*The Multiple Consequences of Obesity DOI: http://dx.doi.org/10.5772/intechopen.104764*

impact of obstructive sleep apnea on nonalcoholic fatty liver disease in patients with severe obesity. Obesity (Silver Spring). 2016;**24**(4):871-877. DOI: 10.1002/oby.21409

[32] Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK. Interactions between obesity and obstructive sleep apnea: Implications for treatment. Chest. 2010;**137**(3):711-719. DOI: 10.1378/chest.09-0360

[33] Willenberg T, Schumacher A, Amann-Vesti B, Jacomella V, Thalhammer C, Diehm N, et al. Impact of obesity on venous hemodynamics of the lower limbs. Journal of Vascular Surgery. 2010;**52**(3):664-668. DOI: 10.1016/j. jvs.2010.04.023

[34] Danielsson G, Eklof B, Grandinetti A. L. Kistner R. The influence of obesity on chronic venous disease. Vascular and Endovascular Surgery. 2002;**36**(4):271-276

[35] Davies HO, Popplewell M, Singhal R, Smith N, Bradbury AW. Obesity and lower limb venous disease - The epidemic of phlebesity. Phlebology. 2017;**32**(4):227-233. DOI: 10.1177/ 0268355516649333

[36] Ageno W, Piantanida E, Dentali F, Steidl L, Mera V, Squizzato A, et al. Body mass index is associated with the development of the post-thrombotic syndrome. Thrombosis and Haemostasis. 2003;**89**:305-309

[37] Hansson PO, Eriksson H, Welin L, Svärdsudd K, Wilhelmsen L. Smoking and abdominal obesity: Risk factors for venous thromboembolism among middle-aged men: The study of men born in 1913. Archives of Internal Medicine. 1999;**159**(16):1886-1890

[38] Kasielska-Trojan A, Sobczak M, Antoszewski B. Risk factors of striae gravidarum. International Journal of Cosmetic Science. 2015;**37**(2):236-240

[39] Oakley AM, Patel BC. Stretch Marks. Treasure Island (FL): StatPearls Publishing; 2021. p. 2021. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK436005/

[40] Waldman RA, Kettler AH. Dermatologic manifestations of obesity: Part I mechanical causes. Journal of Obesity and Weight-loss Medication. 2016;**1**:010

[41] Kalra MG, Higgins KE, Kinney BS. Intertrigo and secondary skin infections. American Family Physician. 2014;**89**(7): 569-573

[42] Scheinfeld NS. Obesity and dermatology. Clinics in Dermatology. 2004;**22**(4):303-309. DOI: 10.1016/j. clindermatol.2004.01.001

[43] El Safoury OS, Ibrahim M. A clinical evaluation of skin tags in relation to obesity, type 2 diabetes mellitus, age, and sex. Indian Journal of Dermatology. 2011;**56**(4):393-397. DOI: 10.4103/0019-5154.84765

[44] Pandey A, Sonthalia S. Skin Tags. Treasure Island (FL): StatPearls Publishing; 2021. p. 2021

[45] Zabawski E, Styles A, Goetz D, Cockerell C. Asymptomatic facial papules and acrochordons of the thighs Birt-Hogg-Dube syndrome. Dermatology Online Journal. 1997;**3**(2):6

[46] Sachs C, Lipsker D. The molluscum pendulum necklace sign in tuberous sclerosis complex: A case series a pathognomonic finding? Journal of the European Academy of Dermatology and Venereology. 2017;**31**(11):e507-e508

[47] Pollitzer S. Acanthosis nigricans: A symptom of a disorder of the

abdominal sympathetic. Journal of the American Medical Association. 1909;**53**(17):1369-1373

[48] Robinson SS, Tasker S. Acanthosis nigricans juvenilis associated with obesity; report of a case, with observations on endocrine dysfunction in benign acanthosis nigricans. Archives of Dermatology and Syphilology. 1947;**55**(6):749-760

[49] Kutlubay Z, Engin B, Bairamov O, Tüzün Y. Acanthosis nigricans: A fold (intertriginous) dermatosis. Clinics in Dermatology. 2015;**33**(4):466-470

[50] Schilling WH, Crook MA. Cutaneous stigmata associated with insulin resistance and increased cardiovascular risk. International Journal of Dermatology. 2014;**53**(9):1062-1069

[51] Waldman RA, Kettler AH. Dermatologic manifestations of obesity: Part 2 endocrine abnormalities. Australian Journal of Dermatology. 2016;**3**(3):1053-1059

