Obesiti: Perbezaan antara semakan

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{{Perubatan}}
{{Infobox disease
|Name = Obesiti
|Image = Obesity-waist circumference.svg
|Alt = Three silhouettes depicting the outlines of a normal sized (left), overweight (middle), and obese person (right).
|Caption = Silhouettes dan lilitan pinggang mewakili normal, berat terlebih, dan obes
| Field = [[Endocrinology]]
|DiseasesDB = 9099
|ICD10 = {{ICD10|E|66| |e|65}}
|ICD9 = {{ICD9|278}}
|MedlinePlus = 007297
|OMIM = 601665
|eMedicineSubj = med
|eMedicineTopic = 1653
|MeshName = Obesity
|MeshNumber = C23.888.144.699.500
|
}}
[[Fail:Italienischer Maler des 17. Jahrhunderts 001.jpg|thumb|220px|Lelaki yang gemuk gedempol. Lukisan oleh Alessandro del Borro, abad ke-17.]]
 
<!-- Definisi dan gejala -->
'''Obesiti''' merupakan keadaan perubatan di mana lemak badan berlebihan yang terkumpul sehingga ke satu tahap yang boleh menjejaskan kesihatan seseorang.<ref name=WHO2015/><ref>{{cite journal|last1=Yazdi|first1=FT|last2=Clee|first2=SM|last3=Meyre|first3=D|title=Obesity genetics in mouse and human: back and forth, and back again.|journal=PeerJ|date=2015|volume=3|pages=e856|pmid=25825681|doi=10.7717/peerj.856|pmc=4375971}}</ref> Individu itu biasanya dianggap sebagai obes apabila indeks jisim badannya (BMI), yakni ukuran yang diperoleh daripada membahagikan jisimberat badannya (dalam kilogram) dengan ketinggian seseorang (dalam meter) yang dikuasa dua.<ref name=WHO2015/> Indeks BMI antara 20 hingga 25 dianggap biasanormal, individu yang mempunyai BMI lebih daripada 25 dikatakan memiliki jisimberat terlebih; dengan 30 dan ke atas, mereka ini dianggap obes, dan dengan 35 dan ke atas, mereka ini dianggap obes parah. melebihi 30 kg/m<sup>2</sup>, bila mana julat antara 25–30 kg/m2 dikelaskan sebagai jisim terlebih. Secara umumnya, angka BMI ini menjadi ukuran kuantitatif yang baik untuk mengenal pasti obesiti seseorang. Walaupun begitu, indeks BMI rupanya peramal yang lemah bagi individu yang sangat cergas, kerana seseorang yang memiliki tisu otot yang lebih tinggi daripada individu biasa, memperoleh keputusan BMI yang lebih tinggi daripada biasanormal, walaupun badan individu itu sangat besar. Indeks jisim badan ini terpakai untuk orang dewasa yang telah membesar sepenuhnya dan tidak harus digunakan untuk kanak-kanak yang sedang membesar. Carta pertumbuhan khusus boleh digunakan untuk mengukur obesiti dalam kalangan kanak-kanak. Beberapa negara Asia Timur menggunakan nilai yang lebih rendah.<ref name=Kan2005>{{cite journal|last1=Kanazawa|first1=M|last2=Yoshiike|first2=N|last3=Osaka|first3=T|last4=Numba|first4=Y|last5=Zimmet|first5=P|last6=Inoue|first6=S|title=Criteria and classification of obesity in Japan and Asia-Oceania.|journal=World review of nutrition and dietetics|date=2005|volume=94|pages=1–12|pmid=16145245|url=https://www.researchgate.net/publication/7616717_Criteria_and_Classification_of_Obesity_in_Japan_and_Asia-Oceania|doi=10.1159/000088200}}</ref> Obesiti meningkatkan kebarangkalian menghidap pelbagai penyakit berkaitan obesiti, termasuklah penyakit kardiovaskular, diabetes melitus tahap 2, apnea tidur obstruktif, jenis-jenis kanser tertentu, osteoartritis, dan asma.<ref name=HaslamJames>{{cite journal | author = Haslam DW, James WP | title = Obesity | journal = Lancet | volume = 366 | issue = 9492 | pages = 1197–209 | year = 2005 | pmid = 16198769 | doi = 10.1016/S0140-6736(05)67483-1 | type = Review }}</ref>
 
Indeks jisim badan ini terpakai untuk orang dewasa yang telah membesar sepenuhnya dan tidak harus digunakan untuk kanak-kanak yang sedang membesar. Carta pertumbuhan khusus boleh digunakan untuk mengukur obesiti dalam kalangan kanak-kanak. Beberapa negara Asia Timur menggunakan nilai yang lebih rendah.<ref name=Kan2005>{{cite journal|last1=Kanazawa|first1=M|last2=Yoshiike|first2=N|last3=Osaka|first3=T|last4=Numba|first4=Y|last5=Zimmet|first5=P|last6=Inoue|first6=S|title=Criteria and classification of obesity in Japan and Asia-Oceania.|journal=World review of nutrition and dietetics|date=2005|volume=94|pages=1–12|pmid=16145245|url=https://www.researchgate.net/publication/7616717_Criteria_and_Classification_of_Obesity_in_Japan_and_Asia-Oceania|doi=10.1159/000088200}}</ref> Obesiti meningkatkan kebarangkalian menghidap pelbagai penyakit berkaitan obesiti, termasuklah penyakit jantung, diabetes tahap 2, apnea tidur obstruktif, jenis-jenis kanser tertentu, dan osteoatritis.<ref name=HaslamJames>{{cite journal | author = Haslam DW, James WP | title = Obesity | journal = Lancet | volume = 366 | issue = 9492 | pages = 1197–209 | year = 2005 | pmid = 16198769 | doi = 10.1016/S0140-6736(05)67483-1 | type = Review }}</ref>
 
