In an exhaustive review of the data, released in 2007, an expert panel assembled by the World Cancer Research Fund and the American Institute for Cancer Research concluded that there was convincing evidence of an association between obesity and cancers of the oesophagus, pancreas, colon and rectum, breast, endometrium, and kidney, and a probable association between obesity and gallbladder cancer. Abdominal obesity and weight gain during adulthood were also linked with several cancers. A later systematic review and meta-analysis confirmed direct associations between obesity and cancers of the breast, colon and rectum, endometrium, oesophagus, kidney, ovary, and pancreas.
An analysis of 17 cross-sectional studies found that people who were obese were more likely to have depression and mood swing than people with healthy weights. New evidence confirms that the relationship between obesity and depression may be a two-way street: A meta-analysis of 15 long-term studies that followed 58,000 participants for up to 28 years found that people who were obese at the start of the study had a 55 percent higher risk of developing depression by the end of the follow-up period, and people who had depression at the start of the study had a 58 percent higher risk of becoming obese.
Obesity can influence various aspects of reproduction, from sexual activity to conception issues like ovulatory infertility, is represented. In a Health Study, infertility was lowest in women with BMIs between 20 and 24, and increased with lower and higher BMIs. This study suggests that 25 percent of ovulatory infertility in the United States may be attributable to obesity. During pregnancy, obesity increases the risk of early and late miscarriage, gestational diabetes, preeclampsia, and complications during labour and delivery. It also slightly increases the chances of bearing a child with congenital anomalies. One small randomized trial suggests that modest weight loss improves fertility in obese women.
In a study of men by Hammoud and colleagues, the incidence of low sperm count (oligospermia) and poor sperm motility (asthenospermia) increased with BMI, from 5.3 and 4.5 percent, respectively, in normal-weight men to 15.6 and 13.3 percent in obese men.
Sexual function may also be affected by obesity. Data from the Health Professionals Follow-Up Study, the National Health and Nutrition Examination Survey (NHANES), and the Massachusetts Male Aging Study indicate that the odds of developing erectile dysfunction increase with increasing BMI. Weight loss appears to be mildly helpful in maintaining erectile function.
A meta-analysis of 10 prospective cohort studies that included almost 42,000 subjects followed for three to 36 years demonstrated a U-shaped association between BMI and Alzheimer’s disease. Compared with being in the normal weight range, being underweight was associated with a 36 percent higher risk of Alzheimer’s disease while being obese was associated with a 42 percent higher risk.
Excess weight places mechanical and metabolic strains on bones, muscles, and joints. In the United States, an estimated 46 million adults (about one in five) report doctor-diagnosed arthritis. (1) Osteoarthritis of the knee and hip are both positively associated with obesity, and obese patients account for one-third of all joint replacement operations. (39) Obesity also increases the risk of back pain, lower limb pain, and disability due to musculoskeletal conditions.
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