[52] Sayed CJ, Hsiao JL, Okun MM. Hidradenitis suppurativa foundation Women's health subcommittee. Clinical epidemiology and Management of Hidradenitis Suppurativa. Obstetrics and Gynecology. 2021;**137**(4):731-746. DOI: 10.1097/AOG.0000000000004321

[53] Burt Solorzano CM, Knudsen KL, Anderson AD, Hutchens EG, Collins JS, Patrie JT, et al. Insulin resistance, hyperinsulinemia, and LH: Relative roles in peripubertal obesity-associated hyperandrogenemia. The Journal of Clinical Endocrinology and Metabolism. 2018;**103**(7):2571-2582. DOI: 10.1210/ jc.2018-00131

[54] McCartney CR, Prendergast KA, Chhabra S, Eagleson CA, Yoo R, Chang RJ, et al. The association of obesity and hyperandrogenemia during the pubertal transition in girls: Obesity as a potential factor in the genesis of postpubertal hyperandrogenism. The Journal of Clinical Endocrinology and Metabolism. 2006;**91**(5):1714-1722. DOI: 10.1210/jc.2005-1852

[55] Napolitano M, Megna M, Monfrecola G. Insulin resistance and skin diseases. The Scientific World Journal. 2015;**1**:247-250. DOI: 10.1155/ 2015/479354

[56] Poretsky L, Cataldo NA, Rosenwaks Z, Giudice LC. The insulinrelated ovarian regulatory system in health and disease. Endocrine Reviews. 1999;**20**:535-582

[57] Kaspersen KA, Pedersen OB, Petersen MS, Hjalgrim H, Rostgaard K, Møller BK, et al. Obesity and risk of infection: Results from the Danish blood donor study. Epidemiology. 2015;**26**(4):580-589. DOI: 10.1097/ EDE.0000000000000301

[58] Harpsøe MC, Nielsen NM, Friis-Møller N, Andersson M, Wohlfahrt J, Linneberg A, et al. Body mass index and risk of infections among women in the Danish National Birth Cohort. American Journal of Epidemiology. 2016;**183**(11):1008-1017. DOI: 10.1093/ aje/kwv300

[59] Kane H, Lynch L. Innate immune control of adipose tissue homeostasis. Trends in Immunology. 2019;**40**:857-872. DOI: 10.1016/j.it.2019.07.006

[60] Nakamizo S, Honda T, Kabashima K. Obesity and inflammatory skin diseases. Trends in Immunotherapy. 2017;**3**(1):98. DOI: 10.24294/ti.v3.i1.98

[61] Hashba H, Bifi J, Thyvalappil A, Sridharan R, Sreenivasan A, Mathew P. Prevalence of metabolic syndrome in

*The Multiple Consequences of Obesity DOI: http://dx.doi.org/10.5772/intechopen.104764*

patients with lichen planus: A crosssectional study from a tertiary care center. Indian Dermatology Online Journal. 2018;**9**(5):304-308. DOI: 10.4103/idoj.IDOJ\_27\_18

[62] Subak LL, Richter HE, Hunskaar S. Obesity and urinary incontinence: Epidemiology and clinical research update. The Journal of Urology. 2009;**182**( Suppl. 6):S2-S7. DOI: 10.1016/j.juro.2009.08.071

[63] Bays HE, Gonzalez-Campoy JM, Bray GA, Kitabchi AE, Bergman DA, Schorr AB, et al. Pathogenic potential of adipose tissue and metabolic consequences of adipocyte hypertrophy and increased visceral adiposity. Expert Review of Cardiovascular Therapy. 2008;**6**(3):343-368

[64] Cinti S. The adipose organ at a glance. Disease Models & Mechanisms. 2012;**5**(5):588-594. DOI: 10.1242/ dmm.009662

[65] Ishibashi J, Seale P. Medicine Beige can be slimming. Science. 2010;**328**:1113-1114

[66] Petrovic N, Walden TB, Shabalina IG, Timmons JA, Cannon B, Nedergaard J. Chronic peroxisome proliferator-activated receptor gamma (PPARgamma) activation of epididymally derived white adipocyte cultures reveals a population of thermogenically competent, UCP1 containing adipocytes molecularly distinct from classic brown adipocytes. Journal of Biological Chemistry. 2015;**285**(10):7153- 7164. DOI: 10.1074/jbc.M109.053942

[67] Boström P, Wu J, Jedrychowski MP, Korde A, Ye L, Lo JC, et al. A PGC1 α-dependent myokine that drives brown-fat-like development of white fat and thermogenesis. Nature. 2012;**481**(7382):463-468

