Weight Loss

Weight and Your Health

For many, excess weight is a lifetime battle. The extra weight is about much more than just your clothing size or how you look. It can seriously affect your health. Your whole body feels it, from your joints to your heart, lungs, kidneys, sugar and lipid levels, as well as a whole host of other systems.

Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both terms mean that a person’s weight is greater than what’s considered healthy for their height. According to the Centers for Disease Control and Prevention, you’re not alone- it is estimated that two-thirds of the U.S. population is defined as weighing too much. Over 35% of American adults are obese, based on having a BMI of 30 or higher (or 20% above your ideal weight). More then 34% are overweight with a BMI of 25.0- 30. This occurrence is three times the prevalence from one generation ago. Nearly 32% of children and adolescents are either obese or overweight.

Fat cells produce inflammation and various hormones, which boosts your odds of chronic medical conditions. Excess fat makes you more likely to have the following conditions- especially if you have a family history of them:

Heart disease:

Coronary heart disease, heart attack, congestive heart failure, and congenital heart disease, are the leading causes of death for men and women in the U.S., According to the American Heart Association. They state that heart disease is the leading cause of death in women over 40 years old, especially after menopause, and it continues to increase with age. Most heart attacks are the end result of coronary heart disease, a condition that clogs coronary arteries with fatty, calcified plaques. Atherosclerosis (hardening of the arteries) occurs when your blood vessel walls thicken due to deposits of fat and plaque. This narrowing or blockage of the arteries causes heart disease so that blood flow to the heart muscle is effected. Getting to a healthy weight, dropping your cholesterol levels, not smoking, exercising, watching your blood pressure and sugars levels, and eating healthy (take a look at our previous Weight Loss posts and the US Government’s Food and Diet Guide) can prevent these issues.

Hyperlipemia:

This is defined as abnormally elevated levels of any or all lipids (cholesterol and triglycerides) or lipoproteins in the blood. Cholesterol helps your body build new cells, insulate nerves and produce hormones. The liver makes all the cholesterol we need, but it’s often elevated by what we eat. Hyperlipidemia’s are either primary or secondary. Primary hyperlipidemia is usually due to genetic causes. Secondary hyperlipidemia occurs due to other underlying issues such as diabetes, obesity, alcohol intake, or kidney disease. Lipid and lipoprotein abnormalities can be impacted by treating or improving those underlying concerns.

In general, fat is useful. Our bodies metabolize lipids for energy. In a properly functioning metabolism, these free fatty acids are broken down into energy in the muscles by specific enzymes that work to ensure a good balance between utilizing lipids for energy versus putting the lipids in storage. Obesity affects lipid metabolism, or the way fat is used for energy. With obesity, the levels of enzymes are altered, making the body inefficient at using lipids for energy. The level of lipid transport or molecules also increases, causing the body to absorb more lipids from the diet. As patients become more obese, more lipids are put into storage, increasing lipid levels. Healthy eating and weight loss can help reset this balance.

High blood pressure:

When somebody takes your blood pressure, it’s stated as one number over another (I.e. 120/80). Blood pressure is made up of the systolic (or upper number) pressure, which is how the heart pushes blood into arteries with every heartbeat that then circulates to the rest of your body. The lower number, or diastolic, is the pressure in those arteries when the heart rests between beats. Last year, new guidelines from the American College of Cardiology and American Heart Association lowered the threshold for determining if someone has the diagnosis of high blood pressure or hypertension. They are now recommending treatment when an individual’s numbers reach 130/80 mm Hg (millimeters in mercury), or higher. This is instead of the long-used threshold of 140/90 mm Hg. Elevations on either side can still be considered treatable. Malignant pressures of greater then 180 on the top or 120 on the bottom should be evaluated immediately. Even if your blood pressure is high, you probably won’t have symptoms. That’s why it’s often called the “silent killer.”

The first symptom of untreated high blood pressure may be a heart attack, stroke or kidney disease. Treating stroke survivors’ blood pressures more aggressively might prevent a substantial number of deaths, a new study estimates in the June 6, 2018 HealthDay news. Checking your pressure at home can give your healthcare provider a better understanding of levels throughout the day. Make sure the cuff fits properly and check once a day, and at different times to assess if it’s stable. Don’t check multiple times at once since this can artificially raise the reading.

