TABLE 2-1 Physical Health, Psychosocial, and Functional Consequences of Obesity Over the Life Course

Physical Health Psychosocial Functional

  Cardiovascular disease


  Glucose intolerance and insulin resistance

  Type 2 diabetes



  Hepatic steatosis


  Sleep apnea

  Reduction of cerebral blood flow

  Menstrual abnormalities

  Orthopedic problems

  Gallbladder disease

  Hyperuricemia and gout


  Negative stereotyping


  Teasing and bullying

  Social marginalization

  Low self-esteem

  Negative body image



  Mobility limitations


  Low physical fitness

  Absenteeism from school or work

  Disqualification from active service in the military and fire/police services

  Reduced productivity

  Reduced academic performance

SOURCE: Adapted from IOM, 2010a.

ditions, and is a major risk factor for cardiovascular diseases. High blood pressure affects a third of U.S. adults aged 20 and over and more than half of adults aged 55 and older. Together high blood pressure, coronary heart disease, heart failure, and stroke affect 37 to 39 percent of women and men aged 40 to 59 and 72 to 73 percent of women and men aged 60 to 79. Eight percent of adults have a diagnosis of type 2 diabetes, another 3 percent are undiagnosed, and an additional 37 percent have prediabetes (Roger et al., 2011). Both high blood pressure and diabetes (diagnosed and undiagnosed) increased between 1988-1994 and 2005-2008 at the same time that increases in obesity were observed (see below). And a growing literature suggests various types of reductions in brain structural integrity (due to low blood flow to the brain) among both obese adolescents and adults (Gunstad et al., 2006; Maayan et al., 2011; Willeumier et al., 2011). In addition to these physical risks, obese adults face discrimination in employment settings and are subjected to inappropriate slurs and humor (Puhl and Heuer, 2001; Wear et al., 2006).

Obese children and adolescents also suffer an array of obesity-related comorbidities, ranging from sleep apnea, to type 2 diabetes, to hypertension, to liver disease, to orthopedic problems. These conditions over time may contribute to

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