The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis

## Abstract ## Background Overweight and obese persons are at risk of a number of medical conditions which can lead to further morbidity and mortality. The primary objective of this study is to provide an estimate of the incidence of each co-morbidity related to obesity and overweight using a meta-analysis. ## Methods A literature search for the twenty co-morbidities identified in a preliminary search was conducted in Medline and Embase (Jan 2007). Studies meeting the inclusion criteria (prospective cohort studies of sufficient size reporting risk estimate based on the incidence of disease) were extracted. Study-specific unadjusted relative risks (RRs) on the log scale comparing overweight with normal and obese with normal were weighted by the inverse of their corresponding variances to obtain a pooled RR with 95% confidence intervals (CI). ## Results A total of 89 relevant studies were identified. The review found evidence for 18 co-morbidities which met the inclusion criteria. The meta-analysis determined statistically significant associations for overweight with the incidence of type II diabetes, all cancers except esophageal (female), pancreatic and prostate cancer, all cardiovascular diseases (except congestive heart failure), asthma, gallbladder disease, osteoarthritis and chronic back pain. We noted the strongest association between overweight defined by body mass index (BMI) and the incidence of type II diabetes in females (RR = 3.92 (95% CI: 3.10–4.97)). Statistically significant associations with obesity were found with the incidence of type II diabetes, all cancers except esophageal and prostate cancer, all cardiovascular diseases, asthma, gallbladder disease, osteoarthritis and chronic back pain. Obesity defined by BMI was also most strongly associated with the incidence of type II diabetes in females (12.41 (9.03–17.06)). ## Conclusion Both overweight and obesity are associated with the incidence of multiple co-morbidities including type II diabetes, cancer and cardiovascular diseases. Maintenance of a healthy weight could be important in the prevention of the large disease burden in the future. Further studies are needed to explore the biological mechanisms that link overweight and obesity with these co-morbidities. Common sense tells us that to lose weight, we must eat less and exercise more. But somehow we get stalled. We start on a weight-loss program with good intentions but cannot stay on track. Neither the countless fad diets, nor the annual spending of $50 billion on weight loss helps us feel better or lose weight. Too many of us are in a cycle of shame and guilt. We spend countless hours worrying about what we ate or if we exercised enough, blaming ourselves for actions that we can't undo. We are stuck in the past and unable to live in the present--that moment in which we do have the power to make changes in our lives. With Savor, world-renowned Zen master Thich Nhat Hanh and Harvard nutritionist Dr. Lilian Cheung show us how to end our struggles with weight once and for all. Offering practical tools, including personalized goal setting, a detailed nutrition guide, and a mindful living plan, the authors help us to uncover the roots of our habits and then guide us as we transform our actions. Savor teaches us how to easily adopt the practice of mindfulness and integrate it into eating, exercise, and all facets of our daily life, so that being conscious and present becomes a core part of our being. It is the awareness of the present moment, the realization of why we do what we do, that enables us to stop feeling bad and start changing our behavior. Savor not only helps us achieve the healthy weight and well-being we seek, but it also brings to the surface the rich abundance of life available to us in every moment. A Buddhist Leader And A Harvard Nutritionist Offer Cutting-edge Science And Deep Buddhist Wisdom On The Subject Of Eating With One's Health And The Welfare Of The Planet In Mind. Pt. 1. A Buddhist Perspective On Weight Control. Ending Your Struggle With Weight -- Are You Really Appreciating The Apple? An Apple Meditation. -- You Are More Than What You Eat -- Stop And Look : The Present Moment -- Pt. 2. Mindful Action Plan. Mindful Eating -- Mindful Moving -- Mindful Living Plan -- Pt. 3. Individual And Collective Effort. A Mindful World. Thich Nhat Hanh And Lilian Cheung. Includes Bibliographical References (p. [267]-283) And Index