How Does Obesity Affect Chronic Venous Insufficiency?

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Chronic venous insufficiency is a vein disorder where the leg veins that pump blood back to the heart stop functioning normally. While it’s most common in people over the age of 50, it’s also a possible health threat for younger adults who are living a sedentary and unhealthy lifestyle. Those who are overweight or obese are at a much higher risk of having this venous disease. 

So how does obesity cause chronic venous insufficiency? It has to do with the blood circulation and the changes in the pressure in the venous system. When you’re obese, the amount of excess body weight and fat puts pressure on your veins which can damage the vein walls and valves that move the blood. This can cause excess pooling of blood within the vessels and lead to painful symptoms of leg ulcers, swelling, and muscle cramps.  

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How Being Obese Increases Risk For Chronic Venous Insufficiency and Leg Vein Problems

Individuals who have accumulated excessive amounts of fat and have a body mass index of over 30 are considered obese. According to statistics, the current rate of obesity in US adults is at 42.4%, which is the highest number ever recorded in recent years. Being obese isn’t ideal because it can expose you to a number of health diseases, and it’s one of the common risk factors for chronic venous insufficiency. 

The state of being obese isn’t just about seeing your body change to become thicker and chubbier. As your body fat continues to build up, there are also changes happening internally particularly as your adipose tissue expands and puts pressure on the important vein structures that carry oxygen-rich blood to your heart. 

Here’s how having that extra weight affects the health of your veins and the overall function of your venous system: 

1) The enlarged fatty tissues can constrict the walls of the veins 

Compared to the arteries that have stronger and thicker structures, the walls in the capillaries and veins are thinner to allow blood to smoothly pass and travel to the heart. However, having excess fat can squeeze and increase venous pressure in the vein walls which can hinder the normal blood flow. 

2) Elevated blood pressure can also weaken the one-way valves in the deep veins 

For veins located in the legs, they have a set of fragile valves that pushes blood up to the heart and prevents them from flowing backward. However, when the vein walls compress due to the stress of excess weight, the valves will also be impaired and they’ll be unable to transport blood in the proper direction. Weakened vein valves are the number one reason for the symptoms of chronic venous insufficiency

3) Damaged vein valves can cause blood to leak and pool within the vessels 

Once blood is unable to pass through the veins due to failing valves, it can begin to accumulate inside the veins and stretch or expand its thin walls. This can lead to the appearance of bulging and discolored varicose veins on the skin surface. Leaky leg veins can also cause symptoms of weakness or heaviness, swelling, leg and ankle pain, and cramps

4) Leaky veins can contribute to increased fluid retention in the legs 

Problems in the vein system and blood circulation can also increase the body’s ability to retain water. When the veins are unable to move blood, excess fluid can build up in the body’s tissues. This can result in lower extremity edema or swelling in the legs. Swollen leg veins can also cause uncomfortable symptoms such as leg weakness or heaviness, ankle pain, persistent cramps, and venous leg ulcers, among other forms of pain and discomfort. 

What Chronic Venous Insufficiency Looks Like In Obese Patients

The most common telltale sign of chronic venous insufficiency is the appearance of spider veins and varicose veins. But in obese patients, the presence of excess body fat can hide the visible veins on their legs. Compared to healthy patients, the varicose veins may not be as prominent or enlarged in those who are obese. 

To better understand how chronic venous insufficiency looks like in obese individuals, it’s important to know the different stages of this vein condition. Experts say that the current standard in classifying venous insufficiency is the CEAP system. It helps doctors to better determine the progression and current severity of chronic venous insufficiency in patients. CEAP stands for:

  • Clinical staging - this tells the doctor how the vein condition is affecting your body. 
  • Etiological - this helps the vein specialist identify the cause of your chronic venous insufficiency 
  • Anatomical - it determines which type of veins are affected and it is usually confirmed with the help of diagnostic testing. 
  • Pathophysiological - this shows how CVI has changed the flow of blood in the veins. 

The symptoms of chronic venous insufficiency are usually categorized using a clinical severity score. Here are common clinical classifications to help accurately diagnose CVI: 

  • Stage C0 - Having a clinical classification of C0 means that you are not yet showing any palpable signs of visible vein disease. This is the baseline level that shows that your venous system is still healthy and your leg veins are normally pumping blood to the heart. 
  • Stage C1 - This means that you already have a mild symptom of venous insufficiency. Upon close examination of the skin, you may notice some small spider veins or reticular veins. These vein conditions are nothing more than a cosmetic concern and don’t pose any serious risks for healthy individuals. 
  • Stage C2 - In this stage, varicose veins begin to form on your calf and lower leg and they can be accompanied by some degree of aching and persistent pain. If left untreated, the pressure in the legs can lead to swelling and progress to the next clinical stage.
  • Stage C3 - Swelling or edema in patients is more common in this stage of CVI. According to a study, symptoms of CVI in overweight and obese individuals are more likely to fall under this category. 
  • Stage C4 - Fluid retention can also progress to skin color changes which are classified under the C4 category. Studies show that obese patients may also see some dark patches or markings in the skin surrounding their swollen legs. They may also feel some hardness or tenderness in their skin texture. 
  • Stage C5 - In this stage, the increased fluid retention and blood pressure in the legs cause breakdown of the skin tissues and lead to venous leg ulcers. However, the ulceration is still mild and they can still heal on their own with medical management and treatments to reduce the persistent edema. Some obese patients can have this symptom of venous insufficiency. 
  • Stage C6 - There’s about 1% of CVI patients and obese individuals who may progress to the sixth stage of CEAP. This happens when the early symptoms of the vein disease were overlooked and have led to inflamed skin, open sores, or venous stasis ulcers in the legs. At this stage, the degree of ulceration is painful and may require special venous ulcer treatment, wound care, and medical dressings to avoid further skin infections. 

