The link between obesity and diabetes, malignant tumors, and gallstones.

What is the relationship between obesity and diabetes?

Diabetes mellitus is a systemic disease primarily characterized by glucose metabolism disorder, caused by an absolute or relative deficiency of insulin secretion in the body. It belongs to the category of endocrine and metabolic diseases. Insulin is the only hormone in the human body that lowers blood sugar, and an absolute or relative deficiency of insulin is the main cause of diabetes. Its prevalence has shown a significant upward trend in modern society. The occurrence of diabetes is closely related to obesity. Statistics show that obese individuals are about 10 times more likely to develop diabetes than those of normal weight. Of the 19.5% of diabetic patients, 75.6% were obese before the onset of the disease. Furthermore, a striking phenomenon is that the prevalence of diabetes worldwide generally increases with weight gain. The incidence rate is four times higher in moderately obese individuals than in those of normal weight, while in extremely obese individuals it can be up to 30 times higher.

Why are obese people more prone to diabetes? This is because, under normal circumstances, the human body contains a certain amount of glucose in the blood, which is what people commonly refer to as blood sugar. Blood sugar is stabilized at a certain level under the regulation of insulin (which lowers blood sugar) and glucagon (which raises blood sugar). However, in obese individuals, the enlargement of fat cells significantly reduces the number of insulin receptors on the cell surface or weakens their ability to bind to insulin. In the early stages of obesity, to maintain normal blood sugar levels, the pancreatic β-cells that secrete insulin proliferate and enlarge, increasing insulin secretion. Long-term obesity damages pancreatic β-cells due to overload, resulting in insufficient insulin secretion and inducing diabetes. Clinical observations show that obesity is often a precursor to diabetes. Therefore, weight loss can prevent diabetes. For some obese diabetic patients, after weight loss treatment such as dietary restriction, their weight decreases, and their diabetes also improves. Even some mild cases of diabetes can be cured simply by controlling diet and maintaining an ideal weight. Among some obese diabetic patients, men tend to have abdominal obesity, while women tend to have more subcutaneous fat accumulation in the waist and legs, possibly related to the higher activity of lipoprotein lipase in the thighs compared to the abdomen.

What is the relationship between obesity and malignant tumors in women?

Obesity and malignant tumors are closely related, a fact that has attracted the attention of the medical community for over 30 years and is widely acknowledged. Most data indicates that obese women are more prone to malignant tumors such as uterine cancer, breast cancer, and colon cancer. Compared to non-obese individuals, obese individuals not only have a higher incidence rate, but also exhibit higher levels of cancerous tissue infiltration, metastasis, and spread in the same malignant tumors, especially breast cancer. Animal experiments have confirmed this conclusion. This is because the occurrence of tumors is related to abnormal immune function in the body; individuals with weakened cellular immunity are more susceptible to various malignant tumors. Regardless of the cause of malignant tumors, as long as cells in the body become cancerous, their cell membranes will display specific antigens, which the body's immune cells will kill. When the body's cellular immune function declines, the body's self-defense ability weakens, allowing cancerous cells to proliferate rapidly without inhibition. Furthermore, obese individuals often suffer from hypercholesterolemia and hyperinsulinemia. This increases cholesterol levels in immune cells, impairing their ability to kill tumor cells. Insulin, on the other hand, inhibits the phagocytic function of immune cells and promotes cell proliferation; if cells in the body become cancerous, it will also promote the proliferation of cancer cells. Many obese individuals also have hyperlipidemia, which accelerates blood clotting, reduces fibrinolytic activity, and makes it easier for tumor emboli to form in blood vessels. Cancer cells within these emboli are difficult for immune cells in the blood to kill and are more likely to travel throughout the body via the bloodstream, increasing the chance of cancer cell metastasis. Obesity impairs the body's immune function and has the adverse effect of promoting the occurrence and development of malignant tumors. Therefore, weight loss is beneficial for cancer prevention, anti-cancer effects, and longevity.

***What is the relationship between obesity and gallstones in women?***

Cholelithiasis is a common disease characterized by the presence of stones in the biliary system. It can lead to cholecystitis, and the two are closely related. Obese individuals have a higher rate of hypercholesterolemia than those of normal cholesterol levels. Cholesterol is insoluble in water, but bile salts and lecithin in bile can dissolve it. Under normal circumstances, bile salts, lecithin, and cholesterol in bile form a certain ratio, keeping cholesterol in a dissolved state and preventing precipitation. If bile salts and lecithin decrease, or cholesterol increases, cholesterol precipitates and aggregates to form gallstones. Gallstones in women are more common in women with multiple pregnancies. Increased blood cholesterol levels in late pregnancy, coupled with slow bile emptying, bile stagnation in the gallbladder, and excessive bile concentration, are all favorable factors for gallstone formation. Cholelithiasis also occurs frequently in obese middle-aged and elderly women. Compared to women of normal age, obese adult women have a 35% increased incidence of gallstones and more than double the incidence of cholecystitis. In summary, the higher rate of hypercholesterolemia among obese individuals provides the chemical basis for cholesterol gallstone formation. Additionally, obese individuals exhibit significantly increased gallbladder volume on an empty stomach, accompanied by reduced gallbladder contraction and weak bile excretion, which may be a physical factor contributing to gallstone formation.