Metabolic
Functional and structural complications of adipose tissue dysfunction and lipotoxicity.
Type 2 Diabetes
Insulin resistance and β-cell dysfunction leading to hyperglycemia
Dyslipidemia
Abnormal lipid profiles with elevated triglycerides and reduced HDL
NAFLD/NASH
Non-alcoholic fatty liver disease progressing to inflammation and fibrosis
Insulin Resistance
Reduced cellular response to insulin signaling and GLUT4 dysfunction
Diagnostic Criteria
- Fasting glucose > 100 mg/dL
- HbA1c ≥ 5.7%
- HOMA-IR > 2.5
- Triglycerides > 150 mg/dL
- AST/ALT elevation
Clinical Management
- Metformin
- GLP-1 agonists
- SGLT2 inhibitors
- Thiazolidinediones
- Dietary modification
- Weight loss programs
Biomechanical
Complications from mechanical burden and pressure effects of excess adiposity.
Obstructive Sleep Apnea
Airway collapse during sleep due to soft tissue obstruction
Osteoarthritis
Joint cartilage degradation from chronic mechanical stress
Gastroesophageal Reflux
Increased intra-abdominal pressure affecting lower esophageal sphincter
Hypoventilation
Reduced lung capacity from diaphragmatic compression
Diagnostic Criteria
- Apnea-Hypopnea Index (AHI)
- Oxygen desaturation index
- Functional capacity testing
- Joint imaging findings
Clinical Management
- CPAP/BiPAP therapy
- Physical therapy
- Weight loss
- Anti-inflammatory medications
- Surgical interventions if severe
Cardiovascular
Cardiac and vascular complications from systemic inflammation and metabolic dysfunction.
Hypertension
Elevated blood pressure from insulin resistance and sodium retention
Heart Failure
Impaired cardiac function with reduced ejection fraction (HFrEF) or diastolic dysfunction (HFpEF)
Coronary Artery Disease
Atherosclerotic plaque formation and arterial narrowing
Atrial Fibrillation
Arrhythmia from atrial remodeling and inflammatory state
Diagnostic Criteria
- Blood pressure ≥ 130/80 mmHg
- BNP > 100 pg/mL
- LDL cholesterol
- Coronary calcium score
- Troponin elevation
Clinical Management
- ACE inhibitors/ARBs
- Beta-blockers
- Statins
- GLP-1 agonists
- SGLT2 inhibitors
- Aspirin therapy
- Revascularization if needed
Psychological
Mental health and psychosocial complications of adiposity-related disease.
Clinical Depression
Major depressive disorder linked to inflammatory cytokines and metabolic dysfunction
Anxiety Disorders
Generalized anxiety, panic disorder, and social anxiety related to weight concerns
Body Image Disorders
Negative self-perception and dissatisfaction with physical appearance
Eating Disorders
Disordered eating patterns and maladaptive food relationships
Diagnostic Criteria
- PHQ-9 score > 10
- GAD-7 score > 10
- Quality of life assessments
- Psychological screening tools
Clinical Management
- Cognitive behavioral therapy (CBT)
- Antidepressants (SSRIs/SNRIs)
- Counseling services
- Support groups
- Integrated mental health care