<!-- Penyebab -->
Obesiti kerap kali terjadi disebabkan oleh kombinasi pengambilan makanan secara keterlaluan, kurangnya aktiviti fizikal, dan kerentanan genetik.<ref name=WHO2015/> Terdapat kes terpencil didapati disebabkan oleh gen, kecelaruan endokrin, pengubatan, atau penyakit mental.<ref name=Ble2008>{{cite journal | author = Bleich S, Cutler D, Murray C, Adams A | title = Why is the developed world obese? | journal = Annu Rev Public Health | volume = 29 | pages = 273–95 | year = 2008 | pmid = 18173389 | doi = 10.1146/annurev.publhealth.29.020907.090954 | type = Research Support }}</ref> Tiada bukti kukuh sebenarnya yang menyokong pandangan bahawa orang obes makan sedikit tetapi berat masih menambah jisimbertambah kerana metabolisme yang rendah.<ref name=OUP2011>{{cite book|title=Oxford Handbook of Medical Sciences|date=2011|publisher=OUP Oxford|location=Oxford|isbn=9780191652295|page=180|edition=2nd|url=https://books.google.ca/books?id=RUQKjpkeLugC&pg=PA180}}</ref> Secara kebiasaannya, orang obes mempunyai penggunaan tenaga yang lebih banyak berbanding orang yang kurus kerana banyak tenaga diperlukan untuk mengekalkan beratjisim badan yang bertambah.<ref name=Humana2007OUP2011/><ref>{{cite book|author=Kushner, Robert |title=Treatment of the Obese Patient (Contemporary Endocrinology) |publisher=Humana Press |location=Totowa, NJ |year=2007 |page=158 |isbn=1-59745-400-1 |url=https://books.google.com/?id=vWjK5etS7PMC |doi= |accessdate=April 5, 2009}}</ref>
 
<!-- Pencegahan dan rawatan -->
<!-- Epidemiologi, masyarakat dan budaya -->
Obesiti menjadi antara punca utama kematian boleh elak di serata dunia, dengan peningkatan kadar dalam kalangan dewasa dan kanak-kanak.<ref name=WHO2015/><ref>{{cite book|title=Encyclopedia of Mental Health|date=2015|publisher=Academic Press|isbn=9780123977533|page=158|edition=2|url=https://books.google.ca/books?id=5aLxBQAAQBAJ&pg=PA158}}</ref> Pada 2014, 600 juta dewasa (13%) dan 42 juta kanak-kanak berumur bawah lima tahun merupakan obes.<ref name=WHO2015>{{cite web|title=Obesity and overweight Fact sheet N°311|url=http://www.who.int/mediacentre/factsheets/fs311/en/|website=WHO|accessdate=2 February 2016|date=January 2015}}</ref> Obesiti lazimnya terjadi dalam kalangan wanita berbanding lelaki.<ref name=WHO2015/> Pihak berkuasa melihat obesiti merupakan antara masalah kesihatan awam paling serius pada abad ke-21.<ref name=Dibaise2013>{{cite journal|author=Dibaise JK, Foxx-Orenstein AE|title=Role of the gastroenterologist in managing obesity|journal=Expert Review of Gastroenterology & Hepatology|volume=7|issue=5|pages=439–51|date=July 2013|pmid=23899283|doi=10.1586/17474124.2013.811061|type=Review}}</ref> Obesiti dicela dan diaibkan dalam dunia moden (khususnya dunia Barat), walaupun pernah dilihat sebagai simbol kekayaan dan kesuburan pada suatu ketika dalam sejarah dan masih lagi berlangsung di beberapa bahagian di dunia ini.<ref name=HaslamJames/><ref name=Woodhouse>{{cite journal | author = Woodhouse R | title = Obesity in art: A brief overview | journal = Front Horm Res | volume = 36 | issue = | pages = 271–86 | year = 2008 | pmid = 18230908 | doi = 10.1159/000115370 | url = https://books.google.com/?id=nXRU4Ea1aMkC&pg=PA271&lpg=PA271 | isbn = 978-3-8055-8429-6 | series = Frontiers of Hormone Research }}</ref> Pada 2013, Persatuan Perubatan Amerika mengklasifikasikan obesiti sebagai suatu penyakit.<ref name=NYTimes20130618>{{cite news|url=http://www.nytimes.com/2013/06/19/business/ama-recognizes-obesity-as-a-disease.html?_r=0 |title=A.M.A. Recognizes Obesity as a Disease |last=Pollack |first=Andrew |date=June 18, 2013 |newspaper=New York Times |archiveurl=http://www.webcitation.org/6Hav05TK0 |archivedate=June 18, 2013}}</ref><ref>{{cite web|url=http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=5870001020 |title=The Facts About Obesity |last1=Weinstock |first1=Matthew |date=June 21, 2013 |website=H&HN |publisher=[[American Hospital Association]] |accessdate=June 24, 2013}}</ref>
 
