Clinical meaning
Obesity is a chronic metabolic disease characterized by excessive adipose tissue accumulation with a BMI ≥ 30 kg/m². Adipose tissue functions as an endocrine organ, secreting pro-inflammatory cytokines (TNF-alpha, IL-6) and adipokines (leptin, adiponectin) that promote chronic low-grade inflammation, insulin resistance, and endothelial dysfunction. Visceral (abdominal) obesity is more metabolically dangerous than subcutaneous fat, as it directly drains pro-inflammatory factors into the portal circulation affecting liver metabolism. Leptin resistance develops as adipose tissue increases, impairing normal appetite regulation. Obesity significantly increases risk for type 2 diabetes, cardiovascular disease, obstructive sleep apnea, osteoarthritis, GERD, certain cancers, and non-alcoholic fatty liver disease. Treatment follows a tiered approach: lifestyle modification first, pharmacotherapy for BMI ≥ 30 or ≥ 27 with comorbidities, and bariatric surgery for BMI ≥ 40 or ≥ 35 with comorbidities.
Exam relevance
Risk factors: - Sedentary lifestyle with prolonged sitting and low physical activity - High-calorie diet rich in processed foods, sugar-sweetened beverages - Genetic predisposition and family history of obesity - Medications that promote weight gain (corticosteroids, some antipsychotics, insulin) - Endocrine disorders (hypothyroidism, Cushing syndrome, PCOS)