Your browser is out of date
With an updated browser, you will have a better Medtronic website experience. Update my browser now.
Obesity-related diseases
A comorbidity (or multi-morbidity) occurs when you have two or more diseases or conditions at the same time. While some comorbidities may be unrelated, many share common risk factors. For instance, individuals with weight problems are more likely to experience comorbidities such as type 2 diabetes, heart disease, and sleep apnoea.2
In Australia, comorbidities are quite common, with the Australian Bureau of Statistics reporting that 20% of Australians (4.9 million people) have one or more chronic conditions.3 Women and older adults are particularly at risk. Depending on their severity, comorbidities can significantly affect your wellbeing and even shorten your lifespan.
Type 2 diabetes is a chronic illness that causes blood sugar levels to be higher than normal.
After most people eat, their bodies break down food into glucose and other nutrients. Eating triggers the pancreas to create a hormone called insulin, which helps release glucose into the bloodstream.
In type 2 diabetes, the body becomes resistant to insulin. This means it becomes less effective in managing the blood glucose levels.
The pancreas tries to help by producing more and more insulin. However, over time, the pancreas wears out. It’s estimated that
by the time a person is diagnosed with type 2 diabetes, they’ve lost 50 – 70% of the insulin-producing cells in their pancreas4.
There is a strong link between obesity and type 2 diabetes, as obesity is a leading risk factor for diabetes5. For example, if you’re a woman with a BMI of over 30 kg/m2, you have a 28 times greater risk of developing diabetes than a woman with a healthy BMI5.
Over half (53%) of diabetes in Australia is because of excess weight6.
You have a higher risk of developing diabetes if it runs in your family. It’s also more common in people from Pacific Island, Indian subcontinent, Chinese cultural, Aboriginal or Torres Strait Islander backgrounds4.
You may be at higher risk of developing type 2 diabetes if you have high blood pressure, have a poor diet, don’t get enough exercise and are overweight4.
Diabetes can affect many parts of your body. People with diabetes are more likely to experience heart, kidney and vision problems. Amputations are also much more common with people with diabetes7.
Many people with diabetes also suffer from mental health conditions such as anxiety and depression7.
Unfortunately, type 2 diabetes can’t be cured, but you can manage it with healthy eating, exercise and medications.
Sometimes you can go into remission. According to Diabetes Australia, people have gone into remission after intensive dietary change or bariatric surgery. They say remission is more likely within the first few years of diagnosis with type 2 diabetes8.
Weight loss studies have shown a significant proportion of people were still in diabetes remission even 7 to 10 years after their surgery 9 10 11.
Sleep apnoea, also known as obstructive sleep apnoea, is a sleep disorder where your throat is partially or completely obstructed during sleep. When these obstructions occur, it can stop breathing from anywhere from 10 seconds to a minute or more12.
During sleep, you wake up briefly, then fall back asleep. These incidents can happen hundreds of times a night.
One of the major contributors to sleep apnoea and snoring are obesity. It’s estimated that 58% of moderate-to-severe sleep apnoea is caused by obesity13.
The reason is mainly because higher fat levels and decreased muscle activity in the upper respiratory tract narrow the airway14. This can also contribute to snoring as it makes your throat narrower and allows it to vibrate more easily. The narrower the throat, the louder you snore15.
Sleep apnoea can occur at any age, although in children it’s usually because of large tonsils or adenoids16. It can run in families and can be affected by the size and positioning of your neck, jaw, tongue and tonsils. It is more likely to occur in men than women17.
You are also more likely to suffer from sleep apnoea if you smoke18, sleep on your back and use sedatives, including alcohol19. Hormone conditions such as hypothyroidism20 can also increase the risk of sleep apnoea.
Sleep apnoea can increase your risk of other diseases, including heart disease, high blood pressure, stroke and diabetes. Lack of sleep can also lead to low mood and irritability. Studies have found that people with sleep apnoea are more likely to be involved in car accidents21.
There are no cures for sleep apnoea but fortunately, it is a treatable condition. The first advice doctors often give is to lose weight22. Decreasing alcohol consumption in the evening and adjusting the sleeping position can also help22.
Other sleep apnoea treatments include a nasal continuous positive airway pressure machine which uses gentle pressure and a mask to keep your airway open overnight. There is also a mandibular advancement device or oral appliance, which is like a mouth guard. It’s fitted by a specialist dentist and helps keep your airway open22.
It’s advisable to talk to your doctor about sleep apnoea treatments and what might be best in your circumstances.
Heart disease is a range of conditions that affect the structure and function of the heart muscle.