==Klasifikasi==
[[File:Obesity & BMI.png|thumb|Obesiti dan BMI]]
[[File:Obesity6.JPG|thumb|upright=1|right|alt=Pandangan depan dan sisi torso lelaki "obes melampau". Tanda regangan pada kulit kelihatan seiring dengan ginekomastia.|Lelaki "obes melampau" dengan BMI 53&nbsp;kg/m<sup>2</sup>: berat 182&nbsp;kg (400&nbsp;lb), tinggi 185&nbsp;cm (6&nbsp;ft 1&nbsp;in)]]
{{main|Klasifikasi obesiti}}
Obesiti merupakan keadaan kesihatan di mana lemak badan berlebihan yang terkumpul sehingga ke satu tahap yang boleh menjejaskan kesihatan seseorang.<ref name="WHO 2000 p.6">WHO 2000 p.6</ref> Ia didefinisikan oleh indeks jisim badan (BMI) dan tentunya dinilai dari segi pengagihan lemak melalui nisbah pinggang-pinggul dan faktor risiko kardiovaskular.<ref name=Sweet2007>{{cite journal | author = Sweeting HN | title = Measurement and Definitions of Obesity In Childhood and Adolescence: A field guide for the uninitiated | journal = Nutr J | volume = 6 | issue = 1 | page = 32 | year = 2007 | pmid = 17963490 | pmc = 2164947 | doi = 10.1186/1475-2891-6-32 | url = http://www.nutritionj.com/content/6/1/32 }}</ref><ref>NHLBI p.xiv</ref> BMI berkait rapat dengan peratusan lemak badan dan jumlah lemak badan.<ref>{{cite journal | author = Gray DS, Fujioka K | title = Use of relative weight and Body Mass Index for the determination of adiposity | journal = J Clin Epidemiol | volume = 44 | issue = 6 | pages = 545–50 | year = 1991 | pmid = 2037859 | doi = 10.1016/0895-4356(91)90218-X }}</ref>
Dalam kalangan kanak-kanak, berat yang sihat berbeza mengikut umur dan jantina. Obesiti dalam kalangan kanak-kanak dan remaja didefinisikan bukan sebagai angka mutlak tetapi berhubungan dengan kumpulan normal sejarah, sepertimana obesiti tergolong dalam BMI lebih daripada 95 persentil.<ref name="cdc.gov">{{cite web|url=http://www.cdc.gov/nccdphp/dnpa/healthyweight/assessing/bmi/childrens_BMI/about_childrens_BMI.htm |title=Healthy Weight: Assessing Your Weight: BMI: About BMI for Children and Teens |publisher=[[Center for disease control and prevention]] |accessdate=April 6, 2009}}</ref> Data rujukan yang digunakan untuk persentil ini berdasarkan antara tahun 1963 hingga 1994, dan tidak terjejas dengan peningkatan berat pada masa ini.<ref name="Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL 2001 1086–93">{{cite journal | author = Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL | title = Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index | journal = Am. J. Clin. Nutr. | volume = 73 | issue = 6 | pages = 1086–93 | date = June 2001 | pmid = 11382664 | doi = | url = http://www.ajcn.org/cgi/content/full/73/6/1086 }}</ref>
BMI diukur berdasarkan berat subjek yang dibahagikan dengan kuasa dua bagi ketinggian mereka dan dikira seperti berikut.
 
:<math>\mathrm{BMI}= \frac{b}{t^2}</math>,
 
:di mana ''b'' and ''t'' merupakan berat subjek dan tinggi subjek masing-masing.
 
BMI diungkapkan dalam kilogram per meter persegi, menjadikan berat diukur dalam kilogram dan tinggi dalam meter. Untuk menukar kepada paun per inci persegi, darabkan {{nowrap|703 (kg/m<sup>2</sup>)/(lb/sq in)}}.<ref>{{nowrap|1 (lb/sq in)}} is more precisely {{nowrap|703.06957964 (kg/m<sup>2</sup>)}}.</ref>
 
{| class="wikitable" style="float: left; margin-right: 1em; text-align:center"
! colspan="2"| BMI (kg/m<sup>2</sup>) !! rowspan="2" valign="top" | Klasifikasi<ref>{{cite web|title=BMI classification|url=http://apps.who.int/bmi/index.jsp?introPage=intro_3.html|work=World Health Organization|accessdate=15 February 2014}}</ref>
|-
! dari !! hingga
|-
| || 18.5 || berat terkurang
|-
| 18.5 || 25.0 || berat normal
|-
| 25.0 || 30.0 || berat terlebih
|-
| 30.0 || 35.0 || obesiti kelas I
|-
| 35.0 || 40.0 || obesiti kelas II
|-
| 40.0 || || obesiti kelas III
|}
Definisi yang paling kerap digunakan, diperkenalkan oleh Pertubuhan Kesihatan Dunia (WHO) pada 1997 dan diterbitkan pada 2000, menyediakan nilai yang disenaraikan di jadual.<ref name="WHO 2000 p.9">WHO 2000 p.9</ref>
 
Beberapa pengubahsuaian kepada definisi WHO dibuat oleh beberapa badan tertentu. Kesusasteraan pembedahan memecahkan kelas III kepada beberapa kategori yang mana nilai tepatnya masih lagi dipertikaikan.<ref name=morbid2007>{{cite journal | author = Sturm R | title = Increases in morbid obesity in the USA: 2000–2005 | journal = Public Health | volume = 121 | issue = 7 | pages = 492–6 | date = July 2007 | pmid = 17399752 | pmc = 2864630 | doi = 10.1016/j.puhe.2007.01.006 }}</ref>
:* Sebarang BMI ≥ 35 or 40&nbsp;kg/m<sup>2</sup> merupakan ''obesiti parah''.
:* BMI ≥ 35&nbsp;kg/m<sup>2</sup> dan mengalami keadaan kesihatan berkaitan obesiti atau ≥40–44.9&nbsp;kg/m<sup>2</sup> merupakan ''obesiti mengerikan''.
:* BMI ≥ 45 atau 50&nbsp;kg/m<sup>2</sup> is ''obesiti melampau''.
 
