Obesity-related Comorbidities and Treatment: An Overview

Nearly 40% of US adults live with obesity, making it the most common chronic disease in America. While common, obesity is also a complex condition that can diminish nearly every aspect of health, from respiratory function to memory and mood. When we think of the health risks associated with obesity, cardiovascular disease (CVD) may be what comes to mind first, however, there are several diseases where the link to obesity may be less well recognized. These comorbid conditions range from gallbladder disease, gout, and arthritis to polycystic ovary syndrome, cataracts, and many cancers.

Whether common or uncommon, the diseases linked to obesity may either co-occur independently, even though there are shared risk factors, or arise due to excess weight. In cases where the condition is secondary to obesity, treating obesity affects—and often resolves—the disease, including type 2 diabetes mellitus (T2D), obstructive sleep apnea (OSA), and fatty liver disease. Other common comorbidities that can be resolved through obesity treatment include hypertension, coronary artery disease, heart failure, and atrial fibrillation. Other conditions that may accompany excess weight, such as depression, anxiety, osteoarthritis, inflammatory diseases, infertility, and cancer, may have other causes and so may not be resolved by weight loss treatment.

There are different treatment paths for addressing obesity and associated diseases. In some cases, clinicians choose a medication that targets obesity and the comorbidity. For example, GLP-1 receptor agonists can help patients with obesity and T2D lose weight and lower their blood sugar. In other cases, treating obesity and the comorbid complication separately achieves optimal results. For example, the treatment of OSA can enhance the treatment of obesity and treating arthritis can enable patients with obesity to be more active. The types of dietary changes that are important in treating obesity may also address conditions such as gout.

In many cases the co-occurrence of other diseases with obesity may help clarify for patients that obesity is more than a weight issue. Similar to cancer, there are a number of factors involved in the development of obesity, including genetics, epigenetics, and environmental factors, that combine to predispose patients to the disease. The consequences are about the excess weight, of course, and also about the risks of suffering from additional common and serious diseases.

Discover more about the intersection of obesity and other areas of health at the spring conference of the Obesity Medicine Association (OMA). To learn more, visit https://obesitymedicine.org/spring/.