As a physician, I see many illnesses and conditions that are caused or aggravated by overweight and obesity. Both terms refer to excessive body fat; obesity is a greater degree of fat. Generally, adverse health effects rise as the amount of excess fat increases.
Body mass index (BMI) is used to define overweight and obesity. Your BMI is your weight in kilograms divided by your height in meters squared. A BMI between 18.5 and 24.9 is considered healthy for people under 65-75 years old. BMIs between 25 and 30 are overweight. Here’s an online BMI calculator to determine your own BMI. For example, a 5-foot, 4-inch person enters obesity territory - BMI over 30 - when weight reaches 174 pounds (79 kilograms). A 5-foot, 10-incher is obese starting at 208 pounds (94.5 kilograms).
People trying to lose excess fat typically have days when willpower, discipline, and commitment waver. On those days, it can help to remember why they started this adventure in the first place. The reasons for many involve improved health and longevity. Even if you have just 20 pounds of excess fat to lose, it will often take twenty weeks. Your weight-loss goal is one to one-and-a-half pounds a week. This race is won not by the swift, but by the slow and steady.
Here’s a laundry list of obesity-related conditions to remind you why you want to avoid overweight and obesity:
- Premature death. It starts at BMI of 30, with a major increase in premature death at BMI over 40. The U.S. has 200,000 yearly deaths directly attributable to obesity.
- Arthritis, especially of the knees.
- Type 2 diabetes melllitus. Eight-five percent of people with type 2 diabetes are overweight.
- Increased cardiovascular disease risk, especially with an apple-shaped fat distribution as compared to pear-shaped. Cardiovascular disease includes heart attacks, high blood pressure, strokes, and peripheral arterial disease (poor circulation).
- Obstructive sleep apnea.
- Gallstones are three or four times more common in the obese.
- High blood pressure. At least one third of cases are caused by excess body fat. Every 20 pounds of excess fat raises blood pressure 2-3 points (mmHg).
- Tendency to higher total and LDL cholesterol, higher triglycerides, while lowering HDL cholesterol. These lipid changes are associated with hardening of the arteries - atherosclerosis - which can lead to heart attacks, strokes, and peripheral arterial disease.
- Increased cancers. Prostate and colorectal in men. Endometrial, gallbladder, cervix, ovary, and breast in women. Kidney and esophageal adenocarcinoma in both sexes. Excess fat contributes to 14-20% of all cancer -related deaths in the U.S. Over 550,000 people die from cancer in the U.S. yearly. Twenty percent of us will die from cancer.
- Low back pain.
- Varicose veins.
- Blood clots in legs and lungs.
- Surgery complications: poor wound healing, blood clots, wound infection, breathing problems.
- Pregnancy complications: toxemia, high blood pressure, diabetes, prolonged labor, greater need for C-section.
- Fat build-up in liver.
- Low sperm counts.
- Decreased fertility.
- Delayed or missed diagnosis due to difficult physical examination or weight exceeding the limit of diagnostic equipment.
My goal with this list is to motivate rather than depress you. For those already overweight or obese, weight loss can significantly improve, alleviate, or prevent these conditions. Many obesity-related medical conditions and metabolic abnormalities are improved with loss of just five or 10% of total body weight. For instance, a 240 pound man with mild diabetes and high blood pressure may be able to reduce or avoid drug therapy by losing just 12 to 24 pounds. He’s still obese, but healthier.
Steve Parker, M.D.