Populasi orang Asia cenderung menghadapi kesan sampingan kesihatan negatif pada kadar BMI lebih rendah berbanding orang Kaukasia, beberapa negara mendefinisikan semula obesiti; orang Jepun mendefinisikan obesiti sebagai sebarang BMI melebihi 25&nbsp;kg/m<sup>2</sup><ref name=Kan2005/> manakala China menetapkan BMI lebih daripada 28&nbsp;kg/m<sup>2</sup>.<ref>{{cite journal | author = Bei-Fan Z | title = Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults | journal = Asia Pac J Clin Nutr | volume = 11 Suppl 8 | issue = | pages = S685–93 | date = December 2002 | pmid = 12534691 | doi = 10.1046/j.1440-6047.11.s8.9.x }}</ref>
 
==Kesan terhadap kesihatan==
Berat badan berlebihan meningkatkan kebarangkalian menghidap pelbagai penyakit berkaitan obesiti, termasuklah penyakit kardiovaskular, diabetes melitus tahap 2, apnea tidur obstruktif, jenis-jenis kanser tertentu, dan asma.<ref name=HaslamJames/><ref name=Poulain/> Hasilnya, obesiti didapati mengurangkan jangka hayat kehidupan.<ref name=HaslamJames/>
 
===Kematian===
{{Double image|right|MenBMIMort.png|200|WomenBMIMort.png|200|alt=(Left) Graf menunjukkan bagaimana risiko kematian berbeza mengikut BMI. Risiko paling rendah didapati pada BMI 20 hingga 25 dan meningkat pada kedua-dua arah. (Right) Graf menunjukkan bagaimana risiko kematian berbeza mengikut BMI. Risiko paling rendah didapati pada BMI 20 hingga 25 dan meningkat pada kedua-dua arah.|Risiko relatif kematian umur melebihi 10 tahun bagi lelaki kulit putih (kiri) dan perempuan kulit putih (kanan) yang tidak pernah merokok di Amerika Syarikat berdasarkan BMI.<ref name=NEJM10>{{cite journal | author = Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ, Moore SC, Tobias GS, Anton-Culver H, Freeman LB, Beeson WL, Clipp SL, English DR, Folsom AR, Freedman DM, Giles G, Hakansson N, Henderson KD, Hoffman-Bolton J, Hoppin JA, Koenig KL, Lee IM, Linet MS, Park Y, Pocobelli G, Schatzkin A, Sesso HD, Weiderpass E, Willcox BJ, Wolk A, Zeleniuch-Jacquotte A, Willett WC, Thun MJ | title = Body-mass index and mortality among 1.46 million white adults | journal = The New England Journal of Medicine | volume = 363 | issue = 23 | pages = 2211–9 | year = 2010 | pmid = 21121834 | pmc = 3066051 | doi = 10.1056/NEJMoa1000367 }}</ref>||}}
 
Obesiti menjadi antara punca utama kematian boleh elak di serata dunia.<ref name=Barn1999>{{cite journal | author = Barness LA, Opitz JM, Gilbert-Barness E | title = Obesity: genetic, molecular, and environmental aspects | journal = American Journal of Medical Genetics | volume = 143A | issue = 24 | pages = 3016–34 | date = December 2007 | pmid = 18000969 | doi = 10.1002/ajmg.a.32035 }}</ref><ref>{{cite journal | author = Mokdad AH, Marks JS, Stroup DF, Gerberding JL | title = Actual causes of death in the United States, 2000 | journal = [[JAMA (journal)|JAMA]] | volume = 291 | issue = 10 | pages = 1238–45 | date = March 2004 | pmid = 15010446 | doi = 10.1001/jama.291.10.1238 | url = http://www.csdp.org/research/1238.pdf | format = PDF }}</ref><ref name=Allison>{{cite journal | author = Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB | title = Annual deaths attributable to obesity in the United States | journal = [[JAMA (journal)|JAMA]] | volume = 282 | issue = 16 | pages = 1530–8 | date = October 1999 | pmid = 10546692 | doi = 10.1001/jama.282.16.1530 | url = http://jama.ama-assn.org/cgi/content/full/282/16/1530 }}</ref> Kajian Amerika dan Eropah berskala besar mendapati risiko kematian paling rendah berada pada BMI 20–25&nbsp;kg/m<sup>2</sup><ref name=NEJM10/><ref name=Lancet2009>{{cite journal | author = Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R | title = Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies | journal = Lancet | volume = 373 | issue = 9669 | pages = 1083–96 | date = March 2009 | pmid = 19299006 | pmc = 2662372 | doi = 10.1016/S0140-6736(09)60318-4 }}</ref> dalam kalangan bukan perokok dan pada 24–27&nbsp;kg/m<sup>2</sup> dalam kalangan perokok semasa, dengan risiko bertambah seiring dengan perubah pada mana-mana arah.<ref>{{cite journal | author = Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW | title = Body-mass index and mortality in a prospective cohort of U.S. adults | journal = N. Engl. J. Med. | volume = 341 | issue = 15 | pages = 1097–105 | date = October 1999 | pmid = 10511607 | doi = 10.1056/NEJM199910073411501 | url = http://content.nejm.org/cgi/content/full/341/15/1097 }}</ref><ref name=Euro2008>{{cite journal | author = Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, van der Schouw YT, Spencer E, Moons KG, Tjønneland A| title = General and abdominal adiposity and risk of death in Europe | journal = N. Engl. J. Med. | volume = 359 | issue = 20 | pages = 2105–20 | date = November 2008 | pmid = 19005195 | doi = 10.1056/NEJMoa0801891 |display-authors=etal}}</ref> Dalam kalangan orang Asia risiko mula bertambah antara 22–25&nbsp;kg/m<sup>2</sup>.<ref>{{cite journal|last1=WHO Expert|first1=Consultation|title=Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.|journal=Lancet|date=Jan 10, 2004|volume=363|issue=9403|pages=157–63|pmid=14726171|doi=10.1016/s0140-6736(03)15268-3}}</ref> BMI melebihi 32&nbsp;kg/m<sup>2</sup> berhubung kait dengan kadar kematian berganda dua dalam kalangan wanita sepanjang tempoh 16 tahun.<ref>{{cite journal | author = Manson JE, Willett WC, Stampfer MJ, Colditz GA, Hunter DJ, Hankinson SE, Hennekens CH, Speizer FE | title = Body weight and mortality among women | journal = N. Engl. J. Med. | volume = 333 | issue = 11 | pages = 677–85 | year = 1995 | pmid = 7637744 | doi = 10.1056/NEJM199509143331101 }}</ref> Di Amerika Syarikat, obesiti dianggarkan menyebabkan 111,909 hingga 365,000 kematian setiap tahun,<ref name=HaslamJames/><ref name=Allison/> manakala 1 juta (7.7%) kematian di Eropah disebabkan oleh berat berlebihan.<ref name=EuroG2008/><ref name=Euro2007>{{cite journal | author = Fried M, Hainer V, Basdevant A, Buchwald H, Deitel M, Finer N, Greve JW, Horber F, Mathus-Vliegen E, Scopinaro N, Steffen R, Tsigos C, Weiner R, Widhalm K | title = Inter-disciplinary European guidelines on surgery of severe obesity | journal = Int J Obes (Lond) | volume = 31 | issue = 4 | pages = 569–77 | date = April 2007 | pmid = 17325689 | doi = 10.1038/sj.ijo.0803560 }}</ref> Secara puratanya, obesiti mengurangkan jangka hayat kehidupan antara enam hingga tujuh tahun,<ref name=HaslamJames/><ref>{{cite journal | author = Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L | title = Obesity in adulthood and its consequences for life expectancy: A life-table analysis | journal = Annals of Internal Medicine | volume = 138 | issue = 1 | pages = 24–32 | date = January 2003 | pmid = 12513041 | doi = 10.7326/0003-4819-138-1-200301070-00008 | url = http://www.annals.org/cgi/reprint/138/1/24 }}</ref> BMI 30–35&nbsp;kg/m<sup>2</sup> mengurangkan jangka hayat kehidupan antara dua hingga empat tahun,<ref name=Lancet2009/> manakala obesiti parah (BMI&nbsp;>&nbsp;40&nbsp;kg/m<sup>2</sup>) mengurangkan jangka hayat kehidupan sebanyak sepuluh tahun.<ref name=Lancet2009/>
 