[68] Shan T, Liang X, Bi P, Zhang P, Liu W, Kuang S. Distinct populations of adipogenic and myogenic Myf5-lineage progenitors in white adipose tissues. Journal of Lipid Research. 2013;**54**(8): 2214-2224. DOI: 10.1194/jlr.M038711

[69] Zwick RK, Guerrero-Juarez CF, Horsley V, Plikus MV. Anatomical, physiological, and functional diversity of adipose tissue. Cell Metabolism. 2018;**27**(1):68-83. DOI: 10.1016/j. cmet.2017.12.002

[70] Monzon JR, Basile R, Heneghan S, Udupi V, Green A. Lipolysis in adipocytes isolated from deep and superficial subcutaneous adipose tissue. Obesity Research. 2002;**10**(4):266-269

[71] Bays H, Mandarino L, DeFronzo RA. Role of the adipocyte, free fatty acids, and ectopic fat in pathogenesis of type 2 diabetes mellitus: Peroxisomal proliferator-activated receptor agonists provide a rational therapeutic approach. The Journal of Clinical Endocrinology and Metabolism. 2004;**89**(2):463-478. DOI: 10.1210/jc.2003-030723

[72] Available from: https://analyzedirect. com/documents/guides/adipose\_tissue\_ classification\_and\_quantification.pdf

[73] Shen W, Wang Z, Punyanita M, Lei J, Sinav A, Kral JG, et al. Adipose tissue quantification by imaging methods: A proposed classification. Obesity Research. 2003;**11**(1):5-16. DOI: 10.1038/ oby.2003.3

[74] Hausman DB, DiGirolamo M, Bartness TJ, Hausman GJ, Martin RJ. The biology of white adipocyte proliferation. Obesity Reviews. 2001;**2**:239-254

[75] Wang Q, Imam MU, Yida Z, Wang F. Peroxisome proliferatoractivated receptor gamma (PPARγ) as a target for concurrent management of diabetes and obesity-related cancer. Current Pharmaceutical Design.

2017;**23**:3677-3688. DOI: 10.2174/1381612 82366617070412510

[76] Rey-López JP, de Rezende LF, Pastor-Valero M, Tess BH. The prevalence of metabolically healthy obesity: A systematic review and critical evaluation of the definitions used. Obesity Reviews. 2014;**15**:781-790. DOI: 10.1111/obr.12198

[77] Stenkula KG, Erlanson-Albertsson C. Adipose cell size: Importance in health and disease. American Journal of Physiology—Regulatory, Integrative and Comparative Physiology. 2018;**315**:R284-R295

[78] Misra A, Vikram NK. Clinical and pathophysiological consequences of abdominal adiposity and abdominal adipose tissue depots. Nutrition. 2003;**19**:457-466

[79] Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nature Reviews. Immunology. 2011;**11**(2):85-97

[80] Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW. Obesity is associated with macrophage accumulation in adipose tissue. The Journal of Clinical Investigation. 2003;**112**:1796-1808. DOI: 10.1172/ JCI200319246

[81] Blouin K, Nadeau M, Perreault M, Veilleux A, Drolet R, Marceau P, et al. Effects of androgens on adipocyte differentiation and adipose tissue explant metabolism in men and women. Clinical Endocrinology. 2010;**72**(2):176-188

[82] Morino K, Petersen KF, Shulman GI. Molecular mechanisms of insulin resistance in humans and their potential links with mitochondrial dysfunction. Diabetes. 2006;**55**(Supplement 2):S9-S15

[83] Snel M, Jonker JT, Schoones J, Lamb H, de Roos A, Pijl H, et al.

Ectopic fat and insulin resistance: Pathophysiology and effect of diet and lifestyle interventions. International Journal of Endocrinology. 2012;**2012**(7):983814. DOI: 10.1155/ 2012/983814

[84] Morawietz H, Bornstein SR. Leptin, endothelin, NADPH oxidase, and heart failure. Hypertension. 2006;**47**(5):e20-e21

[85] Barone I, Giordano C, Bonofiglio D, Andò S, Catalano S. Leptin, obesity and breast cancer: Progress to understanding the molecular connections. Current Opinion in Pharmacology. 2016;**31**:83-89. DOI: 10.1016/j.coph.2016.10.003

[86] Saxena NK, Taliaferro-Smith L, Knight BB, et al. Bidirectional crosstalk between leptin and insulin-like growth factor-I signaling promotes invasion and migration of breast cancer cells via transactivation of epidermal growth factor receptor. Cancer Research. 2008;**68**:9712-9722. DOI: 10.1158/0008- 5472.CAN-08-1952

