11.5: Health Risks of Overweight and Underweight

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Learning Objectives

Describe health risks associated with being overweight and underweight.
Describe symptoms of various eating disorders.

Health Risks of Being Overweight or Obese

According to the CDC, almost 40% of adults over the age of 20 are obese and over 71% of adults are either overweight or obese.¹ Overweight and obesity raise the risk for certain health problems including^2,3:

Type 2 diabetes
High blood pressure
Heart disease
Stroke
Sleep apnea
Metabolic syndrome (blood pressure ≥ 130/85 mm Hg, blood glucose levels ≥ 100 mg/dL, triglycerides ≥ 150 mg/dL, HDL cholesterol < 40 mg/dL for men or < 50 mg/dL for women, too much fat around your waist)
Depression
Certain cancers (including endometrial cancer, liver cancer, kidney cancer, postmenopausal breast cancer, and colon cancer)
Osteoarthritis
Alzheimer's disease

Health Risks of Being Underweight

Being underweight is linked to nutritional deficiencies, delayed wound healing, hormonal abnormalities, increased susceptibility to infection, and increased risk of some chronic diseases such as osteoporosis. In children, being underweight can stunt growth. The most common underlying cause of being underweight in America is inadequate nutrition. Other causes are wasting diseases, such as cancer, multiple sclerosis, tuberculosis, and eating disorders. Some common eating disorders include⁴:

Anorexia nervosa. Anorexia nervosa is a potentially fatal condition characterized by undereating and excessive weight loss. People with this disorder are preoccupied with weight, dieting, calories, and food intake to an unhealthy degree. People with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, often exercise excessively, and/or may force themselves to vomit or use laxatives to lose weight. Symptoms of anorexia include extremely restricted eating, fear of gaining weight, and distorted body image. Signs that may develop over time include bone loss (osteopenia or osteoporosis), brittle hair and nails, constipation, low blood pressure, and multiorgan failure.
Bulimia nervosa. People with bulimia nervosa have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with bulimia nervosa may be slightly underweight, normal weight, or overweight. Symptoms of bulimia include gastric reflux, severe erosion of tooth enamel, dehydration, electrolyte imbalances, and intestinal distress/irritation if laxatives are abused to compensate for binging.
Binge-eating disorder. People who suffer from binge-eating disorder experience regular episodes of eating an extremely large amount of food in a short period of time. Binge eating is a compulsive behavior, and people who suffer from it typically feel it is beyond their control. The episodes of overeating are not followed by fasting, purging, or compulsive exercise. As a result, people with this disorder are often overweight or obese, and their chronic disease risks are those linked to having an abnormally high body weight such as hypertension, cardiovascular disease, and Type 2 diabetes. Symptoms of binge-eating disorder include eating unusually large amounts of food in a specific amount of time (such as a 2-hour period), eating fast during binge episodes, and eating alone or in secret to avoid embarrassment.

Treatment plans for eating disorders are tailored to individual needs and may include individual, group, and/or family psychotherapy; medical care and monitoring; nutritional counseling; and medications. The nutrition counseling portion of treatment aims to return the individual to a healthy body weight, teach normal eating patterns, and address body image issues.

Key Takeaways

Overweight and obesity increase the risk for certain health problems including heart disease, Type 2 diabetes, high blood pressure, sleep apnea, certain cancers, and osteoarthritis.
Being underweight is linked to nutritional deficiencies, delayed wound healing, hormonal abnormalities, increased susceptibility to infection, and increased risk of some chronic diseases such as osteoporosis.
Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder. Treatment plans for eating disorders are tailored to individual needs and may include individual, group, and/or family psychotherapy; medical care and monitoring; nutritional counseling; and medications. The nutrition counseling portion of treatment aims to return the individual to a healthy body weight, teach normal eating patterns, and adress body image issues.

References

FastStats - Overweight Prevalence. cdc.gov. https ://www.cdc.gov/nchs/fastats/obesity-overweight.htm. Accessed July 8, 2020.
Health Risks of Overweight & Obesity. niddk.nih.gov. https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity/health-risks. Accessed July 8, 2020.
Obesity and Cancer Fact Sheet. cancer.gov. https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3. Accessed July 8, 2020.
Eating Disorders. nimh.nih.gov. https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml. Accessed July 8, 2020.