Multiple studies have investigated the possible relationship between soft drink consumption and weight, and they consistently demonstrate that higher soft drink consumption is linked to increased energy (caloric) intake.

Research (Pan and Hu 2011) indicates that those who consume sugary drinks do not feel as satisfied as those who consume the same number of calories from solid food. They also do not appear to reduce their overall calorie intake to make up for the high-calorie content of these drinks. According to studies in children and adults, reducing the intake of sugary drinks among people who are already overweight can improve weight control (Chen et al. 2009; Ebbeling et al. 2006). According to the study of 33,097 adults, those who consumed sugary drinks had a higher risk of being obese than those who did not among those with a genetic susceptibility to the condition (Qi et al. 2012). Furthermore, it has been observed that consuming water instead of sugary beverages or fruit juices results in less overall weight gain (Pan et al. 2013).

From a technical standpoint, obese patients may encounter issues revolving around the improper functioning of medical instrumentation. Obese patients present a series of challenges to the performance and safety of magnetic resonance imaging (MRI) exams (Gach et al. 2019). The inability to accommodate large patients on currently designed imaging equipment and difficulties in acquiring desired image quality using computed tomography imaging (CT) in the context of obesity are already recognized (Uppot et al. 2007). The article (Destounis et al. 2011) discussed potential shortcomings that may exist in breast imaging and interventions for patients who are overweight. Obesity may be viewed as a surgical risk factor (Ri et al. 2018; Jin et al. 2005; Kassahun et al. 2022).

Additionally, obese people often have type 2 diabetes, heart disease, and other concomitant conditions that negatively impact wound healing. These factors mean that obese patients are more prone to wound healing issues such as wound breakdown, dehiscence and evisceration, all of which can lead to the development of fever (among other conditions) and extended hospital stays. Obesity is often associated with obstructive sleep apnea (OSA), which increases the risk of intraoperative and postoperative complications (De Jong et al. 2018). Finally, despite being a valuable option in managing obesity, bariatric surgery in adolescents comes with significant anesthetic challenges that need to be consistently evaluated and managed (Hashim et al. 2022). A higher risk of premature death has also been linked to increased sugary beverage consumption (Malik et al. 2019).

As authors of the report (Ward et al. 2021) indicate, policies to prevent excessive weight gain at all ages are needed to mitigate the health and economic effects of the obesity epidemic, which accounts for over $170 billion in excess medical costs annually in the United States. Although childhood obesity contributes a small proportion of total obesity-related medical costs, excess weight in childhood is a strong predictor of adult obesity. Medical expenses associated with obesity are higher for adult females and rise with age for all individuals, with 60 to 70-year-olds having the most significant predicted expenditures.

Regardless of obesity, routine consumption of sugar-sweetened beverages was linked to a higher incidence of type 2 diabetes. Assuming causation, a significant number of newly diagnosed cases of diabetes may be linked to years of consumption of sugar-sweetened beverages. Moreover, findings support that neither artificially sweetened drinks nor fruit juice are suitable alternatives to sugar-sweetened beverages for the prevention of type 2 diabetes (Imamura et al. 2015).

Type 2 diabetes is a widespread condition that is becoming more common all over the world. Along with other metabolic abnormalities like central obesity, hypertension, and dyslipidemia, type 2 diabetes is linked to several different conditions that increase the risk of cardiovascular morbidity and mortality. Excessive hepatic glucose production, peripheral insulin resistance, and poor beta-cell secretory function are the three primary pathologic defects in diabetes.

No matter the glucose intolerance’s cause, the hyperglycemia’s duration and severity determine the microvascular complications, and the therapeutic objectives should be similar to those of patients with insulin-dependent type 1 diabetes.

Various patient characteristics, including the presence of obesity and dyslipidemia, the duration of diabetes, and other concurrent conditions, affect the choice of an initial oral antidiabetic medication. Combination therapy using two or three different classes of oral antidiabetic medications has been used worldwide and is effective. Medications like troglitazone, which primarily reduces insulin resistance in skeletal muscle; metformin, which inhibits excessive hepatic glucose production; acarbose, which delays the absorption of carbohydrates in the gut; and sulfonylureas, which act by promoting insulin secretion, are used in treatment edelman1998type.