===Morbiditi===
{{main|Morbiditi berkaitan obesiti}}
Obesiti meningkatkan risiko menjejaskan keadaan fizikal dan mental. Komorbiditi sangat kerap ditunjukkan melalui sindrom metabolik,<ref name=HaslamJames/> kombinasi kecelaruan perubatan termasuklah: diabetes melitus type 2, tekanan darah tinggi, kolestrol dalam darah tinggi, dan tahap trigliserida tinggi.<ref>{{cite journal | author = Grundy SM | title = Obesity, metabolic syndrome, and cardiovascular disease | journal = J. Clin. Endocrinol. Metab. | volume = 89 | issue = 6 | pages = 2595–600 | year = 2004 | pmid = 15181029 | doi = 10.1210/jc.2004-0372 }}</ref>
 
Komplikasi sama ada disebabkan secara langsung oleh obesiti atau secara tidak langsung berkaitan dengan mekanisme berkongsi punca lazim seperti diet tidak sihat atau gaya hidup banyak duduk. Kekuatan hubung kait antara obesiti dan keadaan spesifik berbeza. Satu daripada kekuatannya ialah hubungan dengan diabetes mellitus tahap 2. Berat badan berlebihan mendasari 64% kes diabetes dalam kalangan lelaki dan 77% kes dalam kalangan wanita.<ref>Seidell 2005 p.9</ref>
 
Kesan sampingan kesihatan jatuh kepada dua kategori yang luas: kesan yang diagihkan kepada kesan jisim lemak yang bertambah (seperti osteoartritis, apnea tidur obstruktif, pengaiban sosial) dan kesan yang disebabkan oleh bilangan sel lemak yang bertambah (diabetes melitus, kanser, penyakit kardiovaskular, penyakit hati berlemak bukan-beralkohol.<ref name=HaslamJames/><ref name=Bray2004>{{cite journal | author = Bray GA | title = Medical consequences of obesity | journal = J. Clin. Endocrinol. Metab. | volume = 89 | issue = 6 | pages = 2583–9 | year = 2004 | pmid = 15181027 | doi = 10.1210/jc.2004-0535 }}</ref> Pertambahan lemak badan mengubah tindak balas badan kepada insulin, berpotensi menjurus kepada kerintangan insulin. Lemak yang bertambah juga mewujudkan keadaan proradang,<ref>{{cite journal | author = Shoelson SE, Herrero L, Naaz A | title = Obesity, inflammation, and insulin resistance | journal = Gastroenterology | volume = 132 | issue = 6 | pages = 2169–80 | date = May 2007 | pmid = 17498510 | doi = 10.1053/j.gastro.2007.03.059 }}</ref><ref>{{cite journal | author = Shoelson SE, Lee J, Goldfine AB | title = Inflammation and insulin resistance | journal = J. Clin. Invest. | volume = 116 | issue = 7 | pages = 1793–801 | date = July 2006 | pmid = 16823477 | pmc = 1483173 | doi = 10.1172/JCI29069 | url = http://www.jci.org/articles/view/29069 }}</ref> dan keadaan protrombotik.<ref name=Bray2004/><ref>{{cite journal | author = Dentali F, Squizzato A, Ageno W | title = The metabolic syndrome as a risk factor for venous and arterial thrombosis | journal = Semin. Thromb. Hemost. | volume = 35 | issue = 5 | pages = 451–7 | date = July 2009 | pmid = 19739035 | doi = 10.1055/s-0029-1234140 }}</ref>
 