Heart disease includes:
In 2015, obesity contributed 25% of the disease burden associated with coronary heart disease24 and excess body fat is a considerable risk factor for heart disease.
Being overweight or obese can increase the fatty build up in your arteries. This can lead to higher cholesterol or higher blood pressure. These can all increase your likelihood of a heart attack25.
There are many risk factors of developing heart disease. Some of it is out of your control. Some heart diseases can be genetic, so you’re more likely to develop it if it runs in your family. There are also some ethnicities that are more likely to develop heart disease, such as people from South Asian, Middle Eastern, Maori or Pacific Islander descent. Heart disease is also high in Aboriginal and Torres Strait Islander peoples in Australia25.
There are many lifestyle factors you can control to reduce your risk of heart disease. These include smoking, unhealthy diet, being inactive, unhealthy weight and drinking alcohol excessively25.
Heart disease is the leading cause of death in Australia23 so it’s important that we do all we can to prevent it. It can also lead to ongoing health problems that may require lifelong care.
Unfortunately, there isn’t a cure for heart disease. However, depending on the condition, you can manage it with medication or surgery and lifestyle improvements.
Many risk factors for heart disease can be prevented though, so it’s important to reduce your risk of heart disease by improving your health and losing weight25.
Blood pressure is the pressure on your arteries as your blood is pumped around your body26. Although your blood pressure will vary depending on what you’re doing, if it’s consistently high, you may be told you have high blood pressure or hypertension.
Blood pressure is measured by two numbers, such as 120/80. The larger number is the systolic blood pressure, which is the pressure as your heart pumps blood out.
The lower number is the pressure as your heart relaxes. This is called diastolic blood pressure.
Hypertension is diagnosed when you receive a blood pressure reading on two separate days that shows a systolic reading of equal or over 140/mmHg and/or a diastolic reading of equal or over ≥90 mmHg27.
Over one in five Australians have measured a high blood pressure reading28.
Being overweight or obese is a major risk factor in developing hypertension or high blood pressure. One study found that obesity may be responsible for 78% of hypertension in men and for 65% of hypertension in women29.
The hormone leptin regulates the amount of fat stored in the body. When a person gains weight, leptin rises, which increases blood pressure30.
There are many ways to lower the risk of developing high blood pressure. Risk factors for high blood pressure include eating an unhealthy diet high in salt, not getting enough exercise, smoking, drinking too much alcohol and being overweight or obese27.
There are also blood pressure risk factors that are out of your control. Hypertension can run in families and Indigenous adults are also more likely to have high blood pressure than non-indigenous adults31. Uncontrolled high blood pressure is more common in the lowest socioeconomic areas31.
High blood pressure puts you at increased risk of developing heart disease or having a stroke. The increased pressure on the heart can lead to chest pain, a heart attack, heart failure, and even sudden death27.
Hypertension can also put pressure on your kidneys, leading to kidney failure27.
There are many things you can do to prevent high blood pressure or help lower it if you have it. It’s important to eat a healthy diet that is low in salt, saturated fats and processed foods and high in fresh fruits and vegetables. You could become more physically active and reduce your consumption of alcohol and tobacco.
As obesity and high blood pressure are closely related, losing weight can be directly linked to decreasing blood pressure32.It’s important to look after your other comorbidities, such as diabetes and mental health, as they can all contribute to higher blood pressure.
There are also medications to help lower blood pressure.
Infertility is when a couple isn’t able to fall pregnant after at least 12 months of trying33.
It’s estimated one in nine Australian couples of reproductive age will experience infertility34.
Although there are many causes for infertility, there is a well-known link between obesity and fertility in females.
Obesity can affect ovulation and menstruation because of hormone imbalances. Studies have found women with a higher BMI are three times more likely to have difficulties conceiving35.
When a woman gets pregnant, obesity is also linked to higher rates of miscarriage36, pregnancy complications and increased risk of birth defects and admission to neonatal intensive care37.
There is also a connection between obesity and male fertility. Men with a higher BMI are also more likely experience to infertility38. Sleep apnoea, hormone changes and a higher scrotum temperature can affect the number of sperm and how they move.
There can be many causes of infertility. For women, it can be affected by age, endometriosis, ovulation issues caused polycystic ovarian syndrome, obesity or thyroid disfunction, fibroids, problems with your fallopian tubes, pelvic inflammatory disease or a sexually transmitted infection39.
For men, your fertility can be impacted by genetic problems, low sperm count, high numbers of abnormal sperm if you make antibodies that attack sperm, problems with your sperm DNA and issues with the tubes that connect to the testes39.
