While the association of obesity with conditions like diabetes and cardiovascular diseases is well-known, emerging evidence highlights obesity as a risk factor for cancer, particularly gastrointestinal (GI) cancers.

GI cancers refer to malignancies affecting the digestive system, including the oesophagus, stomach, liver, pancreas, colon, and rectum. 

Dr. Deep Goel, a highly recommended surgical gastroenterologist in India, advises, “Patients should focus on maintaining a healthy weight through a balanced diet, regular exercise, and regular health checkups. If you have risk factors such as obesity, diabetes, or a family history of GI cancers, talk to your doctor about personalised prevention strategies.”

What is Obesity?

Obesity is characterised by excessive body fat accumulation, typically measured by a body mass index (BMI) of 30 or higher. 

A study published in JAMA Network Open found that each 1-unit increase in BMI is associated with a 2-4% increased risk for colorectal and other GI cancers. 

How Does Obesity Increase the Risk of Gastrointestinal Cancer?

The relationship between obesity and gastrointestinal cancer involves several biological mechanisms. The following conditions lead to a negative impact of obesity on cancer risk.

1. Chronic Inflammation

Excess adipose tissue in obese individuals produces inflammatory cytokines, creating a favourable environment for inflammation. This can damage DNA and promote the formation of cancerous cells in the GI tract.

2. Hormonal Imbalances

Obesity changes the balance of hormones such as insulin and insulin-like growth factors (IGFs). Elevated levels of these hormones can stimulate cell multiplication.

3. Immune System Dysfunction

Excess fat impairs the immune system’s ability to identify and destroy abnormal or cancerous cells, increasing the chances of tumour formation and spread.

4. Changes in Gut Microbiota

Obesity affects the composition of gut bacteria, leading to dysbiosis. This imbalance can promote inflammation and produce carcinogenic compounds.

5. Direct Physical Effects

Conditions like gastroesophageal reflux disease (GERD) are more common in obese individuals and can cause stomach acid to damage the oesophageal lining over time, increasing the risk of oesophageal cancer.

Sachin Sharma, one of Dr. Deep’s happy patients, expressed his gratitude: “I had been struggling with severe obesity for years, which affected my health and confidence. Thanks to Dr. Deep Goel’s expertise in bariatric surgery, I underwent a successful gastric bypass procedure. I have lost significant weight, and my health has improved dramatically. Dr. Goel’s care and skill have truly transformed my life.”

Which Gastrointestinal Cancers are Caused by Obesity?

Certain GI cancers have a stronger association with obesity:

1. Esophageal Cancer

Abdominal obesity is linked to oesophageal adenocarcinoma. The condition is often preceded by Barrett’s oesophagus, a complication of chronic GERD worsened by obesity.

2. Colorectal Cancer

Excess fat tissue promotes inflammation, insulin resistance, and hormonal changes, all contributing to tumour development in the colon and rectum.

3. Liver Cancer

Non-alcoholic fatty liver disease (NAFLD) is strongly associated with obesity and can progress to liver fibrosis, cirrhosis, and ultimately hepatocellular carcinoma.

4. Pancreatic Cancer

Obesity increases the risk of pancreatic cancer, potentially due to chronic inflammation, insulin resistance, and metabolic abnormalities.

5. Stomach Cancer

While less common, obesity has been linked to certain forms of stomach cancer, particularly those affecting the upper stomach near the oesophagus.

This strong link between obesity and gastrointestinal cancer development highlights the need for proactive weight management and lifestyle modifications to reduce cancer risk.

How Obesity Increases Cancer Risk: The Role of Fat Distribution

Visceral fat, the fat stored around the abdominal organs, is more dangerous than subcutaneous fat (fat stored under the skin). It is highly metabolically active and produces inflammatory molecules and hormones that increase the risk of cancer. 

Research suggests that individuals with central obesity (excess abdominal fat) have a higher likelihood of developing gastrointestinal cancers compared to those with evenly distributed fat.

A 47-year-old patient of Dr. Deep, who underwent stage II colon cancer surgery, expresses his gratitude, “I was taken aback when I was diagnosed with colon cancer. As someone who struggled with obesity for years, I didn’t realise how much it increased my risk. Dr. Deep advised surgery, and after a successful procedure and follow-up treatment, I am now cancer-free. I have since adopted a healthier lifestyle, lost weight, and feel better than ever.”

What are the Strategies to Prevent Obesity-Related Cancers?

Reducing the risk of GI cancers begins with addressing obesity. Below are some steps to get you started:

1. Adopt a Healthy Diet

Choose a balanced diet rich in fruits, vegetables, proteins, and whole grains. Limit the intake of processed foods and sugary beverages that are linked to cancer risk.

2. Regular Physical Activity

Engaging in at least 30 minutes of exercise per day helps maintain a healthy weight, improves insulin sensitivity, and reduces inflammation.

3. Maintain a Healthy Weight

Regular monitoring of BMI and waist circumference can help individuals track their risk. For those who are overweight or obese, gradual and sustained weight loss can lower cancer risk.

4. Limit Alcohol Consumption

Both alcohol and tobacco use are independent risk factors for many GI cancers. Combining these habits with obesity further amplifies the risk.

5. Seek Regular Medical Checkups

Routine screenings for conditions like colorectal cancer, especially in high-risk individuals, can help detect and treat cancer early.

6. Manage Chronic Conditions

Address underlying issues like diabetes, high blood pressure, and GERD, which are often associated with obesity and contribute to cancer risk.

Sustainable lifestyle changes and preventive healthcare can help lower our risk of obesity-related gastrointestinal cancers.

Which Healthcare Professionals to Consult if You Are Affected by Obesity?

Gastroenterologists and oncologists play a vital role in addressing obesity-related cancers. By providing personalised guidance on weight management, dietary counselling, and cancer screenings, healthcare professionals can help individuals reduce their GI cancer risks.

In some cases, bariatric surgery may be recommended for individuals with severe obesity, not only to aid in weight loss but also to reduce their risks.

What is the Standard Cost of Bariatric Surgery in India?

In India, the cost of bariatric surgery depends on factors such as the type of procedure, hospital location, and surgeon expertise. For international patients, gastric bypass surgery costs between USD 6000 and USD 7000, and sleeve gastrectomy costs between USD 5000 and USD 6000.

Conclusion

The link between obesity and gastrointestinal cancer highlights the importance of a proactive approach to health and wellness. Through healthy lifestyle choices and regular screenings with healthcare professionals, individuals can take meaningful steps to mitigate their risks.

If you are concerned about obesity’s impact on your gastrointestinal health, consult Dr. Deep Goel for personalised guidance today.

FAQs

1. Are people with obesity more likely to experience complications during cancer treatment?

Yes, obesity can increase the risk of complications during cancer surgery and therapies. It may also affect medication metabolism during treatment.

2. How does obesity affect cancer recurrence after treatment?

Obese patients have a higher risk of cancer recurrence due to persistent inflammation, insulin resistance, and hormonal imbalances. 

3. Can dietary supplements help prevent gastrointestinal cancer in obese individuals?

While some supplements, such as vitamin D and fibre, may support gut health, a balanced diet is the only proper substitute. 

4. Are children and adolescents with obesity at risk for developing GI cancer later in life?

Yes, prolonged exposure to harmful metabolic and inflammatory processes can increase the likelihood of GI cancers.

5. Does weight cycling affect GI cancer risk?

Frequent weight fluctuations can disrupt metabolism and increase inflammation.

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