[87] Mori H, Hanada R, Hanada T, Aki D, Mashima R, Nishinakamura H, et al. Socs3 deficiency in the brain elevates leptin sensitivity and confers resistance to diet-induced obesity. Nature Medicine. Jul 2004;**10**(7):739-743

[88] Noel P, Patel K, Durgampudi C, Trivedi RN, de Oliveira C, Crowell MD, et al. Peripancreatic fat necrosis worsens acute pancreatitis independent of pancreatic necrosis via unsaturated fatty acids increased in human pancreatic necrosis collections. Gut. 2016;**65**:100-111

[89] Sarwar R, Pierce N, Koppe S. Obesity and nonalcoholic fatty liver disease: Current perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2018;**11**:533-542. DOI: 10.2147/DMSO.S146339

*The Multiple Consequences of Obesity DOI: http://dx.doi.org/10.5772/intechopen.104764*

[90] Chait A, den Hartigh LJ. Adipose tissue distribution, inflammation and its metabolic consequences, including diabetes and cardiovascular disease. Frontiers in Cardiovascular Medicine. 2020;**7**:22. DOI: 10.3389/ fcvm.2020.00022

[91] Qi XY, Qu SL, Xiong WH, Rom O, Chang L, Jiang Z-S. Perivascular adipose tissue (PVAT) in atherosclerosis: A double-edged sword. Cardiovascular Diabetology. 2018;**17**(134):1-20. DOI: 10.1186/s12933-018-0777-x

[92] Hursting SD, Digiovanni J, Dannenberg AJ, et al. Obesity, energy balance, and cancer: New opportunities for prevention. Cancer Prevention Research (Philadelphia, Pa.). 2012;**5**:1260-1272

[93] Bhaskaran K, Douglas I, Forbes H, et al. Body- mass index and risk of 22 specific cancers: A population-based cohort study of 5.24 million UK adults. Lancet. 2014;**384**:755-765

[94] Niedermaier T, Behrens G, Schmid D, Schlecht I, Fischer B, Leitzmann MF. Body mass index, physical activity, and risk of adult meningioma and glioma: A meta-analysis. Neurology. 2015;**85**(15):1342-1350. DOI: 10.1212/ WNL.0000000000002020

[95] Solinas G, Karin M. JNK1 and IKKbeta: Molecular links between obesity and metabolic dysfunction. The FASEB Journal. 2010;**24**:2596-2611

[96] Nakamura T, Furuhashi M, Li P, Cao H, Tuncman G, Sonenberg N, et al. Double-stranded RNA-dependent protein kinase links pathogen sensing with stress and metabolic homeostasis. Cell. 2010;**140**:338-348

[97] Iyengar NM, Hudis CA, Dannenberg AJ. Obesity and cancer: Local and systemic mechanisms. Annual Review of Medicine. 2015;**66**:297-309

[98] Lonergan PE, Tindall DJ. Androgen receptor signaling in prostate cancer development and progression. Journal of Carcinogenesis. 2011;**10**:20

[99] Subbaramaiah K, Morris PG, Zhou XK, et al. Increased levels of COX-2 and prostaglandin E2 contribute to elevated aromatase expression in inflamed breast tissue of obese women. Cancer Discovery. 2012;**2**:356-365

[100] Irahara N, Miyoshi Y, Taguchi T, et al. Quantitative analysis of aromatase mRNA expression derived from various promoters (I.4, I.3, PII and I.7) and its association with expression of TNFalpha, IL-6 and COX-2 mRNAs in human breast cancer. International Journal of Cancer. 2006;**118**:1915-1921

[101] Brown KA, McInnes KJ, Hunger NI, et al. Subcellular localization of cyclic AMP-responsive element binding protein-regulated transcription coactivator 2 provides a link between obesity and breast cancer in postmenopausal women. Cancer Research. 2009;**69**:5392-5399

[102] Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: Geographical distribution and riskfactors. International Journal of Cancer. 2006;**118**(7):1591-1602

[103] Bishayee A. The role of inflammation and liver cancer. Advances in Experimental Medicine and Biology. 2014;**816**:401-435

[104] Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer ina prospectively studied cohort of U.S. adults. New England Journal of Medicine. 2003;**348**(17):1625-1638

[105] Schmitz KH, Neuhouser ML, Agurs-Collins T, Zanetti KA, Cadmus-Bertram L, Dean LT, et al. Impact of obesity on cancer survivorship and the potential relevance of race and ethnicity. Journal of the National Cancer Institute. 2013;**105**(18):1344-1354. DOI: 10.1093/jnci/djt223

[106] Paskett ED, Dean JA, Oliveri JM, Harrop JP. Cancer-related lymphedema risk factors, diagnosis, treatment, and impact: A review. Journal of Clinical Oncology. 2012;**30**(30):3726-3733