Metabolic syndrome:

This is a group of five factors that increase the risk of developing heart disease, diabetes and stoke. The American Heart Association reports that 23% of adults have metabolic syndrome. It is diagnosed when at least three of the five factors are positive. They include:

  • Blood pressures greater the 130/80 mm hg
  • Elevated triglycerides
  • Low HDL levels or high density lipoprotein (good cholesterol)

But the two most important risk factors according to the National Heart, Lung, and Blood Institute are:

  • Elevated blood glucose level (or insulin resistance)
  • Abdominal obesity.

Too much fat around the waist, (the “apple” shape), may increase health risks even more than having fat in other parts of your body (such as a “pear” shape where excess weight is mostly around the hips and buttock). Women with a waist size of more than 35 inches and men with a waist size of more than 40 inches may be at increased risk for other health issues as well.  Weight loss alone can result in a significant reduction in the prevalence of metabolic syndrome.

Stroke:

Stroke is caused by a blocked blood vessel or bleeding in the brain. There are 3 types of strokes- ischemic (blood flow is stopped to a portion of the brain), hemorrhagic (a bleed), and TIA’s- “transient ischemic attack” or ” mini strokes” (where there was evidence of a blockage but it did not last long enough to cause permanent damage). Then there are silent strokes. Patients either never recognized the signs of a silent stroke or don’t remember having them. Regardless of the type, early treatment is critical to recovery and survival.The signs of a stroke include a sudden, severe headache, weakness, numbness, vision problems (especially in one eye), confusion, trouble walking, talking or moving a limb, dizziness and slurred speech. Anything that prevents blood from getting to the brain can result in a stroke. It can developed gradually, like a slow bleed that causes symptoms over time. Years ago I had a patient who was hit in the head by a baseball. He was wearing a helmet so he was sure it was not an issue. Over the next few weeks, he began to have severe headaches, imbalance and nausea. He had developed a slow bleed into the brain. With most stokes, you’ll experience sudden symptoms like confusion, weakness, vision changes, balance problems, sensory changes, and motor or sensory deficits.

Diabetes:

Normally, the pancreas (an organ behind the stomach) releases insulin to help your body store and use the sugar and fat from the food you eat. Diabetes can occur when the pancreas produces very little or no insulin, or when the body does not respond appropriately to insulin. Since there is no cure yet, those with diabetes need to manage their disease, and all its manifestations to stay healthy. Symptoms can include constant thirst, slow to heal wounds, increased urination, nausea, fatigue, abdominal aches, breathing issues, yeast infections, dry mouth, itchy skin, sensory changes in the feet, and breath that smells like nail polish (a sign of high ketones). When diagnosed early, you can avoid nerve damage, heart, kidney and eye trouble, and other complications.Early symptoms from elevated blood glucose levels can be so mild they often go unnoticed. Some people don’t find out they have type-2 Diabetes until they have associated issues from long-term damage caused by the disease. This is in contrast to type 1 Diabetes, where symptoms usually happen quickly (in a matter of days or a few weeks), and are much more severe.

Cancers:

Some studies suggest the possible link between obesity and increased cancer risk and growth is due to higher levels of insulin and insulin growth factor 1(IGF1), which may encourage cancer development. Chronic low level inflammation, higher levels of estrogen produced by fat tissue, and rapid fluctuations in weight may also increase cancer risks. Cancers of the colon, breast (after menopause), endometrium (the lining of the uterus), kidneys, head and neck, prostrate, gallbladder and esophagus are linked to obesity. Some studies have also reported links between obesity and cancers of the gallbladder, ovaries, and pancreas.

Gallbladder disease:

The gallbladder is a small pouch that sits just under the liver. The gallbladder stores bile produced by the liver and helps digest fats. Before a meal, the gallbladder may be full of bile and about the size of a small pear. In response to signals, the gallbladder squeezes stored bile into the small intestine through a series of tubes called ducts. After meals, the gallbladder is empty and flat, like a deflated balloon. The gallbladder itself is not essential. Removing the gallbladder in an otherwise healthy individual typically causes no observable problems with health or digestion, but some may experience diarrhea and fat malabsorption.

It’s unclear why substances in bile can crystallize in the gallbladder, forming gallstones. They are usually harmless, but sometimes gallstones can cause pain, nausea, or inflammation. When it becomes infected, severe pain and fever ensues, and may require surgery. Although rare, gallbladder cancer is difficult to diagnose and usually found at late stages when symptoms appear. Symptoms may resemble those of gallstones.  An impacted gallstone that blocks ducts that drain the pancreas can result in inflammation of the pancreas or pancreatitis as well.

