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Morbid Obesity

Digestive Health
Heart & Vascular Health
Contributed byKrish Tangella MD, MBAJan 15, 2019

What are the other Names for this Condition? (Also known as/Synonyms)

  • Extreme Obesity
  • Grade 3 Overweight
  • Severe Obesity

What is Morbid Obesity? (Definition/Background Information)

  • Morbid Obesity is a condition when an individual weighs twice or thrice his/her ideal body weight (a body mass index between 20 to 25)
  • This condition interferes with one’s normal physiological activities and can potentially lead to the development of serious endocrine and cardiac disturbances, as well as some forms of cancerSome risk factors for developing Morbid Obesity include genetic predisposition for obesity; eating foods that are not nutrient-dense, but high in calories; and a lack of adequate sleep
  • Hormonal abnormalities, issues with metabolism, lack of regular physical activity, psychological problems, and eating disorders are some known causes of Morbid Obesity
  • The typical symptoms associated with Morbid Obesity include shortness of breath, high blood pressure, depression, and a lack of self esteem. The body mass index or BMI is the most reliable indicator of Morbid Obesity diagnosis
  • Diet control, exercise, enrolling in weight-loss programs, and weight loss surgery are some frequently recommended treatment options for the condition
  • Morbid Obesity can lead to complications that include heart conditions, respiratory issues, and metabolic syndromes such as diabetes. Therefore, for a good long-term outcome, an individual is generally advised to follow a diet plan and continue exercising, even after the ideal body weight is achieved

Who gets Morbid Obesity? (Age and Sex Distribution)

  • Morbid Obesity can occur at any age; it is even observed in very young individuals
  • The condition is not specific to a gender and both males and females are affected
  • There is no specific preference for any race or ethnicity

What are the Risk Factors for Morbid Obesity? (Predisposing Factors)

The following are some known risk factors for developing Morbid Obesity

  • Poor diet: Increased intake of high calorie and low nutrient foods
  • Sedentary lifestyle: A lack of physical activity leading to less calories being burnt than consumed, thus increasing the risk of an individual becoming obese
  • Improper sleep: Irregular timing or lack of proper sleep
  • Genes: Hereditary or genetic factor may also play a role in obesity

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Morbid Obesity? (Etiology)

Research around the world has shown that one or more of the following factors can contribute to the development of Morbid Obesity:

  • Poor nutrition
  • Hormonal issues such as hypothyroidism
  • Psychological problems that include depression
  • Lack of exercise
  • Inadequate sleep or sleeping problems
  • Eating disorders that include binge eating
  • Metabolic abnormalities
  • Genetic factors
  • Pregnancy and menopause

What are the Signs and Symptoms of Morbid Obesity?

Some typical signs and symptoms associated with Morbid Obesity include:

  • Having a body configuration that indicates obesity
  • Low self-esteem
  • High blood pressure signs and symptoms related to Morbid Obesity that include:
    • Headache
    • Lack of energy or altered mental status
    • Light-headedness
    • Chest pain and rapid heart rate (in some individuals)
  • Osteoarthritis causing pain, stiffness, and swelling in the joints
  • Depression that may lead to insomnia, irritability, crying or anger outbursts, and reduced sex drive
  • Heart failure signs and symptoms related to Morbid Obesity that include:
    • Shortness of breath
    • Fatigue (tiredness)
    • Swelling in the legs
  • The quality of life is moderately to severely affected

How is Morbid Obesity Diagnosed?

  • The most common method for a physician to diagnose Morbid Obesity is through body mass index (BMI) assessment. BMI is a weight suggestion chart based on height, age, and sex
  • If an individual has a BMI of 40 or more, or a BMI of 35 or higher and shows certain symptoms, then the individual is diagnosed as morbidly obese

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Morbid Obesity?

Morbid Obesity can result in several physiological and psychological complications that include:

  • Heart diseases: Hypertension is common in obese individuals. It may lead to heart attack, congestive heart failure, stroke, or arterial blockage
  • Diabetes: Type II diabetes is 10-times more common in individuals who are obese than those who are non-obese. Elevated blood sugar levels may sometimes lead to kidney failure, blindness, and tissue damage throughout the body
  • Cancer: Research has reported that women who are obese have a higher risk of breast, ovarian, and uterine cancers. Similarly, research from around the world indicates that men who are obese have a higher risk of esophageal, colon, and prostate cancers
  • Infertility: Women may experience changes in sex hormone levels; this can potentially lead to irregular menstrual cycles and infertility
  • Degenerative arthritis: Morbid Obesity can cause damage to the lower back and joints leading to degenerative arthritis. Osteoarthritis of spine can cause chronic pain due to nerve compression
  • Obesity hypo-ventilation syndrome occurs in those who weigh over 350 pounds or more. This condition may cause blood thickening and lung failure
  • Respiratory conditions: Sleep apnea, asthma, and  bronchitis are common respiratory conditions observed in those who are obese
  • Venous stasis causing varicose veins of the legs
  • Gastroesophageal reflux disease with associated signs and symptoms

How is Morbid Obesity Treated?

Morbid Obesity is generally treated using the following measures:

  • Proper diet control
  • Weight loss programs (long-term)
  • Weight loss surgery (in case of severe Morbid Obesity)
  • Pharmacologic therapy using medications
  • Treating associated complications such as:
    • Electrolyte imbalance such as decreased potassium levels (hypokalemia)
    • Hyperuricemia, which increased blood uric acid levels
    • Psychological sequelae or associated mental depression and emotional stress
    • Signs and symptoms due to gallstones (cholelithiasis)

How can Morbid Obesity be Prevented?

Following measures may help prevent Morbid Obesity from developing:

  • Regular exercise, which should be performed daily, if possible
  • Following a proper diet and healthy lifestyle
  • Avoiding out-of-control eating of ‘high in fat’ food content, more so if you are obese
  • Regular monitoring of weight

What is the Prognosis of Morbid Obesity? (Outcomes/Resolutions)

The prognosis for Morbid Obesity depends upon the associated complications and response to weight loss treatment.

  • Individuals with severe underlying complications and/or those who do not respond to treatment have poorer prognosis
  • Those who are severely obese have a risk of dying from a heart attack 40 times greater than those who are not obese
  • Repeated losing and regaining of weight encourages the body to store fat and may increase the risk of developing heart disease
  • Individuals who lose weight and do not continue regular physical activity are reported to regain their lost weight within two years

Therefore, the primary factor in maintaining weight loss is a long-term commitment to regular exercise and proper eating habits.

Additional and Relevant Useful Information for Morbid Obesity:

  • Bariatric surgery is a surgical procedure where the stomach size is either reduced, resected, and/or its intake volume limited, to ensure a critical weight loss. Hence, it is also known as weight loss surgery

The following article link will help you understand bariatric surgery:


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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team


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