{| class="wikitable"
|-
! Bidang perubatan
! Keadaan
! Bidang perubatan
! Keadaan
|-
<!--Mengikut abjad-->|width=10%| [[Kardiologi]]
|
* [[penyakit jantung koronari]]:<ref>{{cite journal|last1=Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated|first1=Effects)|last2=Lu|first2=Y|last3=Hajifathalian|first3=K|last4=Ezzati|first4=M|last5=Woodward|first5=M|last6=Rimm|first6=EB|last7=Danaei|first7=G|title=Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants.|journal=Lancet (London, England)|date=15 March 2014|volume=383|issue=9921|pages=970–83|doi=10.1016/S0140-6736(13)61836-X|pmid=24269108}}</ref> [[angina]] and [[penginfarkan miokardium]]
* [[kegagalan jantung kongestif]]<ref name=HaslamJames/>
* [[tekanan darah tinggi]]<ref name=HaslamJames/>
* [[dislipidemia]]<ref name=HaslamJames/>
* [[trombosis vena dalam]] dan [[embolisme pulmonari]]<ref>{{cite journal | author = Darvall KA, Sam RC, Silverman SH, Bradbury AW, Adam DJ | title = Obesity and thrombosis | journal = Eur J Vasc Endovasc Surg | volume = 33 | issue = 2 | pages = 223–33 | date = February 2007 | pmid = 17185009 | doi = 10.1016/j.ejvs.2006.10.006 }}</ref>
| <!--Mengikut abjad-->[[Dermatologi]]
|
* [[tanda regangan]]<ref name=derm2007/>
* [[akantosis nigrikans]]<ref name=derm2007>{{cite journal | author = Yosipovitch G, DeVore A, Dawn A | title = Obesity and the skin: skin physiology and skin manifestations of obesity | journal = J. Am. Acad. Dermatol. | volume = 56 | issue = 6 | pages = 901–16; quiz 917–20 | date = June 2007 | pmid = 17504714 | doi = 10.1016/j.jaad.2006.12.004 | url = }}</ref>
* [[limfedema]]<ref name=derm2007/>
* [[selulitis]]<ref name=derm2007/>
* [[hirsutisme]]<ref name=derm2007/>
* [[intertrigo]]<ref>{{cite journal | author = Hahler B | title = An overview of dermatological conditions commonly associated with the obese patient | journal = Ostomy Wound Manage | volume = 52 | issue = 6 | pages = 34–6, 38, 40 passim | date = June 2006 | pmid = 16799182 | doi = | url = }}</ref>
|-
| <!--Mengikut abjad-->[[Endokrinologi]] dan [[Perubatan pembiakan]]
|
* [[diabetes melitus]]<ref name=HaslamJames/>
* [[sindrom ovari polisistik]]<ref name=HaslamJames/>
* kecelaruan [[haid]]<ref name=HaslamJames/>
* [[kemandulan]]<ref name=HaslamJames/><ref name=OBGYN2008>{{cite journal |authors=Arendas K, Qiu Q, Gruslin A |title=Obesity in pregnancy: pre-conceptional to postpartum consequences |journal=Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC |volume=30 |issue=6 |pages=477–88 |year=2008 |pmid=18611299 |doi= |url=}}</ref>
* [[komplikasi ketika mengandung]]<ref name=HaslamJames/><ref name=OBGYN2008/>
* [[kecacatan lahir]]<ref name=HaslamJames/>
* [[kematian bayi dalam rahim]]<ref name=OBGYN2008/>
| <!--Mengikut abjad-->[[Gastroenterologi]]
|
* [[penyakit refluks gastroesofagus]]<ref name=Dibaise2013/>
* [[penyakit hati berlemak bukan-beralkohol]]<ref name=Dibaise2013/>
* [[kolelitiasis]] (batu hempedu)<ref name=Dibaise2013/>
|-
| <!--Mengikut abjad-->[[Neurologi]]
| style="width:40%;"|
* [[strok]]<ref name=HaslamJames/>
* [[meralgia parestetika]]<ref>{{cite journal | author = Harney D, Patijn J | title = Meralgia paresthetica: diagnosis and management strategies | journal = Pain Med | volume = 8 | issue = 8 | pages = 669–77 | year = 2007 | pmid = 18028045 | doi = 10.1111/j.1526-4637.2006.00227.x | url = | type = Review }}</ref>
* [[migrain]]<ref>{{cite journal | author = Bigal ME, Lipton RB | title = Obesity and chronic daily headache | journal = Curr Pain Headache Rep | volume = 12 | issue = 1 | pages = 56–61 | date = January 2008 | pmid = 18417025 | doi = 10.1007/s11916-008-0011-8 | url = | type = Review }}</ref>
* [[sindrom terowong karpal]]<ref>{{cite journal | author = Sharifi-Mollayousefi A, Yazdchi-Marandi M, Ayramlou H, Heidari P, Salavati A, Zarrintan S, Sharifi-Mollayousefi A | title = Assessment of body mass index and hand anthropometric measurements as independent risk factors for carpal tunnel syndrome | journal = Folia Morphol. (Warsz) | volume = 67 | issue = 1 | pages = 36–42 | date = February 2008 | pmid = 18335412 | doi = }}</ref>
* [[demensia]]<ref>{{cite journal | author = Beydoun MA, Beydoun HA, Wang Y | title = Obesity and central obesity as risk factors for incident dementia and its subtypes: A systematic review and meta-analysis | journal = Obes Rev | volume = 9 | issue = 3 | pages = 204–18 | date = May 2008 | pmid = 18331422 | doi = 10.1111/j.1467-789X.2008.00473.x | type=Meta-analysis}}</ref>
* [[tekanan darah tinggi idiopatik intrakranium]]<ref>{{cite journal | author = Wall M | title = Idiopathic intracranial hypertension (pseudotumor cerebri) | journal = Curr Neurol Neurosci Rep | volume = 8 | issue = 2 | pages = 87–93 | date = March 2008 | pmid = 18460275 | doi = 10.1007/s11910-008-0015-0 | url = | type = Review }}</ref>
* [[sklerosis berbilang]]<ref>{{cite journal | author = Munger KL, Chitnis T, Ascherio A | title = Body size and risk of MS in two cohorts of US women | journal = Neurology | volume = 73 | issue = 19 | pages = 1543–50 | year = 2009 | pmid = 19901245 | pmc = 2777074 | doi = 10.1212/WNL.0b013e3181c0d6e0 | type = Comparative Study }}</ref>
| <!--Mengikut abjad-->[[Onkologi]]<ref>{{cite journal|last1=Basen-Engquist|first1=Karen|last2=Chang|first2=Maria|title=Obesity and Cancer Risk: Recent Review and Evidence|journal=Current Oncology Reports|date=16 November 2010|volume=13|issue=1|pages=71–76|doi=10.1007/s11912-010-0139-7|pmid=21080117}}</ref>
|
* [[kanser esofagus]]
* [[kanser kolorektum]]
* [[kanser pankreas]]
* [[kanser pundi hempedu]],
* [[kanser endometrium]]
* [[karsinoma sel renal]]
* [[leukemia]]
* [[karsinoma hepatoselular]]<ref name=Dibaise2013/>
* [[melanoma malignan]]
|-
| style="width:10%;"| <!--Mengikut abjad-->[[Psikiatri]]
| style="width:40%;"|
* [[Kecelaruan kemurungan utama]]<ref name=HaslamJames/>
* [[keaiban sosial]]<ref name=HaslamJames/>
| <!--Mengikut abjad-->[[Respirologi]]
|
* [[apnea tidur obstruktif]]<ref name=HaslamJames/><ref name=Poulain>{{cite journal | author = Poulain M, Doucet M, Major GC, Drapeau V, Sériès F, Boulet LP, Tremblay A, Maltais F | title = The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies | journal = CMAJ | volume = 174 | issue = 9 | pages = 1293–9 | date = April 2006 | pmid = 16636330 | pmc = 1435949 | doi = 10.1503/cmaj.051299 | url = http://www.cmaj.ca/cgi/content/full/174/9/1293 }}</ref>
* [[sindrom hipoventilasi obesiti]]<ref name=HaslamJames/><ref name=Poulain/>
* [[asma]]<ref name=HaslamJames/><ref name=Poulain/>
* komplikasi bertambah semasa [[anestesia umum]]<ref name=HaslamJames/>
|-
| <!--Mengikut abjad-->[[Reumatologi]] dan [[Ortopedik]]
|
* [[gout]]<ref>{{cite journal|last1=Aune|first1=D|last2=Norat|first2=T|last3=Vatten|first3=LJ|title=Body mass index and the risk of gout: a systematic review and dose-response meta-analysis of prospective studies.|journal=European journal of nutrition|date=December 2014|volume=53|issue=8|pages=1591–601|doi=10.1007/s00394-014-0766-0|pmid=25209031}}</ref>
* mobiliti lemah<ref>{{cite journal | author = Tukker A, Visscher TL, Picavet HS | title = Overweight and health problems of the lower extremities: osteoarthritis, pain and disability | journal = Public Health Nutr | volume = 12 | issue = 3 | pages = 1–10 | date = April 2008 | pmid = 18426630 | doi = 10.1017/S1368980008002103 | url = | type = Research Support }}</ref>
* [[osteoartritis]]<ref name=HaslamJames/>
* [[sakit belakang rendah]]<ref>{{cite journal | author = Molenaar EA, Numans ME, van Ameijden EJ, Grobbee DE | title = [Considerable comorbidity in overweight adults: results from the Utrecht Health Project] | language = Dutch | journal = Ned Tijdschr Geneeskd | volume = 152 | issue = 45 | pages = 2457–63 | date = November 2008 | pmid = 19051798 | doi = | url = | type = English abstract }}</ref>
| <!--Mengikut abjad-->[[Urologi]] dan [[Nefrologi]]
|
* [[disfungsi erektil]]<ref>{{cite journal|last1=Corona|first1=G|last2=Rastrelli|first2=G|last3=Filippi|first3=S|last4=Vignozzi|first4=L|last5=Mannucci|first5=E|last6=Maggi|first6=M|title=Erectile dysfunction and central obesity: an Italian perspective.|journal=Asian Journal of Andrology|date=2014|volume=16|issue=4|pages=581–91|doi=10.4103/1008-682X.126386|pmid=24713832}}</ref>
* [[inkontinens urinari]]<ref>{{cite journal | author = Hunskaar S | title = A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women | journal = Neurourol. Urodyn. | volume = 27 | issue = 8 | pages = 749–57 | year = 2008 | pmid = 18951445 | doi = 10.1002/nau.20635 | url = | type = Review }}</ref>
* [[kegagalan renal kronik]]<ref>{{cite journal | author = Ejerblad E, Fored CM, Lindblad P, Fryzek J, McLaughlin JK, Nyrén O | title = Obesity and risk for chronic renal failure | journal = J. Am. Soc. Nephrol. | volume = 17 | issue = 6 | pages = 1695–702 | year = 2006 | pmid = 16641153 | doi = 10.1681/ASN.2005060638 | type = Research Support }}</ref>
* [[hipogonadisme]]<ref>{{cite journal | author = Makhsida N, Shah J, Yan G, Fisch H, Shabsigh R | title = Hypogonadism and metabolic syndrome: Implications for testosterone therapy | journal = J. Urol. | volume = 174 | issue = 3 | pages = 827–34 | date = September 2005 | pmid = 16093964 | doi = 10.1097/01.ju.0000169490.78443.59 | type = Review }}</ref>
* [[penis tersembunyi]]<ref name="pmid19935302">{{cite journal | author = Pestana IA, Greenfield JM, Walsh M, Donatucci CF, Erdmann D | title = Management of "buried" penis in adulthood: an overview | journal = Plast. Reconstr. Surg. | volume = 124 | issue = 4 | pages = 1186–95 | date = October 2009 | pmid = 19935302 | doi = 10.1097/PRS.0b013e3181b5a37f | type = Review }}</ref>
|}
 