According to IVF Australia, in 40% of couples the cause of infertility will be attributed to the sperm, in another 40% the cause is from the female reproductive system. A third of couples will have a combination of male and female factors39.
When you want to have a baby and can’t, it can affect every part of your life. People with infertility report feeling more depressed, anxious and stressed40.
Going through fertility treatments can also affect your self-esteem, relationship, and finances. It can lead to a feeling of loss of control and lower self-worth41.
Studies have found that even small amounts of weight loss can improve pregnancy outcomes42. Many fertility specialists will recommend weight loss if it’s suspected to be contributing to your infertility.
Other fertility treatments include ovulation tracking, medicines to encourage ovulation, artificial insemination, invitro fertilisation and surgery39.
Polycystic Ovarian Syndrome (PCOS) is one of the most common reproductive conditions. 8-13% of women are affected by it, and it’s suspected 70% of affected women are undiagnosed43.
PCOS is because of a hormone imbalance in the ovaries. Women with PCOS usually have higher levels of insulin and/or androgens, which are male hormones. These hormones mean your ovaries and eggs don’t work normally.
Women with PCOS also often have enlarged ovaries with many small fluid-filled follicles on them.
Obesity has a strong link with PCOS. Obesity can increase insulin resistance and can hyperandrogenism, which may increase the prevalence of PCOS43.
It’s not known whether obesity causes PCOS or PCOS causes obesity or whether both are true. Generally, women with PCOS are more likely to be overweight and obese43. They’re also more likely to gain weight44 and find it difficult to lose weight45.
Doctors aren’t exactly sure what causes PCOS. There is evidence that genes play a role, as do lifestyle choices and the environment46.
Many women with PCOS are insulin resistant47 which is also often caused by obesity.
It’s also more often seen in Indigenous women, possibly because of higher obesity and insulin resistance in these populations48.
PCOS is one of the leading causes of infertility in women. It can also increase the risk of you developing diabetes, cardiovascular disease and metabolic syndrome. There are links between PCOS and depression and sleep apnoea49.
There is also a two to six-fold increased risk of endometrial cancer for women with PCOS43 although the risk is still relatively low.
If you have obesity and PCOS, it’s likely doctors will suggest weight loss as the first option43 if possible.
Other treatments may include the oral contraceptive pill, medication to block hormones, insulin sensitising medications, or infertility medications.
Anxiety and depression are two reasonably common mental health conditions. 13% of Australians have an anxiety related condition and 10% have depression or feelings of depression50.
Anxiety is common in new or challenging situations, and everyone experiences it from time to time. However, for people with an anxiety disorder, these anxious thoughts can become severe and can interrupt their daily life51.
Anxiety disorders can include Generalised Anxiety Disorder, specific phobias, panic disorder, Agoraphobia, Obsessive compulsive disorder (OCD) and social anxiety disorder52.
Although everyone feels sad every so often, depression is a serious mental health condition where a feeling of sadness and emptiness lasts for a long period. Depression can affect every facet of your daily life.
There are many links between obesity, depression, and anxiety. If you have obesity, you’re more likely to become depressed. People with depression are more likely to become obese53. It’s believed between 20% and 60% of persons with obesity suffer from a psychiatric illness54.
People with obesity face stigma in all areas of life, from education to personal relationships to healthcare55. This discrimination affects the confidence you have in your abilities and your self-worth. It can lead to loneliness56, lower self-esteem, depression, and anxiety57.
Mental health conditions like depression and anxiety are caused by a range of factors. Genes can play a part, as can the way the brain responds to stress and emotions.
A person is more likely to develop depression if they’ve experienced several stressful life events58. These life events can also act as a trigger for an anxiety disorder.
The way a person thinks, such as if they dwell on negative thoughts, worry excessively and have difficulty accepting uncertainty, may also increase the likelihood of them developing a mental health condition linked to depression or anxiety59.
Having poor mental health impacts every aspect of life. It impacts on day-to-day functioning, on relationships and general happiness.
Unfortunately, many mental health conditions are also linked to several other diseases, including heart disease and cancer60. This can affect your quality of life and even your life expectancy.
The more severe your depression or anxiety is, the higher your chances are of having various chronic diseases, particularly if you’re overweight or obese61. One study found men with obesity and depression had 7.6 times the risk of developing diabetes and 6.7 times the risk of developing high blood pressure62.
If you are experiencing depression and/or anxiety, it’s important to seek help. Speak to your GP about getting a referral to a psychologist or psychiatrist.
If you’re embarking on a weight loss treatment, it’s important that you also work on your mental health at the same time63.