[107] Gacci M, Sebastianelli A, Salvi M, et al. Role of abdominal obesity for functional outcomes andcomplications in men treated with radical prostatectomy for prostate cancer: Results of the MulticenterItalian report on radical prostatectomy (MIRROR) study. Scandinavian Journal of Urology. 2014;**48**(2):138-145

[108] Meyerhardt JA, Tepper JE, Niedzwiecki D, et al. Impact of body mass index on outcomes and treatmentrelated toxicity in patients with stage II and III rectal cancer: Findings from intergroup trial 0114. Journal of Clinical Oncology. 2004;**22**(4):648-657

[109] Teras LR, Kitahara CM, Birmann BM, et al. Body size and multiple myeloma mortality: A pooled analysisof 20 prospective studies. British Journal of Haematology. 2014;**166**(5):667-676

[110] Zang EA, Wynder EL. The association between body mass index and the relative frequencies of diseases in a sample of hospitalized patients. Nutrition and Cancer. 1994;**21**:247-261

[111] Cheung N, Wong TY. Obesity and eye diseases. Survey of Ophthalmology. 2007;**52**(2):180-195

[112] Klein BE, Klein R, Linton KL. Intraocular pressure in an American community. The beaver dam eye study. Investigative Ophthalmology & Visual Science. 1992;**33**:2224-2228

[113] Mori K, Ando F, Nomura H, et al. Relationship between intraocular pressure and obesity in Japan. International Journal of Epidemiology. 2000;**29**:661-666

[114] Age-Related Eye Disease Study Research Group. Risk factors associated with age-related macular degeneration. A case-control study in the age-related eye disease study: Age-related eye disease study report number 3. Ophthalmology. 2000;**107**:2224-2232

[115] Spaide RF, Armstrong D, Browne R. Continuing medical education review: Choroidal neovascularization in agerelated macular degeneration--what is the cause? Retina. 2003;**23**:595-614

[116] van Leiden HA, Dekker JM, Moll AC, et al. Blood pressure, lipids, and obesity are associated with retinopathy: The Hoorn study. Diabetes Care. 2002;**25**:1320-1325

[117] Wong TY, Larsen EK, Klein R, et al. Cardiovascular risk factors for retinal vein occlusion and arteriolar emboli: The atherosclerosis risk in Communities & Cardiovascular Health studies. Ophthalmology. 2005;**112**:540-547

[118] Teuscher AU, Meienberg O. Ischaemic oculomotor nerve palsy. Clinical features and vascular risk factors in 23 patients. Journal of Neurology. 1985;**232**:144-149

[119] Raina J, Foster JA. Obesity as a cause of mechanical entropion. American Journal of Ophthalmology. 1996;**122**:123-125

[120] Krispel CM, Keltner JL, Smith W, Chu DG, Ali MR. Undiagnosed papilledema in a morbidly obese patient *The Multiple Consequences of Obesity DOI: http://dx.doi.org/10.5772/intechopen.104764*

population: A prospective study. Journal of Neuro-Ophthalmology. 2011;**31**:310-315

[121] Kristinsson JK, Carlson AN, Kim T. Keratoconus and obesity-a connection? Investigative Ophthalmology & Visual Science. 2003;**44**:812

[122] Venneman NG, van Erpecum KJ. Pathogenesis of gallstones. Gastroenterology Clinics of North America. 2010;**39**:171-183

[123] Py S, Hsu YC, Cheng YF, Kor CT, Su WW. Strong association between metabolically-abnormal obesity and gallstone disease in adults under 50years. BMC Gastroenterol. 2019;**19**:117. DOI: 10.1186/s12876-019-1032-y

[124] Lammert F, Gurusamy K, Ko CW, Miquel JF, Mendez-Sanchez N, Portincasa P, et al. Gallstones. Nature Reviews Disease Primers. 2016;**2**:16024. DOI: 10.1038/nrdp.2016.24

[125] Pariente A, Erlinger S. Cholelithiasis and obesity: Epidemiology, pathophysiology, clinical manifestations and prevention. Hepato-Gastro Oncologie Digestive. 2017;**24**(1):18-25. DOI: 10.1684/hpg.2016.1395

[126] El-Serag HB, Hashmi A, Garcia J, Richardson P, Alsarraj A, Fitzgerald S, et al. Visceral abdominal obesity measured by CT scan is associated with an increased risk of Barrett's oesophagus: A case-control study. Gut. 2014;**63**(2):220-229