===Paradoks kemandirian===
{{See also|Paradoks obesiti}}
Walaupun kesan sampingan kesihatan negatif obesiti dalam populasi penduduk disokong kukuh dengan bukti sedia ada, hasil kesihatan bagi beberapa subkumpulan kelihatan meningkat pada BMI yang bertambah, fenomena yang dikenali sebagai paradoks kemandirian obesiti.<ref name=Schmidt2007>{{cite journal | author = Schmidt DS, Salahudeen AK | title = Obesity-survival paradox-still a controversy? | journal = Semin Dial | volume = 20 | issue = 6 | pages = 486–92 | year = 2007 | pmid = 17991192 | doi = 10.1111/j.1525-139X.2007.00349.x | type = Review }}</ref> Paradoks ini pertama kali diperihalkan pada 1999 dalam kalangan orang berat terlebih dan obes yang menjalani hemodialisis,<ref name=Schmidt2007/> dan kemudiannya didapati dalam kalangan mereka yang menghidap kegagalan jantung dan penyakit vaskular periferal.<ref name=paradox2003>{{cite journal | author = U.S. Preventive Services Task Force | title = Behavioral counseling in primary care to promote a healthy diet: recommendations and rationale | journal = Am Fam Physician | volume = 67 | issue = 12 | pages = 2573–6 | date = June 2003 | pmid = 12825847 | doi = | type = Review }}</ref>
 
