Fat Chance: The Health Risks of Obesity

Dr. Christopher McGowan
noviembre 10, 2020

Look around on social media, or in the advertisements in any magazine, and there is intense pressure to be as thin as possible. Despite this pressure, people in the United States are increasingly overweight with every passing year. 

It is no surprise that the images we see every day aren’t always real, but this leaves us with a question: is there a real advantage to staying at a healthy weight? Putting social pressures aside, it turns out you are at a much higher risk of many health conditions if you are overweight. 

What Being Overweight Does to Your Body

Carrying excess weight affects your body in a variety of ways. From increased strain on your heart and vascular tissue, to pressure on internal organs, joint issues and mobility problems, and even increased difficulty breathing during sleep, health problems can arise in nearly every part of your body as a result of obesity. Excess weight gain can put you at risk of heart disease, type 2 diabetes, sleep apnea, and high blood pressure. Recently there is even evidence to suggest your chances of experiencing severe symptoms or even dying from COVID-19 are increased by being overweight. 

Health Risks of Excess Weight Gain

The list of diseases and conditions highly correlated to having an extremely elevated body mass index (BMI) of 40 or higher reads like a laundry list of the deadliest health risks in the western world. There are many dietary and lifestyle choices that can lead to increased risks of a heart attack, liver, or gallbladder problems, but few conditions are as strongly correlated to such a wide range of problems as carrying excess weight. 

The Centers for Disease Control and Prevention (CDC) has identified the following conditions, among many others, in which excess weight is a risk factor:

  • gallstones
  • heart failure
  • high cholesterol
  • high blood pressure
  • sleep apnea
  • type 2 diabetes
  • depression
  • certain types of cancer
  • osteoarthritis

Some of these conditions are related to the raw physical pressure of extra weight being carried on your body. Skeletal issues such as osteoarthritis can be caused or aggravated by the extra pressure on your joints. Breathing problems, such as sleep apnea, may not be specifically caused by weight gain, and can be made worse by the extra pressure caused as fat builds in the neck and constricts your airway while you sleep. 

Other health consequences of excess body fat can be restricted to individual organs. Fatty liver disease, for example, is a condition of the liver where accumulations of fat on and around the organ can hinder the performance and long-term health of your liver. 

The stress placed on other organs is not as direct as the physical pressure of body fat, but comes about as your body has to work harder to support extra tissue. High blood pressure, also known as hypertension, and some forms of kidney disease can be exacerbated by the increased load of blood that needs to be circulated and filtered to keep your body functioning. 

Heart disease is one of the areas where a wide range of potential health risks begin to compound if you are overweight. Simply put, people with an above average BMI are at higher risk of developing unhealthy cholesterol and triglyceride levels, high blood pressure, high blood sugar levels, increased chances of stroke, higher likelihood of heart attacks, and other vascular conditions.

Type 2 diabetes is another condition where a high body mass index can put you at a disadvantage. High blood sugar levels, which often go hand in hand with excess weight gain, can lead to increased insulin resistance. Other forms of diabetes, such as gestational diabetes also list a high BMI as a risk factor. 

Some health risks of being overweight can affect all people, but others are more specific. Women who have a BMI over 40, for instance, are at increased risk for gestational diabetes, preeclampsia, miscarriage, and other serious complications. Being overweight is even identified as a potential risk factor for infertility, as even the ovaries can be affected by excess body fat. 

Sleep Apnea and Weight Gain

The relationship between weight gain and health issues is not only a one-way street either. Conditions like sleep apnea, often caused or significantly worsened by obesity, can actually cause you to gain more weight. As surprising as this may sound to some, the hormonal disturbances associated with poor sleep quality can have a direct impact on how much you weigh. 

When you are suffering from sleep apnea, your body comes close to being starved of oxygen multiple times a night. This can elevate levels of stress hormones such as cortisol in your blood. Elevated cortisol levels, and fewer hours of sleep overall, contribute to imbalances in ghrelin and leptin, the two hormones that help you know when to feel hungry and full respectively. With too much ghrelin in your system and not enough leptin, you will feel hungry more often and not feel full as quickly as you should. This can lead to eating more calories and gaining even more weight. 

Beyond adjusting your hormone levels in unfortunate ways, sleep apnea also contributes to weight gain by reducing your mobility during the day. If you are suffering from sleep apnea, you are less likely to be active and serious exercise may be out of the question. This lack of movement can make it even harder to achieve the caloric deficit that produces weight loss.