[127] Emerenziani S, Rescio MP, Guarino MP, Cicala M. Gastroesophageal reflux disease and obesity, where is the link? World Journal of Gastroenterology. 2013;**19**(39):6536- 6539. DOI: 10.3748/wjg.v19.i39.6536

[128] Eisenberg ML, Kim S, Chen Z, Sundaram R, Schisterman EF, Buck Louis GM. The relationship between male BMI and waist circumference on semen quality: Data from the LIFE study. Human Reproduction. 2014;**29**(2):193- 200. DOI: 10.1093/humrep/det428

[129] Amiri M, Ramezani TF. Potential adverse effects of female and male obesity on fertility: A narrative review. International Journal of Endocrinology and Metabolism. 2020;**18**(3):e101776. DOI: 10.5812/ijem.101776

[130] Glenn T, Harris AL, Lindheim SR. Impact of obesity on male and female reproductive outcomes. Current Opinion in Obstetrics and Gynecology. 2019;**31**(4):201-206. DOI: 10.1097/ GCO.0000000000000549

[131] De Lorenzo A, Noce A, Moriconi E, Rampello T, Marrone G, Di Daniele N, et al. MOSH syndrome (male obesity secondary hypogonadism): Clinical assessment and possible therapeutic approaches. Nutrients. 12 Apr 2018; **10**(4):474. DOI: 10.3390/nu10040474

[132] Tremellen K. Gut endotoxin leading to a decline IN Gonadal function (GELDING) - a novel theory for the development of late onset hypogonadism in obese men. Basic and Clinical Andrology. 2016;**26**(1):1-13

[133] Dohle GR, Arver S, Bettocchi C, Jones TH, Kliesch S. EAU guidelines in male hypogonadism. European Association of Urology. 2015;**3**:242-252

[134] Costanzo PR, Pacenza NA, Aszpis SM, Suárez SM, Pragier UM, Usher JGS, et al. Clinical and etiological aspects of gynecomastia in adult males: A multicenter study. BioMed Research International. 2018;**1**:1-7. DOI: 10.1155/2018/8364824

[135] Isidori AM, Caprio M, Strollo F, et al. Leptin and androgens in male

obesity: Evidence for leptin contribution to reduced androgen levels. The Journal of Clinical Endocrinology and Metabolism. 1999;**84**:3673-3680

[136] Hrabovszky E, Ciofi P, Vida B, et al. The kisspeptin system of the human hypothalamus: Sexual dimorphism and relationship with gonadotropin-releasing hormone and neurokinin B neurons. European Journal of Neuroscience. 2010;**31**:1984-1998

[137] Ohtaki T, Shintani Y, Honda S, et al. Metastasis suppressor gene KiSS-1 encodes peptide ligand of a G-protein-coupled receptor. Nature. 2001;**411**:613-724

[138] Dhillo WS, Chaudhri OB, Patterson M, et al. Kisspeptin-54 stimulates the hypothalamic-pituitary gonadal axis in human males. The Journal of Clinical Endocrinology and Metabolism. 2005;**90**:6609-6615

[139] George JT, Veldhuis JD, Tena-Sempere M, Millar RP, Anderson RA. Exploring the pathophysiology of hypogonadism in men with type 2 diabetes: Kisspeptin-10 stimulates serum testosterone and LH secretion in men with type 2 diabetes and mild biochemical hypogonadism. Clinical Endocrinology. 2013;**79**:100-104

[140] Cohen PG. The hypogonadalobesity cycle: Role of aromatase in modulating the testosterone-estradiol shunt—A major factor in the genesis of morbid obesity. Medical Hypotheses. 1999;**52**:49-51

[141] Janiszewski PM, Janssen I, Ross R. Abdominal obesity and physical inactivity are associated with erectile dysfunction independent of body mass index. The Journal of Sexual Medicine. 2009;**6**:1990-1998

[142] Sermondade N, Faure C, Fezeu L, Shayeb AG, Bonde JP, Jensen TK, et al.

