ABSTRACT
Severe obesity is associated with a large number of associated problems that have given rise to the term ‘‘morbid obesity’’ (Table 1). Although some consider this term to be perjorative, severe obesity is often associated with a number of problems that are truly morbid and incapacitating. The medical problems caused by obesity begin with the head and end with the toes and involve almost every organ in-between. Several of these problems contribute to the earlier mortality associated with obesity and include coronary artery disease, severe hypertension that may be refractory to medical management, impaired cardiac function, adult onset (Type II) diabetes mellitus, obesity hypoventilation and sleep apnea syndromes, cirrhosis, venous stasis and hypercoagulability leading to an increased risk of pulmonary embolism, and necrotizing panniculitis (1,2). Morbidly obese patients can also die as a result of difficulties in recognizing the signs and symptoms of peritonitis (3). There is an increased risk of prostate, uterine, breast, kidney, esophageal, and colon cancer. Premature death is much more common in the severely obese individual; one study noted a 12-fold excess mortality in morbidly obese men in the 25-to 34-year age group (4). Increased morbidity and mortality have been noted in several other studies (5-8).
