Co-Morbidities

Cardiac

• High blood pressure (hypertension)
• Heart disease (coronary artery disease- CAD)
• Heart attack
• Stroke
• Cardiomyopathy

Pulmonary

• Obstructive sleep apnea (OSA)
• Asthma
• Respiratory insufficiency
• Obesity hypoventilation syndrome (Pickwickian syndrome)

Endocrine/Metabolic

• Type II Diabetes Mellitus
• Metabolic Syndrome
• High cholesterol
• High triglycerides
• Dyslipidemia
• Insulin resistance

Musculoskeletal

• Arthritic degeneration of hips, knees, other joints including ankles and feet
• Disk herniation
• Chronic lower back pain

Gastrointestinal/Abdominal

• GERD-gastroesophageal reflux disease
• Acid reflux (heart burn)
• Hiatal hernia
• Gallstones
• Recurrent abdominal wall hernias
• NASH- non-alcoholic steatohepatitis/liver failure

Genito-Urinary

• Menstrual irregularity
• Infertility
• PolyCystic Ovarian Syndrome (PCOS)
• Stress urinary incontinence
• Frequent urinary track infections (UTI’s)

Cancer

• Breast
• Colon
• Uterine
• Prostrate

Skin

• Rashes
• Fungal infections
• Paniculitis
• Venous stasis disease

Neurologic

• Psuedotumor cerebri (Benign Intracranial Hypertension)
• Stroke

Psycho-Social/Emotional

• Depression
• Low self esteem
• Quality of life issues
• Social effects, including discriminations

Sudden Death

Many, if not all of these disorders, can be expected to improve with weight loss. Many will resolve entirely. Unfortunately, non operative approaches to weight loss in this extreme overweight group rarely result in significant sustained weight loss. After failure of non operative medical treatment, weight loss surgery is then considered reasonable and appropriate.