Insulin therapy is required when oral antidiabetic drug dosages are at their highest level and still fail to control blood sugar levels. Combination therapy, which includes oral antidiabetic medication(s) taken during the day and intermediate-acting insulin taken at bedtime, can be an efficient way to normalize glucose control in some patients without the need for strict insulin regimens. A split-mixed regimen using premixed 70/30 insulin prebreakfast and predinner can be very effective in obese subjects when combination therapy fails. More rigorous regimens may be necessary in thin type 2 diabetic subjects who need insulin. Patients with type 2 diabetes generally have a low risk of developing severe hypoglycemia, and the main side effect of insulin therapy is weight gain. Prevention of glucose intolerance and aggressive treatment of the other detrimental metabolic conditions linked to type 2 diabetes will not only improve quality of life, but also provide long-term cost savings.

According to research on eight European countries (Jönsson 2002) in 1999, total direct medical costs of type 2 diabetes were estimated at EUR 29 billion a year. The estimated average yearly cost per patient was EUR 2834 a year. Of these costs, hospitalizations accounted for the most significant proportion (55%, range 30–65%), totaling EUR 15.9 billion. During the 6-month evaluation period, 13% of the type 2 diabetic patients were hospitalized, with an average of 23 days in hospital projected annually. Contrarily, the cost of medications to treat type 2 diabetes was very modest. Insulin and anti-diabetic medications made up just 7% of the overall cost of treatment for people with type 2 diabetes. Authors of the most recent systematic review on type 2 diabetes (Soares Andrade et al. 2023) indicate that in most EU countries, the disease burden of type 2 diabetes is increasing dramatically over time, as reflected in the increasing expenditure on this population. There is no doubt that incidence and prevalence have grown over time. Due to a lack of information on mortality rates, authors were unable to produce reliable hypotheses. However, it is worth noticing that the total costs of type 2 diabetes have been increasing in the EU-28 countries over the years. The authors also indicate that well-designed, population-based disease burden studies are needed across the EU-28 to build a coherent picture.

Microvascular dysfunction is an early complication in obesity-related cardiovascular disease that affects the smallest blood vessels that branch off from the coronary arteries. With this condition, which can lead to changes in hemodynamic function and endothelial cell expression throughout the vasculature that is vessel specific (Soares and Murias 2018), oxygenated blood can get through the coronary arteries, but it cannot get through these crucial, small blood vessels the way it should, which can cause chest pain.

Diabetes mellitus is one of the most substantial risk factors for cardiovascular disease and, in particular, for ischemic heart disease (Severino et al. 2018). Furthermore, patients with diabetes mellitus have a significantly reduced capacity for the ischemic tissue to coordinate the molecular and cellular processes, leading to the restoration of tissue perfusion in response to the atherosclerotic occlusion of a patent artery. As a consequence, adverse tissue remodeling and the extent of ischemic injury are intensified, leading to increased morbidity and mortality (Howangyin and Silvestre 2014).

Ischemia is defined as inadequate blood supply (circulation) to a local area due to blockage of the blood vessels supplying the area. Ischemic heart disease, also called coronary heart disease (CHD) or coronary artery disease, is the name given to cardiac issues brought on by clogged coronary arteries, which supply blood to the heart muscle. Although the narrowing can be caused by a blood clot or by constriction of the blood vessel, most often, it is caused by a buildup of plaque, called atherosclerosis.

A heart attack, also referred to as a myocardial infarction (MI), occurs when the blood supply to the heart muscle is completely cut off. Most people with early CHD (less than 50% narrowing) lack any symptoms of blood flow restrictions. However, symptoms could appear as atherosclerosis worsens, particularly if they remain untreated. When the demand for the oxygen carried by the blood increases during exercise or emotional stress, they are most likely to happen. The discomfort experienced when the heart muscle is deprived of adequate oxygen is called angina pectoris. This is a clinical syndrome characterized by pain in the chest, jaw, shoulder, back, or arms that is typically aggravated by exertion or emotional stress and relieved promptly with rest or by taking nitroglycerin. Angina usually occurs in patients with CHD but can also occur in individuals with valvular disease, hypertrophic cardiomyopathy, and uncontrolled hypertension. Infrequently, patients with normal coronary arteries may experience angina related to coronary spasm or endothelial dysfunction (Rimmerman 2010).

According to research that followed 40,000 men over the course of two decades, those who drank an average of one can of a sugary beverage per day had a 20% greater chance of suffering a heart attack or passing away from one than those who drank less frequently dekoning2012sweetened. According to the Nurses’ Health Study, which followed the health of over 90,000 women for two decades, those who consumed more than two servings of sugary beverages each day had a 40% increased chance of suffering a heart attack or passing away from the condition (Fung et al. 2009).

