Hurst's Central Illustration: Pathophysiology of Obesity and Consequential Cardiovascular Disease
Pathophysiology of obesity and consequential cardiovascular disease. Genetic, environmental, and behavioural factors all contribute to obesity. Obesity causes changes to the hypothalamic regulation of appetite that make it challenging to reduce adiposity and maintain any weight loss, and thereby promote obesity. Obesity also promotes the behavioural factors that promote obesity; for example, by causing psychological changes to food preferences (toward foods with greater caloric density with high fat and sugar content), by making physical activity more difficult, and by increasing the risk of sleep apnea and thereby impacting negatively on sleep hygiene. Obesity is also associated with alterations in adiposity-accumulation of intra-abdominal fat and of lipids within muscles and liver cells-that result in insulin resistance and dysregulated secretion of adipokines, which lead to diabetes mellitus and the metabolic syndrome, and can eventually result in the development of cardiovascular disease.