Weight Gain and High Blood Pressure

Sleep apnea is mostly inconvenient, though it could contribute to an increase in heart disease. High blood pressure, on the other hand, is far, far more dangerous. High blood pressure is one of the strongest predictors of heart disease, and while there can be other causes, there are very evident relationships between excess body weight and higher chances of heart failure. 

Carrying extra body weight means your body needs to maintain a larger volume of blood. This creates extra pressure on your entire cardiovascular system. Your heart and vascular system also face the pressure of increased vascular resistance caused by the force needed to push blood through tissues compressed by extra fatty deposits. 

High blood pressure also contributes to increased insulin resistance. This can lead to type 2 diabetes over time, as well as create a negative feedback loop over time since increased insulin resistance contributes to elevated sympathetic nervous system activation, which in turn causes your blood pressure to rise. 

The physical toll of extra body weight can also be a factor in how blood flow and blood pressure affect individual organs. This is illustrated in the way extra visceral adipose tissue (VAT) impacts kidney function. Fat cells can secrete hormones that disrupt the renin-angiotensin-aldosterone system (or RAAS), which your body uses to manage salt levels. When this balance is disturbed, your kidneys need to work harder to keep salt excretion balanced. This would be hard enough on the kidneys, but excess fatty tissue can actually inhibit blood flow to the kidneys. This compounds the problem since adequate blood flow is vital to proper kidney function under the best of circumstances. 

Can an Overweight Person be Healthy?

The answer to whether you can be overweight and still be healthy lies partly in how you define “health.” Not everyone’s body is the same, and some people will naturally carry more weight than others. The important thing is to maintain as healthy a lifestyle as you can, no matter what the scale says. 

At the simplest level, measuring your body mass index, or BMI, as a benchmark of health is a start, but there is more to the picture. Though you are at an increased risk of many health conditions if you have a high BMI, eating a proper diet and getting a healthy amount of exercise can keep you as healthy as possible, even if you naturally carry more weight. Keeping your consumption of alcohol to a minimum and avoiding unhealthy habits like smoking can also help you stay healthier even if you carry more body fat than some other people might. 

Healthy eating habits and a balanced diet rich in vegetables, whole grains, and lean protein sources but low in sugar and unhealthy fats is a start down the path to lowering the health risks associated with being overweight. The effectiveness of diet and exercise in fending off some health concerns diminish, though, as your BMI increases toward obese levels.

Losing Weight Can Help Reduce Health Risks

Losing weight is essential if you have a high BMI and other risk factors for certain diseases. If you have a family history of heart disease or certain types of cancer, the health risks of being overweight are significantly greater than that of the broader population. 

If you or your doctor have started to become concerned that your excess body weight might be putting you at risk for other medical conditions, there is some good news. Even a small amount of physical activity and healthy eating can begin to make dramatic differences in your overall health. Weight loss can seem daunting, but if you have a BMI that is considered obese, losing even a small amount of weight can dramatically lower your risks of heart disease and type 2 diabetes. 

Weight Loss Surgery and Excess Body Weight

For some people, lowering their body weight is absolutely essential, but diet and exercise have proven to be ineffective. In these cases, bariatric surgery is sometimes considered as an option. Bariatric surgeries or procedures that reduce the size of the stomach or alter the path of the digestive system can be effective in helping people lose extra weight in the short term. For the majority of patients, lower overall weight for the rest of their lives can be achieved, though this demands serious changes in lifestyle and diet. 

Traditional bariatric surgery is not without serious risks, though, and the side effects can be life-altering or even life-threatening. For these reasons, other procedures such as endoscopic sleeve gastroplasty have been developed. These and other procedures have been proven to help people lose dramatic amounts of weight but carry fewer dangerous side effects than bariatric surgery. 

If you are concerned about your weight, have found that losing weight through diet and exercise hasn’t worked for you, and are feeling out of options, it may be time to consider a weight loss procedure. The first step is getting as much information as you can to see if you are a candidate for a procedure, learn about what is involved, and discover what life could look like after a procedure has been performed. 
At True You Weight Loss, our physician-founded practice exists solely to help people lose weight successfully through non-surgical weight loss procedures. If you want to learn more about weight loss procedures, solicitar una consulta today. We can help you determine if there is a procedure or program, such as our medical nutrition therapy that is right for you. If so, we will be with you every step of the way as you find the freedom you have been looking for from the risks and dangers of excess weight gain.

Dr. Christopher McGowan
Dr. Christopher McGowan
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