Osteoarthritis:

This is ” wear and tear” on joints and ligaments as we reviewed in our post about Osteoarthritis.

Gout:

Gout is a type of arthritis that results from an elevated blood level of uric acid that can then form sharp crystals in one or more of your joints. This usually happens in your big toe as was repeatedly referenced in old movies as an affliction of royalty based on their excessively rich diets as contrasted to commoners. It can also occur in the knee, ankle, foot, hand, wrist, or elbow. Attacks are sudden and cause serious pain, often with redness and swelling around the joint. Episodes usually last 3 to 10 days, but the first 36 hours are typically the most painful. After the first attack, some people don’t have another one for months or maybe years. Men outnumber women 3-to-1 and it’s more common in men over 40. Women are more likely to get it after menopause. You’re at higher risk if you’re overweight, drink alcohol often, have a family history, and take diuretics or some types of arthritic medicines. High blood pressure and/or cholesterol, diabetes, heart issues and a history of gastric bypass surgery increase risk as well. There are many treatments options for gout.

Sleep apnea:

Sleep apnea occurs when breathing stops repeatedly while sleeping, sometimes hundreds of times. This means the brain and the rest of the body may be deprived of oxygen. Sleep apnea is more common in those who are overweight, over 40, and male.

There are two types of sleep apnea, Obstructive Sleep Apnea (OSA) being the more common type. It is caused when soft tissue in the back of the throat collapses and blocks the airway during sleep. In the second type, Central Sleep Apnea, the airway is not blocked. Instead, the brain fails to signal the muscles to breathe, due to instability in the respiratory control center. A large neck size (17 inches or greater in men and 16 inches or greater in women), being over 40, large tonsils, tongue or a small jaw bone can contribute to sleep apnea risk. Additional risk factors includea family history of sleep apnea, gastroesophageal reflux (GERD or indigestion) or nasal obstruction from sinus, allergies or a deviated septum.

Once diagnosed, sleep apnea can improve with weight loss and a continuous positive airway pressure (CPAP) machine. Symptoms are daytime sleepiness, witnessed episodes of not breathing during the night (apnea), snoring, fatigue, poor memory, poor performance or concentration at work, and insomnia (trouble sleeping).Untreated sleep apnea can cause hypertension, stroke, or heart failure.

Asthma:

Asthma is a chronic disease involving the airways of the lungs. These are called bronchial tubes and they allow air in and out of the lungs.  With asthma, these passages are always inflamed and become even more swollen and narrowed when the muscles around them tighten due to a triggering event, making it hard to breath. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasms. Asthmatic symptoms can be triggered by air pollution, allergens, and smoking, among other things. Triggers result in coughing, especially at night, wheezing, shortness of breath, chest pain tightness or pressure. Asthma can be controlled with proper treatment. According to the Journal of Applied Physiology, the correlation between obesity and asthma may be due to decreased respiratory function resulting from a buildup of fat and the fact that fat tissue leads to a pro-inflammatory state.

Depression:

Research has shown that there’s no clear, one-way connection between obesity and depression. Instead, studies have shown that the two tend to feed off each other in a vicious, self-destructive cycle. The relationship between obesity and depression is what researchers call “bidirectional”. Being obese or overweight increases the risk of depression, and vice versa. According to the CDC, about 43 percent of people with depression are obese, compared with a third of the general population. People who are obese are 55% more likely to be depressed, and people with depression are 58% more likely to develop obesity, according to one 2010 CDC study. You’re not alone. Talk to your healthcare provider and let them know all your issues. Together you can come up with a better, more comprehensive approach to finding treatment options that will work for you.

If it seems like the odds are stacked against you, remember that it’s possible to beat them. According to NIH (National Institute of Diabetes and Digestive and Kidney Diseases), even losing 5 to 10 percent of your weight can delay or prevent some of these diseases. That translates to losing 10-20 pounds if you weigh 200 pounds. Set small, attainable goals that can be achieved before moving on to the next one. Get screened and talk to your healthcare provider today about your specific needs. The repercussions of weight loss go far beyond having an amazing new look. It’ll add happier, healthier, more productive years to your life.

-Dr. Courtney

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