Osteoarthritis of weight-bearing joints. The additional weight placed on joints, particularly knees and hips, results in rapid wear and tear, along with pain caused by inflammation. Similarly, bones and muscles of the back are constantly strained, resulting in disk problems, pain and decreased mobility.

Sleep apnea/respiratory problems. Fat deposits in the tongue and neck can cause intermittent obstruction of the air passage. Because the obstruction is increased when sleeping on your back, you may find yourself waking frequently to reposition yourself. The resulting loss of sleep often results in daytime drowsiness and headaches.

Gastroesophageal reflux/Heartburn. Acid belongs in the stomach and seldom causes any problem when it stays there. When acid escapes into the esophagus through a weak or overloaded valve at the top of the stomach, the result is called gastroesophageal reflux, and "heartburn" and acid indigestion are common symptoms. Approximately 10% to 15% of patients with even mild sporadic symptoms of heartburn will develop a condition called Barrett's esophagus, which is a premalignant change in the lining membrane of the esophagus, a cause of esophageal cancer. For more information on heartburn, its causes and possible cures, visit www.heartburnhelp.com.

Depression. Seriously overweight persons face constant challenges to their emotions: repeated failure with dieting, disapproval from family and friends, sneers and remarks from strangers. They often experience discrimination at work and cannot fit comfortably in theatre seats or ride in a bus or plane.

Infertility. The inability or diminished ability to produce offspring.

Urinary stress incontinence. A large, heavy abdomen and relaxation of the pelvic muscles, especially associated with the effects of childbirth, may cause the valve on the urinary bladder to be weakened, leading to leakage of urine with coughing, sneezing or laughing.

Menstrual irregularities. Morbidly obese individuals often experience disruptions of the menstrual cycle, including interruption of the menstrual cycle, abnormal menstrual flow and increased pain associated with the menstrual cycle.