined as a BMI of 30
hypertension, stroke, and heart disease h
Being overweight or obese increases the risk of high cholesterol, hypertension high blood pressure, cardiovascular disease, angina, heart attack, and stroke The prevalence of high cholesterol is greater in overweight and obese adults than those of ideal weight See Figure 8 The most recent data show that 329 percent of Utahns who were obese had high cholesterol levels compared to 197 percent of those who were at their ideal weight This is also true for high blood pressure In Utah, 339 percent of people who were
obese had high blood pressure, compared to 142 percent of those who were at their ideal weight Since high cholesterol and high blood pressure are associated with
cardiovascular disease, angina, heart attack, and stroke, it is important to maintain both cholesterol levels and blood pressure within normal ranges Unfortunately, across all weight categories, there appears to be a fairly large number of people with untreated high blood pressure Obese people have more angina heart pain than those at ideal weight There may
Figure 8
Percentage of Adults with High Cholesterol or High Blood Pressure by Weight Category, Utah 2001-2003
Source: Utah BRFSS 2001 to 2003; Age-adjusted to the 2000 population Overweight is defined as a BMI of 250-299 and obese is defined as a BMI of 30
Page 10 Tipping the Scales Toward a Healthier Population in Utah
Chapter Two: Overweight and Obesity and Co-Existing Chronic Diseases Figure 9
Percentage of Adults with Angina, Heart Attack, or Stroke by Weight Category, Utah 2001-2003
also be an increased risk of heart attack in obese people compared to those at ideal weight See Figure 9 Obesity in youth is also related to elevated blood cholesterol levels and high blood pressure which could lead to cardiovascular disease in young adults27
Source: Utah BRFSS 2001-2003; Age-adjusted to 2000 population Overweight is
defined as a BMI of 250-299 and obese is defined as a BMI of 30
a arthritis
Being overweight or obese increases the risk for certain types of arthritis Osteoarthritis, a slowly evolving degenerative disease, is the most common form of arthritis, and is a major cause of pain and physical disability in older adults The relationship between obesity and osteoarthritis may be explained in two ways First, a person who is overweight
or obese has increased force exerted on their joints, which may result in a breakdown of cartilage; and second, an overweight or obese person may have increased bone mineral density, which is a possible risk factor for osteoarthritis28 Although this may explain damage to the knee and/or hip joints, it does not explain increased arthritis of the hand observed in overweight or obese persons Utah survey data BRFSS 20022003 suggest that overweight or obese adults may be more likely to have arthritis than adults at ideal weight See Figure 10 Additionally, women are more likely to report arthritis than men across all weight categories
Figure 10
Percentage of Adults With Doctor-Diagnosed Arthritis by Gender and Weight Category, Utah 2002-2003
Source: Utah
BRFSS 2002-2003; Age-adjusted to 2000 population Overweight is defined as a BMI of 250-299 and obese is defined as a BMI of 30
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Chapter Two: Overweight and Obesity and Co-Existing Chronic Diseases Figure 11
Percentage of Adults with Doctor Diagnosed Arthritis by Age and Weight Category, Utah 2003
The percentage of adults with arthtitis increases with age for all weight categories See Figure 11 Across all age groups obese adults appear to be more likely to report arthritis than those at ideal weight
Source: Utah BRFSS 2003 Overweight is defined as a BMI of 250-299 and obese is defined as a BMI of 30
a asthma
Asthma leads to reduced physical activity Childhood and adult asthma is a growing health problem Asthma is one of the ten leading chronic conditions that results in physical activity limitation In 2004, about nine percent of Utahns were under medical care for asthma, including about eight percent of children29 Nationally, 125 percent of children 18 years of age have had
asthma diagnosed at some time during their lives30 About 223,000 Utahns are currently being tre 
ated for asthma, and 61,500 of these people
are aged 18 or under29 A total of 1,577 Utahns were hospitalized with asthma during 200331
Figure 12
Source: Utah BRFSS 2002-2004; Age-adjusted to 2000 population
It appears that more obese adults have asthma compared to those at an ideal weight See Figure 12 Although it is unclear whether obesity leads to asthma or asthma leads to obesity, unmanaged asthma may result in a decrease in Percentage of Adults with Asthma by Weight Category, activity that can Utah 2002-2004 lead to weight gain See Figure 13 Additionally, restricted physical activity may lead to asthma since only physical activity allows the lungs to fully expand Children who are overweight
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Chapter Two: Overweight and Obesity and Co-Existing Chronic Diseases Figure 13
Percentage of Adults with Asthma Who Met Physical Activity Guidelines by Weight Category, Utah 2001 and 2003
Source: Utah BRFSS 2001 and 2003; Age-adjusted to 2000 population Overweight is defined as a BMI of 250-299 and obese is defined as a BMI of 30
may have a higher prevalence of respiratory symptoms, including asthma Children with asthma and higher measures of BMI may miss more
school and take more prescription medications than children without asthma
c cancer