BMI in relation to sperm count: An updated systematic review and collaborative meta-analysis. Human Reproduction Update. 2013;**19**(3):221-231

[143] Tunc O, Bakos HW, Tremellen K. Impact of body mass index on seminal oxidative stress. Andrologia. 2011;**43**:121-128

[144] Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as disruptor of the female fertility. Reproductive Biology and Endocrinology. 2018;**16**(1):22. DOI: 10.1186/s12958-018-0336-z

[145] Broughton DE, Moley KH. Obesity and female infertility: Potential mediators of obesity's impact. Fertility and Sterility. 2017;**107**(4):840-847. DOI: 10.1016/j.fertnstert.2017.01.017

[146] Practice Committee of the American Society for Reproductive Medicine. Obesity and reproduction: A committee opinion. Fertility and Sterility. 2015;**104**(5):1116-1126

[147] Duggal PS, Van Der Hoek KH, Milner CR, Ryan NK, Armstrong DT, Magoffin DA, et al. The in vivo and in vitro effects of exogenous leptin on ovulation in the rat. Endocrinology. 2000;**141**(6):1971-1976. DOI: 10.1210/ endo.141.6.7509

[148] Dunaif A. Insulin resistance and the polycystic ovary syndrome: Mechanism and implications for pathogenesis. Endocrine Reviews. 1997;**18**(6):774-800. DOI: 10.1210/edrv.18.6.0318

[149] Cano F, Garcia-Velasco JA, Millet A, Remohi J, Simon C, Pellicer A. Oocyte quality in polycystic ovaries revisited: Identification of a particular subgroup of women. Journal of Assisted Reproduction and Genetics. 1997;**14**(5):254-261. DOI: 10.1007/ BF02765826

*The Multiple Consequences of Obesity DOI: http://dx.doi.org/10.5772/intechopen.104764*

[150] Carpentier AC. Postprandial fatty acid metabolism in the development of lipotoxicity and type 2 diabetes. Diabetes & Metabolism. 2008;**34**(2):97-107

[151] Tee MK, Dong Q, Miller WL. Pathways leading to phosphorylation of p450c17 and to the posttranslational regulation of androgen biosynthesis. Endocrinology. 2008;**149**(5):2667-2677

[152] Parihar M. Obesity and infertility. Reviews in Gynaecological Practice. 2003;**3**:120-126

[153] Giviziez CR, Sanchez EG, Approbato MS, Maia MC, Fleury EA, Sasaki RS. Obesity and anovulatory infertility: A review. JBRA Assisted Reproduction. 2016;**20**(4):240-245. DOI: 10.5935/1518-0557.20160046

[154] Wise LA, Rothman KJ, Mikkelsen EM, Sorensen HT, Riis A, Hatch EE. An internet-based prospective study of body size and time-topregnancy. Human Reproduction. 2010;**25**:253-264

[155] Gesink Law DC, Maclehose RF, Longnecker MP. Obesity and time to pregnancy. Human Reproduction. 2007;**22**:414-420

[156] Machtinger R, Combelles CM, Missmer SA, Correia KF, Fox JH, Racowsky C. The association between severe obesity and characteristics of failed fertilized oocytes. Human Reproduction. 2012;**27**(11):3198-3207

[157] Bellver J, Ayllon Y, Ferrando M, Melo M, Goyri E, Pellicer A, et al. Female obesity impairs in vitro fertilization outcome without affecting embryo quality. Fertility and Sterility. 2010;**93**:447-454

[158] Luke B, Brown MB, Stern JE, Missmer SA, Fujimoto VY, Leach R. SART writing group. Female obesity adversely affects assisted reproductive technology (ART) pregnancy and live birth rates. Human Reproduction. 2011;**26**(1):245-252

[159] Igosheva N, Abramov AY, Poston L, Eckert JJ, Fleming TP, Duchen MR, et al. Maternal diet-induced obesity alters mitochondrial activity and redox status in mouse oocytes and zygotes. PLoS One. 2010;**5**(4):e10074

[160] Parkash V, Fadare O, Tornos C, WG MC. Committee Opinion No. 631: Endometrial Intraepithelial Neoplasia. Obstetrics & Gynecology. 2015; **126**(4):897. DOI: 10.1097/AOG. 0000000000001071

[161] Siegel RL, Miller KD, Jemal A. Cancer statistics. A Cancer Journal for Clinicians. 2018;**68**(1):7-30. DOI: 10.3322/caac.21442

[162] American College of Obstetricians and Gynecologists. ACOG practice bulletin no 156: Obesity in pregnancy. Obstetrics & Gynecology. 2015;**126**:e112-e126

[163] Hahn KA, Hatch EE, Rothman KJ, Mikkelsen EM, Brogly SB, Sørensen HT, et al. Body size and risk of spontaneous abortion among Danish pregnancy planners. Paediatric and Perinatal Epidemiology. 2014;**28**(5):412-423

[164] Schummers L, Hutcheon JA, Bodnar LM, Lieberman E, Himes KP. Risk of adverse pregnancy outcomes by prepregnancy body mass index: A population-based study to inform prepregnancy weight loss counseling. Obstetrics and Gynecology. 2015; **125**(1):133

