Obesity is a growing epidemic around the world, affecting millions of people. The World Health Organization (WHO) reports that since 1975, the global rate of obesity has tripled. Over 1.9 billion adults were overweight in 2016, with over 650 million classified as obese.
This condition not only increases the risk of chronic diseases such as diabetes and heart disease but also can have a significant impact on wound healing. Obesity can delay wound healing, increase the risk of infection, and lead to other complications. In this article, we’ll explore the effects of obesity on wound healing and provide tips for how to help manage wounds in obese patients.
What Is Obesity?
Obesity is characterized by a surplus of body fat to the point where it severely impacts health. The BMI (body mass index), a measurement of body fat based on weight and height, is used to calculate the condition. According to the Centers for Disease Control and Prevention (CDC), a BMI of 30.0 or higher classifies someone as within the obesity range.
Obesity is a significant threat to the community’s health because of its link to a higher risk of many chronic diseases, including stroke, heart disease, diabetes, and multiple kinds of cancer. It can also cause psychological suffering, physical limitations, and a lower overall quality of life.
Genetic, environmental, and behavioral variables among other root causes are all involved in the risk of developing obesity. Sedentary behavior, a calorie-dense diet, heredity, particular drugs, and underlying medical disorders are just a few of the prevalent causes.
Millions of people around the world are affected by obesity, which makes it a serious public health issue. This condition has an impact on both wound healing as well as general health. Before we delve into the impact of obesity on the body’s ability to heal, let’s first explore the physiology of wound healing and why it’s relevant.
Understanding The Physiology Of Wound Healing
Hemostasis, inflammation, proliferation, and remodeling are typically used to classify the stages involved in the wound healing process. As immune cells remove pathogens and debris during inflammation, platelets form clots to stop bleeding during hemostasis. The proliferation stage is characterized by the growth of new tissue, whereas the maturation and remodeling of new tissue characterize the remodeling stage.
Obesity as an inflammatory condition is one of many factors that can easily upset the delicate balance that the wound-healing process depends on.
The Impact Of Obesity On Wound Healing
Obesity affects wound healing in various ways. The excess fat tissue in the body can lead to chronic inflammation, which can slow down the healing process. Inflammation can also impair the immune response, which serves to further delay wound healing. Moreover, body fat or adipose tissue can cause poor circulation, leading to limited blood supply to the wound site. This can reduce the delivery of much needed nutrients and oxygen to the wound, thereby increasing the risk of infection and other complications.
Obesity can also result in other comorbidities, including diabetes and cardiovascular disease, which can impair wound healing. Let’s further break down how obesity can affect some of the physiological processes essential for proper wound healing:
Vascular Insufficiency
Vascular insufficiency can negatively affect wound healing and play a major role in the development of certain chronic wounds. As adipose tissue grows in those struggling with obesity, it puts added stress on the circulatory system, resulting in vascular insufficiency, inflammation, delayed angiogenesis, and poor oxygenation. All of which can slow wound healing.
Impaired Immune Function
The immune system may be compromised by obesity, making it more challenging for the body to fight illnesses. This raises the possibility of wound infections, which can slow healing and cause further problems.
Chronic Inflammation
Chronic low-grade inflammation linked to obesity slows the healing of wounds. Overproduction of cytokines because of chronic inflammation can obstruct the healing process.
Reduced Blood Supply
Obesity decreases blood flow to the wound site, which hinders the delivery of nutrients and oxygen. As a result, the healing process is slowed down, and problems are more likely.
Poor Nutritional Status
Poor nutrition and malnutrition are frequently linked to obesity, which has been associated with slower wound healing. The healing process depends on proper nutrition, and vitamin and mineral deficits slow down the process.
Research on the Effects of Obesity On Wound Healing
Recent research has shed further light on the impact of obesity on wound healing.
- According to a recent review on ‘Obesity and Surgical Wound Healing’, “[obesity] induces complex negative effects on multiple organ system functions and processes, including issues related to wound healing.”
- This was further supported by an article published in ‘Advances in Wound Care’ that concluded that obesity, along with diabetes and other conditions can lead to a low inflammatory state potentially impairing wound healing and resulting in a higher risk of infection, prolonged pain, and other issues.
- Moreover, obesity has been associated with a greater risk of surgical site infection due to delayed wound healing; with some studies showing the risk increases five-fold.
- Another paper by the Journal of Dermatology and Skin Science found that 50% of individuals with obesity display skin changes including skin infections, with Staphylococcal and streptococcal infections being the most common.
The Link Between Obesity, Diabetes and Wound Healing
Obesity and diabetes are closely linked, and both can have a significant impact on wound healing. Obesity can increase the risk of developing type 2 diabetes, a condition characterized by high blood sugar levels. Diabetes can further complicate wound healing, leading to delayed healing, infections, and other complications. In fact, diabetic patients are more likely to develop chronic wounds than non-diabetic patients. The combination of obesity and diabetes can also affect the immune system, making it more challenging for the body to fight infections.
Managing wounds in obese patients with diabetes requires a comprehensive approach that addresses the underlying conditions. Wound care specialists work closely with patients to manage their weight, blood sugar levels, and other underlying conditions such as hypertension and high cholesterol. This may involve dietary changes, medication management, and regular physical activity.
Strategies To Improve Wound Healing In Obese Patients
Despite the challenges posed by obesity, several strategies can improve wound healing outcomes in obese patients. Your wound specialist can help outline a treatment plan and lifestyle changes for you to follow.
Early Intervention
- Early intervention is essential when managing wounds in obese patients. Wound and healthcare professionals should assess the patient’s overall health and take measures to manage their weight and other underlying conditions.
Wound Care Strategies
- Wound care strategies for obese patients must be tailored to their specific needs. For instance, wound specialists should consider the patient’s BMI when determining the type of dressing to use. Additionally, certain treatment approaches such as negative pressure wound therapy (NPWT) can be used in certain cases to improve wound healing in obese patients.
Weight Loss
- Weight loss is one of the most effective strategies for improving wound healing in obese patients. Weight loss improves immune function, reduces inflammation, and increases blood supply to the wound site.
Proper Nutrition
- Proper nutrition is essential for the healing process and is a necessary part of treatment for obese patients. Obese patients may be at increased risk for nutritional deficiencies, and addressing these deficiencies improves wound healing outcomes. Wound care specialists can work with a nutritionist to develop a dietary plan that meets the patient’s needs.
Regular Exercise
- Several studies have demonstrated that exercise tends to reduce inflammation in those struggling with obesity and improve wound healing. That said, it’s always recommended to consult with a wound care specialist before starting any exercise regimen to avoid exacerbating the wound or delaying healing.
Unlike other practices, at West Coast Wound Center, we don’t just focus on the wound, but take into consideration the most important factors that affect healing including overall health. We understand the crucial impact obesity and poor nutrition can have on healing and take a holistic and integrated approach to your wound care. We also work closely with each patient’s nutritionist to help optimize the wound healing process.
By addressing the challenges of managing wounds in obese patients, we can improve quality of life and reduce the burden of obesity-related complications. Book an appointment with our specialized team today.