What are the effects of morbid (Mx) obesity?

From the Guidelines

Morbid obesity is associated with a significantly higher risk of cardiovascular disease, cardiovascular morbidity, and mortality, with a competing hazard ratio of 3.14 for men and 2.53 for women, and is also associated with a shorter overall lifespan. The effects of morbid obesity are multifaceted, including an increased risk of developing cardiovascular disease at an earlier age, and a higher risk of adverse clinical outcomes in patients with coronary artery disease 1.

Key Findings

• Morbid obesity is defined as a body mass index (BMI) of 40 or greater, and is associated with a higher risk of comorbidities and premature mortality 1.
• The risk of cardiovascular disease is higher in individuals with morbid obesity, with a competing hazard ratio of 3.14 for men and 2.53 for women 1.
• Morbid obesity is also associated with a shorter overall lifespan, and being overweight is associated with developing cardiovascular disease at an earlier age 1.
• Intentional weight loss is associated with a significantly lower risk of adverse clinical outcomes, and has beneficial effects on risk-factor control and quality of life 1.

Management

• Healthy diets with energy intake limited to the amount needed to obtain and maintain a healthy weight, and combined with increasing physical activity, are recommended for weight management 1.
• Pharmacological treatment with glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide and tirzepatide, may be considered for further weight reduction 1.
• Bariatric surgery in severe obesity appears to be a safe and effective intervention for further weight loss in patients with coronary artery disease 1.
• Cardiac rehabilitation programmes should include weight-loss interventions to reach a healthy weight as a specific component 1.

Treatment Options

• Medications for obesity treatment include GLP-1 receptor agonists like semaglutide and tirzepatide, which work by reducing appetite, increasing feelings of fullness, and slowing gastric emptying 1.
• Other options include orlistat, which blocks fat absorption, and phentermine-topiramate, which suppresses appetite 1.
• These medications should be used alongside lifestyle modifications, including calorie reduction and increased physical activity, and are generally indicated for patients with BMI ≥30 kg/m² or BMI ≥27 kg/m² with weight-related comorbidities 1.

From the Research

Effects of Morbid Obesity

The effects of morbid obesity are numerous and can have a significant impact on an individual's health. Some of the key effects include:

• Increased risk of chronic conditions such as cardiovascular disease, type 2 diabetes, and hyperlipidemia 2
• Difficulty in achieving and sustaining successful long-term weight loss through lifestyle modifications alone 3, 4
• Need for a comprehensive treatment strategy that incorporates lifestyle changes, pharmacological approaches, and potentially surgical interventions 3, 4

Health Risks Associated with Morbid Obesity

Morbid obesity is associated with a range of health risks, including:

• Cardiovascular disease 2
• Type 2 diabetes 2, 5
• Hyperlipidemia 2
• Increased risk of mortality 3

Treatment Options for Morbid Obesity

Treatment options for morbid obesity include:

• Lifestyle modifications such as diet and exercise 3, 4, 2, 5
• Pharmacological approaches, including anti-obesity drugs such as orlistat, naltrexone/bupropion, and liraglutide 3, 4, 6
• Surgical interventions, which may be necessary in cases of morbid obesity 4