Obesity is associated with cancers of the colon, breast, endometrium lining of the uterus, kidney, and esophagus Since some studies show a decreased risk for cervical, gallbladder, prostate, and thyroid cancer in people with low-fat diets and/or a higher level of physical activity, an obesity link to these diseases is also suspected Obesity is associated with Hodgkins disease in men; non-Hodgkins lymphoma in women; and cancers of the pancreas, bladder, ovary, brain, liver, small
intestine, and larynx in both men and women32-38 Overall a 33 percent excess incidence of cancer was seen in obese persons33 Studies have also shown that overweight and obesity may also increase the risk of death from cancer34, 39-40 See Figure 14 One study concluded that the current pattern of obesity accounts for 14 percent of cancer deaths in men and 20 percent of cancer deaths in
Figure 14
Mortality Risk from Any Cancer by Gender and Weight Category, US 1982-1998
Source: Cancer Prevention Study II 1982 to 1998; New England Journal of Medicine April 24, 2003 volume 348, No 1740
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Population in Utah Page 13
Chapter Two: Overweight and Obesity and Co-Existing Chronic Diseases women40 Unfortunately, only one of four individuals is aware that obesity is a cancer risk32 Obesity may play a significant role in predisposing men and women to certain types of cancer For example, obese men have a 40 percent higher risk of developing colon cancer than do men at ideal weight34 Obese men are also less likely to survive prostate cancer than men who are not obese38 Prior to menopause, obese women have a lower risk of developing breast cancer than do women at ideal weight, but after menopause this tendency reverses Postmenopausal obese women are 150 percent more likely to develop breast cancer35 Obese women are also two to five times more likely to develop endometrial cancer than are non-obese women, particularly if they are postmenopausal37 Distribution of body fat, especially in the abdominal area, may increase breast cancer risk for women35,36 Finally, obese womens overall risk of cancer may be higher than mens; in a long-term study of almost 30,000 patients, 37 percent of obese women developed cancer compared to 25 percent of obese men33
v violence injury
Obesity can
increase the risk of injury Obese and overweight people may be at higher risk for injury and deaths related to motor vehicle crashes MVC Injury can result from the use of emergency medical equipment that is not designed to handle obese people Additionally, obese people may be more vunerable to weight-based teasing and social isolation, thereby resulting in low self-esteem, depression, and suicide41
to die or to be seriously injured in a MVC than those with a BMI less than 2047 According to the Royal Automibile Club RAC Foundation, overweight persons are more likely to suffer from sleep disorders, such as sleep apnea, which increases the likelihood of falling asleep while driving47 Obese persons are also
Obese people are less likely to wear seatbelts when driving Motor vehicle crashes are the leading cause of injury deaths in Utah and the second leading cause of injury hospitalizations in the US42 BMI is associated with an increased risk of injury or death resulting from MVCs People who are considerably larger than the 50th percentile in height and weight are at increased risk for more severe injuries and even death resulting from MVCs43-48 Obese people were almost twice as likely
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Chapter Two: Overweight and Obesity and Co-Existing Chronic Diseases more difficult for emergency personnel to remove from crashed vehicles, and using medical stretchers designed for people at ideal weights may result in injury for both overweight or obese patients, and emergency responders49 Since motor vehicle manufacturers design vehicle cabins and equipment based on the average male, overweight and obese persons are at increased risk for injury and death resulting from MVCs Based on the Utah BRFSS data, obese Utahns use seatbelts less often than non-obese people See Figure 15 They are nearly twice as likely to report Sometimes, Seldom or Never when asked about current seat belt usage than are those who are at their ideal weight 142 percent compared to 74 percent Overweight and obese children suffer early and systematic discrimination, resulting in low self-esteem and depression, which continues into adolescence Being overweight or obese may contribute to teen suicide According to the Center for Disease Control and Prevention, suicide is the second leading cause of teen death in Utah41 A study of junior high and
high school students demonstrated that teasing about body weight was consistently associated with low body satisfaction, low self-esteem, depression, suicidal thoughts, and suicide attempts Rates of suicidal thoughts and attempts associated with weight-based teasing were two to three times higher among those who were teased by peers and family compared with those who were not teased41 Futhermore, it is well documented that many obesityrelated chronic diseases, such as arthritis, heart disease, and stroke, often result in physical disability and difficulty participating in social activities This can isolate individuals mentally and emotionally and may contribute to mental health problems
Figure 15
Percentage of Adults Who Wear Seatbelts Sometimes, Seldom, or Never by Weight Category, Utah 2002
Source: Utah BRFSS 2002; Age-adjusted to 2000 population Overweight is defined as a BMI of 250-299 and obese is defined as a BMI of 30
Tipping the Scales Toward a Healthier Population in Utah Page 15
Source:health.utah.gov