[165] Marchi J, Berg M, Dencker A, Olander EK, Begley C. Risks associated with obesity in pregnancy, for the

mother and baby: A systematic review of reviews. Obesity Reviews. 2015;**16**(8):621-638

[166] Lutsiv O, Mah J, Beyene J, McDonald SD. The effects of morbid obesity on maternal and neonatal health outcomes: A systematic review and meta-analyses. Obesity Reviews. 2015;**16**(7):531-546

[167] Weiss JL, Malone FD, Emig D, Ball RH, Nyberg DA, Comstock CH, et al. Obesity, obstetric complications and cesarean delivery rate–a populationbased screening study. American Journal of Obstetrics and Gynecology. 2004;**190**(4):1091-1097

[168] Spieker EA, Pyzocha N. Economic impact of obesity. Primary Care. 2016;**43**(1):83-95. DOI: 10.1016/j. pop.2015.08.013

[169] Thompson D, Edelsberg J, Colditz GA, Bird AP, Oster G. Lifetime health and economic consequences of obesity. Archives of Internal Medicine. 1999;**159**(18):2177-2183. DOI: 10.1001/ archinte.159.18.2177

[170] Kjellberg J, Tange LA, Ibsen R, Højgaard B. The socioeconomic burden of obesity. Obesity Facts. 2017;**10**: 493-502. DOI: 10.1159/000480404

[171] Lee H, Ahn R, Kim TH, Han E. Impact of obesity on employment and wages among young adults: Observational study with panel data. International Journal of Environmental Research and Public Health. 2019;**16**(1):139. DOI: 10.3390/ijerph16010139

[172] Leeper L. Body size stigmatization in preschool children: The role of control attributions. Journal of Pediatric Psychology. 2004;**29**:613-620

[173] Klesges RC, Haddock CK, Stein RJ, Klesges LM, Eck LH, et al. Relationship

between psychosocial functioning and body fat in preschool children: A longitudinal investigation. Journal of Consulting and Clinical Psychology. 1992;**60**:793-796

[174] Pierce JW, Wardle J. Cause and effect beliefs and self-esteem of overweight children. Journal of Child Psychology and Psychiatry. 1997;**38**:645-650

[175] Van Geel M, Vedder P, Tanilon J. Are overweight and obese youths more often bullied by their peers? A meta-analysis on the relation between weight status and bullying. International Journal of Obesity. 2014;**38**:1263-1267

[176] Puhl RM, Brownell KD. Bias, discrimination, and obesity. Obesity Research. 2001;**9**:788-805

[177] Bacchini D, Licenziati MR, Garrasi A, Corciulo N, Driul D, Tanas R, et al. Bullying and victimization in overweight and obese outpatient children and adolescents: An Italian multicentric study. PLoS One. 2015;**10**(11):e0142715. DOI: 10.1371/journal.pone.0142715

[178] Griffiths LJ, Wolke D, Page AS, Horwood P. Obesity and bullying: Different effects for boys and girls. Archives of Disease in Childhood. 2006;**91**:121-125

[179] Kessler RC, Berglund PA, Chiu WT, Deitz AC, Hudson JI, Shahly V, et al. The prevalence and correlates of binge eating disorder in the World Health Organization world mental health surveys. Biological Psychiatry. 2013;**73**(9):904-914

[180] Jacobi C, Hayward C, de Zwaan M, Kraemer HC, Agras WS. Coming to terms with risk factors for eating disorders: Application of risk terminology and suggestions for a general

*The Multiple Consequences of Obesity DOI: http://dx.doi.org/10.5772/intechopen.104764*

taxonomy. Psychological Bulletin. 2004;**130**(1):19-65

[181] Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Archives of General Psychiatry. 2010;**67**(3):220-229. DOI: 10.1001/ archgenpsychiatry.2010.2

[182] Penninx BW, Beekman AT, Honig A, Deeg DJ, Schoevers RA, van Eijk JT, et al. Depression and cardiac mortality: Results from a community-based longitudinal study. Archives of General Psychiatry. 2001;**58**(3):221-227

[183] Taylor VH, Forhan M, Vigod SN, McIntyre RS, Morrison KM. The impact of obesity on quality of life. Best Practice & Research. Clinical Endocrinology & Metabolism. 2013;**27**(2):139-146

[184] Stephenson J, Smith CM, Kearns B, et al. The association between obesity and quality of life: A retrospective analysis of a large-scale populationbased cohort study. BMC Public Health. 2021;**21**(1):1-9. DOI: 10.1186/ s12889-021-12009-8

[185] De Gonzalez AB, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ, et al. Body-mass index and mortality among 1.46 million white adults. NEJM. 2010;**363**(23):2211-2219
