We all know that obesity increase the chance of many chronic diseases and an early death, however few know that obesity can also rob you of your eyesight. Learn how obesity affects vision health in today’s post!
Public awareness about the overall dangers of obesity is at an all-time high, with television shows such as “The Biggest Loser” and public health initiatives such as First Lady Michelle Obama’s “Let’s Move!” campaign bringing these issues to the forefront. However, despite the general knowledge of obesity’s effects on stroke, heart disease, osteoarthritis and hypertension, it is still the rare patient who is aware of obesity’s impact on eye health.
Knowledge of the various connections between obesity and ocular health is virtually absent from the public consciousness, according to Jeffrey R. Anshel, OD, FAAO, a private practitioner in Carlsbad, Calif., founding director of the Ocular Nutrition Society (ONS) and PCON Editorial Board member. Dr. Anshel cited a survey conducted by the ONS of more than 1,000 baby boomers on the subject of eye health. He said although the survey respondents ranked their vision as being their most valuable sense and a top health priority, they knew very little about any connection between nutrition and the eye.
“They said they worried about loss of vision almost as much as heart attack and cancer,” he told PCON, “but as far as knowledge went, they were basically clueless.”
Dr. Anshel said obesity is linked to “just about all” of the major ocular conditions. “We’re finding out that most of the chronic diseases are based on inflammation, and, in America, we have a pro-inflammatory diet,” he said. “There’s close to 60 peer-reviewed studies that link obesity to an increase in these conditions.”
Dr. Pelino said although cataracts are among the many diseases that are linked to obesity, the precise nature of this connection is not yet fully understood.
“Obesity has been found to be a risk factor in cataracts, but the mechanism is unclear,” he said. “Of the different types of cataracts, cortical cataracts and posterior subcapsular cataracts have been most consistently associated with obesity.”
Dr. Pelino cited findings from the Barbados Eye Study, in which a higher waist-hip ratio was associated with increased incidence of cortical cataracts in African Americans. He said the Blue Mountain Eye Study yielded similar findings.
“This study, which looked at white Australians, suggested that a person with a BMI of more than 30 kg/m2 had an increased risk of both cortical and posterior subcapsular cataracts,” he said. “But it’s not understood why.” Dr. Pelino referenced findings from the Age-Related Eye Disease Study (AREDS), which found that a high BMI was associated with moderate cortical cataracts.
While the correlation between cataracts and obesity may still be unclear, other conditions have a more measurable connection. He said diabetic retinopathy is one condition for which the connection is relatively straightforward.
“Many patients with diabetes can eliminate their need for medications after losing weight and waist circumference, and may also even eliminate the diagnosis of diabetes from their medical problem list,” he said. “Obviously, if they no longer have diabetes, then they have significantly decreased their risk of developing diabetic retinopathy.”
While the relationship of obesity to age-related macular degeneration is somewhat more complex, researchers have put forth credible theories, Dr. Bohlman said. “Scientists have proposed that adipose tissue competitively absorbs the same nutrients that are necessary for good macular health,” he said. “As adipose tissue in the body decreases, this becomes less of a risk for macular degeneration to develop, and less of a risk to progress once it’s begun.”
According to Dr. Pelino, studies have found a relationship between obesity and high intraocular pressure. He cited the Beaver Dam Eye Study, which reported a significantly positive association between elevated IOP and a BMI of more than 30 kg/m2. “There is evidence of a relationship between obesity and increased IOP, but not necessarily glaucoma,” he said. While obese patients are more likely to have high IOP, Dr. Bohlman said a study by Gasser found that they were less likely to have glaucoma than those with normal BMI. He noted that the type of tonometry used may make a difference.
Other ocular conditions that have been linked to obesity include floppy lid syndrome, pseudotumor cerebri, exophthalmos, thyroid eye disease and nonarteritic anterior ischemic optic neuropathy. Dr. Pelino said pseudotumor cerebri, in particular, is a condition that can benefit significantly from a patient losing weight.
“Losing weight is likely to help all of these conditions, but for pseudotumor cerebri, weight gain is the main risk factor, so that will make a big difference,” he said. “If a pseudotumor cerebri patient loses 5% to 10% of their body weight, this is going to help the condition.”
Some other ocular conditions, such as dry eye, have not been directly linked to obesity, but are linked to a healthy diet, Dr. Anshel said. “Dry eye can be improved through a balance of omega-3 and omega-6 fatty acids,” he said. “By cutting back on junk food, a patient can lower his or her omega-6 intake and help achieve that balance.”
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Dr. Terry Chambers is a Board certified chiropractor and acupuncturist, licensed in WV, and trained to perform functional medicine.
Article Source: http://www.healio.com/optometry/primary-care-optometry/news/print/primary-care-optometry-news/%7B3183bae8-ebda-40c0-ac51-1d6cbb90d986%7D/obesity-and-eye-health-an-important-connection-to-convey-to-patients