In 2015, cardiovascular disease cost EU healthcare systems almost €111 billion, of which approximately €18 billion was due to ischemic heart disease and more than €20 billion due to stroke. Furthermore, production losses due to mortality and morbidity associated with cardiovascular disease cost €54 billion, and the total cost of providing informal care for people with cardiovascular disease was almost €45 billion (Wilkins et al. 2017).

Hepatocellular carcinoma (HCC) development is associated with several risk factors, including obesity. Obesity is highly prevalent in patients with non-alcoholic fatty liver disease (NAFLD), which is becoming one of the most frequent causes of liver disease worldwide. In many nations, NAFLD-related HCC is the liver transplant indication that is expanding the fastest. Obese HCC patients have higher death rates, which may not only be due to inferior treatment outcomes but also to delayed detection due to infrequent and subpar abdominal ultrasonography monitoring. This test is used worldwide for HCC screening. Moreover, obesity is associated with reduced survival in HCC patients (Saitta et al. 2019).

According to findings from a Women’s Health Initiative study that followed 98,786 postmenopausal women (aged 50 to 79) for roughly 20 years, those who consumed the most sugar-sweetened beverages had a higher chance of developing liver cancer (Zhao et al. 2023). More specifically, women who consumed one or more servings per day had significantly higher rates of liver cancer (18.0 vs. 10.3 per 100,000 person-years; adjusted hazard ratio (HR), 1.85; and chronic liver disease mortality (17.7 vs. 7.1 per 100,000 person-years; adjusted HR, 1.68) compared to those who consumed three or fewer servings per month of sugar-sweetened beverages. A considerably greater incidence of liver cancer and death from chronic liver illnesses was linked to consuming one or more sugar-sweetened beverages per day as opposed to 3 or fewer sugar-sweetened drinks per month.

The cost of HCC in Europe was €4 billion according to the study carried out by IHE across 31 countries: the EU-27 member states, Iceland, Norway, Switzerland, and the UK for the year 2018 (Hofmarcher and Lindgren 2020). According to estimates, the total yearly cost of HCC in the US is \( \$ \)437 million, or \( \$ \)31,641 per patient. In 2008, healthcare expenses made up 89.2% (\( \$ \)390 million) of the overall cost, while lost productivity costs made up 10.8% (\( \$ \)47 million) of the total (Gondek et al. 2008).

Gout is a painful and complex variant of arthritis. It occurs when a surplus of uric acid accumulates as sharp crystals in joints. The body produces uric acid naturally when it breaks down purines. Using multivariate regression analysis, researchers (Zgaga et al. 2012) found that dairy, calcium and lactose intakes were inversely associated with urate (p = 0.008, p = 0.003, p = 0.0007, respectively). On the other hand, sugar-sweetened beverage consumption was positively related to high plasma urate levels (p = 0.008). Flare-ups of symptoms such as intense joint pain, swelling, lingering discomfort and range of motion limitation are most commonly associated with gout.

An estimated 8 million Americans suffer from gout, and those who work miss an average of nearly 5 more days from work each year than those without the condition. The added annual cost of care for a gout sufferer is projected to be more than $3000 when compared to a non-gouty person (Wertheimer et al. 2013).

Consumption of sweetened beverages may pose a challenge to maintaining a healthy skeletal system. Consuming more phosphate than calcium can have a deleterious effect on bone health (Malik et al. 2006). The majority of soft beverages lack calcium and other beneficial minerals. In a meta-analysis, authors of the article (Ahn and Park 2021) prove a significant inverse association between the consumption of sugary beverages and bone mineral density (BMD). The results of the qualitative review supported the finding that soda intake was linked to bone health. Bones containing more minerals are denser, so they tend to be stronger and less likely to break. When too much bone is lost, osteoporosis can develop.

In 2005, the direct medical costs of osteoporosis in the United States were estimated to be 13.7 to 20.3 billion dollars. It is also projected that by 2025, more than 3 million cases of osteoporotic fracture will occur annually, with an estimated cost of 25.3 billion dollars (Burge et al. 2007). The total direct cost of osteoporotic fractures in 2019 in Europe (all 27 EU countries + Switzerland, UK) was estimated at €56.9 billion (Kanis et al. 2021).