Dalam kalangan penghidap kegagalan jantung, mereka yang mempunyai BMI antara 30.00 hingga 34.9 memiliki kematian lebih rendah berbanding mereka yang mempunyai berat normal. Hal ini disebabkan oleh hakikat bahawa manusia sering hilang berat badan apabila mereka secara berperingkat-peringkat semakin sakit.<ref>{{cite journal | author = Habbu A, Lakkis NM, Dokainish H | title = The obesity paradox: Fact or fiction? | journal = Am. J. Cardiol. | volume = 98 | issue = 7 | pages = 944–8 | date = October 2006 | pmid = 16996880 | doi = 10.1016/j.amjcard.2006.04.039 | type = Review }}</ref> Penemuan sama juga dilihat pada jenis penyakit jantung lain. Orang yang mempunyai obesiti kelas I dan penyakit jantung tidak mempunyai kadar masalah lanjutan jantung yang lebih besar daripada orang yang mempunyai berat normal yang turut menghidap penyakit jantung. Dalam kalangan orang yang mempunyai darjah obesiti yang lebih besar, walau bagaimanapun, risiko masalah lanjutan kardiovaskular bertambah.<ref>{{cite journal | author = Romero-Corral A, Montori VM, Somers VK, Korinek J, Thomas RJ, Allison TG, Mookadam F, Lopez-Jimenez F | title = Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: A systematic review of cohort studies | journal = Lancet | volume = 368 | issue = 9536 | pages = 666–78 | year = 2006 | pmid = 16920472 | doi = 10.1016/S0140-6736(06)69251-9 | type = Review }}</ref><ref>{{cite journal | author = Oreopoulos A, Padwal R, Kalantar-Zadeh K, Fonarow GC, Norris CM, McAlister FA | title = Body mass index and mortality in heart failure: A meta-analysis | journal = Am. Heart J. | volume = 156 | issue = 1 | pages = 13–22 | date = July 2008 | pmid = 18585492 | doi = 10.1016/j.ahj.2008.02.014 | url = | type = Meta-analysis, Review }}</ref> Walaupun selepas pembedahan pintasan koronari arteri, tiada pertambahan kematian dilihat berlaku dalam kalangan orang yang berat terlebih dan obes.<ref>{{cite journal | author = Oreopoulos A, Padwal R, Norris CM, Mullen JC, Pretorius V, Kalantar-Zadeh K | title = Effect of obesity on short- and long-term mortality postcoronary revascularization: A meta-analysis | journal = Obesity (Silver Spring) | volume = 16 | issue = 2 | pages = 442–50 | date = February 2008 | pmid = 18239657 | doi = 10.1038/oby.2007.36 | type = Meta-analysis }}</ref> Satu kajian mendapati kemandirian yang bertambah dapat dijelaskan oleh rawatan yang lebih agresif yang diterima oleh orang obes selepas peristiwa kardium.<ref>{{cite journal | author = Diercks DB, Roe MT, Mulgund J, Pollack CV, Kirk JD, Gibler WB, Ohman EM, Smith SC, Boden WE, Peterson ED | title = The obesity paradox in non-ST-segment elevation acute coronary syndromes: Results from the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the American College of Cardiology/American Heart Association Guidelines Quality Improvement Initiative | journal = Am Heart J | volume = 152 | issue = 1 | pages = 140–8 | date = July 2006 | pmid = 16824844 | doi = 10.1016/j.ahj.2005.09.024 | type = Research Support }}</ref> Satu lagi penemuan mendapati jika seseorang mengalami penyakit pulmonari obstruktif kronik serentak dengan penyakit vaskular periferal, manfaat obesiti tidak lagi wujud.<ref name=paradox2003/>
 
== Siapakah yang tergolong dalam obesiti ==
== Lihat juga ==
* [[Obesiti di Malaysia]]
 
==Rujukan==
{{reflist}}
 
== Pautan luar ==
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