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How Vein Doctors Diagnose Chronic Venous Insufficiency

Using the CEAP classification is helpful for identifying the extent of the CVI symptoms which can be seen externally. But to analyze the exact underlying issues in your venous system, a vein specialist may conduct diagnostic tests to examine the diseased veins. Here are some tests that may be performed for diagnosing chronic venous insufficiency: 

Physical leg examination During this test, your doctor will visually examine your leg size and look for any present varicose veins. They’ll also assess the severity of any swelling or ulceration that is present. A Trendelenburg test may also be performed to help identify where the valvular incompetence is located in the deep veins. 
Venous duplex ultrasound Duplex scanning or ultrasound is a usual practice to diagnose chronic venous insufficiency. This involves the use of high-frequency sound waves to generate visual images of the blood vessels in the legs. This will help analyze the flow of blood and look for potential blockages or blood clots within the veins. 
Magnetic resonance venogram A magnetic resonance imaging (MRI) test uses radiofrequency technology to produce images of the leg veins. During this exam, the doctor also injects contrast dye into the veins so that it’s easy to search for any vein damage and monitor blood flow on the computer screen. 
CT venogram In a CT venography test, the images of the veins are produced using a series of X-rays and computer software. The doctor will also inject contrast dye to project and highlight the movement of blood in the veins to the computer monitor. 

Other Types of Blood Vessel Disease That Can Be Caused By Obesity  

People who are obese are generally at high risk for many health problems including diabetes, ischemic heart disease, coronary heart disease, and congestive heart failure. Aside from chronic venous insufficiency, it can also cause several serious vascular and vein diseases. Here are some of the possible complications from untreated venous insufficiency conditions: 

  • Deep vein thrombosis - DVT is a type of venous thromboembolism disorder where a blood clot has formed in the deep veins. It commonly happens in the veins in your legs and can be a primary cause of constant leg swelling and pain. Studies show that the risk for having DVT is almost five times higher for obese patients compared to nonobese individuals. 
  • Pulmonary embolism - This is another form of thromboembolism where a clot travels through the vessels and reaches the lungs. Obese patients with existing deep vein thrombosis are at higher risk for developing pulmonary embolism. This condition often causes shortness of breath and other debilitating symptoms like irregular heartbeat and chest pain. It can be potentially life-threatening so it’s important that you get immediate medical treatment to remove the clots. 
  • Postthrombotic syndrome - A post-thrombotic syndrome (PTS) occurs in obese patients who were previously diagnosed with venous thrombosis. It can develop within weeks or months after developing clots in the deep veins. Its symptoms can be similar to venous insufficiency where patients experience chronic leg pain, swelling, aching, redness, and venous leg ulcers.
  • Peripheral arterial disease - Obese individuals are also believed to be more likely to develop a peripheral arterial disease in their lower limbs. PAD is a vascular disease caused by the narrowing of the blood vessels which reduces the flow of blood to the legs. This can lead to leg pain and cramping which are more prominent whenever you are walking or standing.

Will Losing Weight Cure Chronic Venous Insufficiency?  

Going on a weight loss program can help improve some of the symptoms of chronic venous insufficiency and varicose veins. If you drop a few pounds and lose some amount of body fat, it can alleviate the pressure in your leg veins and promote healthier blood flow in the vessels. 

However, losing weight may not always be enough to solve the issue of damaged vein valves. For this reason, you will need to visit a vein specialist who can recommend the appropriate treatments for venous insufficiency conditions. Here are some of the effective CVI treatments and vein removal procedures: 

Sclerotherapy With a sclerotherapy treatment, a liquid or foam solution is injected directly into the diseased vein. This injection will irritate the vein, causing scar tissue to form to seal it and prevent blood flow. 
Endovenous laser ablation This vein treatment uses laser energy to heat and collapse the damaged veins. During this procedure, your doctor will insert a laser fiber into a catheter to send the heat into the affected vessels. 
Radiofrequency venous ablationA radiofrequency ablation is another catheter-assisted treatment that relies on electric energy to heat and close the vein wall. Over time, the treated vein will be absorbed by the body while blood flow is rerouted to healthy veins. 
Stents A venous stent placement helps to stretch or expand narrow or blocked veins to improve overall blood flow. The stents are applied to the vein by inserting a catheter through a small incision. 
VenaSeal VenaSeal is a vein closure treatment that delivers a small amount of medical adhesive to close the diseased veins. This will help reroute the blood supply to healthier veins and improve the appearance of varicose veins. 

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woman caring about her legs and veins

Making lifestyle changes and diet modifications to improve your obesity condition can significantly improve chronic venous insufficiency. But when these are not enough, there are available non-surgical procedures that can give relief from the uncomfortable symptoms of leg veins and enhance your quality of life. 

Discover more about the possible treatments for chronic venous insufficiency and varicose veins by consulting with our specialists at Vein Center Doctor. Our team is experienced in providing accurate diagnoses and high standards of care for patients with CVI and other types of vein conditions. To inquire about our procedures or to book a consultation with one of our doctors, call us today.

Your First Step To Being Vein Pain Free

Find exactly what you need to get rid of your vein-related problems. Dr. Sood and the rest of our team at Vein Center Doctor are ready to help: schedule your free consultation today.

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