The Relationship Between Cholesterol and Weight

Dr. Christopher McGowan
October 26, 2021

The quest to lose weight is a familiar one for most Americans, in large part because of the ever-expanding multibillion dollar weight loss industry. Through elaborate diets and expensive low fat and low calorie processed foods, the airwaves are flooded with endless dos and don’ts about what you should eat and what you shouldn’t. Blood cholesterol has long been one of the biggest boogeymen in this mix, but the concern about your food’s cholesterol content is one you should heed from doctors and nutritionists alike. 

What is Cholesterol?   

Cholesterol is a type of organic molecule called a lipid, a fatty or oily compound that is not dissolvable in water. The term lipid is often used interchangeably with the word fat, as in one of the three main components of the food we eat and the cells in our body: carbohydrates, proteins, and fats. Cholesterol, however, is a special type of lipid that is used by our cells for a variety of purposes, including the creation of cell membranes and the synthesis of some important hormones and vitamins. 

The liver actually produces up to 80% of the cholesterol we need for our bodies to function properly, so the rest must come from dietary sources like poultry, red meat, eggs, fish, and dairy products (but not from any plant products). The cholesterol that comes from these sources is broken down in the digestive system like any other substance, and it is absorbed by the small intestine and stored in the liver.  

Types of Cholesterol  

Since the body produces most of the cholesterol we need, only a small amount should come from the food we eat. If too much cholesterol is consumed from dietary sources, however, it can cause health problems over time. The main reason for this is based on the difference between the two subtypes of cholesterol: low-density lipoproteins and high-density lipoproteins. Cholesterol is able to move through the bloodstream by attaching itself to one of the two types:    

  • Low-density lipoproteins (LDL): LDL cholesterol has a high ratio of cholesterol to protein, and this makes these compounds more likely to become “stuck” to the wall of an artery in the form of plaque; this hardened substance is composed cholesterol as well as other lipids, calcium, and cellular waste. LDL cholesterol is often referred to as the “bad cholesterol.”   
  • High-density lipoproteins (HDL): HDL cholesterol has a low ratio of cholesterol to protein, by contrast, so it actually has the opposite effect and carries away up to a third of LDL cholesterol molecules. HDL cholesterol is thus referred to as the “good cholesterol.” 

Another type of fat, known as triglycerides, is related to cholesterol and the propensity for plaque to build up in the arteries. Triglycerides are the result of excess calories being consumed and then stored as fat. Indeed, this is the primary means of the body storing energy for future use. Over time, elevated triglyceride levels can additionally increase the amount of plaque that will build up in the arteries. LDL, HDL, and triglyceride levels are all used to derive a person’s overall cholesterol level as determined by a cholesterol test. 

Why is Cholesterol Bad for You? 

The main reason cholesterol needs to be taken seriously is because of the dangers associated with the plaque buildup described above. As the buildup continues, the blood vessels are physically narrowed enough to cause reduced blood flow and high blood pressure. This decreased blood flow means that cells and organs all over the body get less oxygen and fewer nutrients than they need to function properly. The resulting abnormalities on the artery walls, called atherosclerosis, are linked to a number of serious conditions: 

  • Coronary heart disease: Also known as coronary artery disease, this condition occurs when veins that flow to the heart become narrowed by plaque. The resulting reduction in blood flow can lead to numerous heart problems, ranging in severity from chest pain (angina) to heart attack or stroke.  
  • Heart attack: A heart attack happens when blood flow gets very low or is stopped completely. Even if blood flow is only stopped temporarily (known as ischemia), damage can be done to the heart muscle. Depending on the timing and the size of the area, the resulting damage can be permanent and even cause sudden death. 
  • Stroke: A stroke is similar to a heart attack in that it occurs when blood flow is slowed or stopped for a time. In this case, though, it happens when the blood supply to the brain is cut off. Like with a heart attack, the size of the area and the amount of time of the reduction determines how severe a stroke can be. In many cases the patient survives yet experiences loss of some bodily functions due to brain damage.  

The connection between cholesterol and atherosclerosis is somewhat insidious, because high cholesterol—whether because of family history or lifestyle choices—gradually leads to arterial plaque buildup. For most people, this process takes years and occurs without any symptoms. The earliest symptom of atherosclerosis is angina, a form of chest pain or pressure that indicates that blood flow is reduced enough to start negatively affecting cells and organs. But by that point, any attempt to reduce cholesterol and plaque buildup will be much more difficult. 

What Impact Does Weight Gain Have on High Cholesterol? 

Unfortunately, high cholesterol is often also a concern for people who are carrying too much excess body weight. Foods that are high in cholesterol, for instance, also tend to be high in saturated fats and trans fats. When saturated fats and trans fats are processed by the digestive system, they cause the liver to increase the amount of cholesterol released into the bloodstream. This means that weight gain brought on by consuming large amounts of saturated fat will increase LDL levels even beyond the increase from any cholesterol present in the food. 

The other way weight gain can increase cholesterol is through higher triglycerides. When excess calories in the form of glucose and free fatty acids are formed into triglycerides, these molecules collect as fat tissue; it creates a cycle where additional fat creates additional cholesterol. High triglycerides can also cause insulin resistance and widespread inflammation that can negatively impact how the body manages the beneficial HDL cholesterol.  

The Importance of Losing Weight

Given the risk factors involved in having high cholesterol, and the tendency of carrying excess body fat to add to cholesterol problems, it isn’t surprising that losing weight can have the opposite effect. When fat is burned through weight loss, the body begins to respond in a number of ways. Simply carrying less fat will lower cholesterol levels, but it will also reduce inflammation and insulin resistance so that hormone and HDL regulation returns to normal. 

The great news is that the benefits to cholesterol can be realized very quickly after starting to lose weight. Research shows that even losing 10 pounds can be enough to begin the process of reducing cholesterol. With LDL levels going down and HDL levels going up, the impact can also start to be seen in the arteries; plaque can start to be carried away by HDL molecules. And along with a reduction in arterial plaque comes substantially reduced risk of heart disease, heart attack, and stroke. 

Where to Get Help

If you struggle with obesity and have high cholesterol, you are at increased risk for several serious conditions. Losing weight is the number one way to prevent those potentially devastating health outcomes, but that is often easier said than done. Lifestyle changes like a healthy diet and exercise are important components of living a healthier life, but most people are not able to have the kind of sustainable success that they want. 

At True You Weight Loss, we understand that it’s a journey and that sometimes you need help. We offer several state-of-the-art non-surgical weight loss procedures that can help you jumpstart your weight loss journey in a way that has proven to be much more effective than traditional methods. If you have high cholesterol, or if you are just ready to find the freedom you’ve been looking for, contact us today to request a consultation.

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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