4.3: Negative Health Implications of Obesity

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Negative Health Implications of Obesity

People who are obese, compared to those with a normal or healthy weight, are at increased risk for many serious diseases and health conditions, including the following:

• All causes of death (mortality)
• High blood pressure (Hypertension)
• High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides (Dyslipidemia)
• Type 2 diabetes
• Coronary heart disease
• Stroke
• Gallbladder disease
• Osteoarthritis (a breakdown of cartilage and bone within a joint)
• Sleep apnea and breathing problems
• Many types of cancer
• Low quality of life
• Mental illnesses such as clinical depression, anxiety, and other mental disorders
• Body pain and difficulty with physical functioning

Understanding Diabetes

The body breaks down the food we eat to turn it into energy, this process is called metabolism. Diabetes affects how your body turns food into energy. There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant). More than 122 million Americans are living with diabetes (37.3 million, 11.3% of the US population) or prediabetes (96 million, 38.0% of the adult US population).

Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream. When your blood sugar goes up, it signals your pancreas to release insulin. Insulin acts like a key to let the blood sugar into your body’s cells for use as energy. Without insulin, blood sugar can’t get into cells causing the blood sugar to build up in the bloodstream. High amounts of blood sugar are damaging to the body and cause many of the symptoms and complications of diabetes.

If you have type 1 diabetes, your pancreas doesn’t make insulin or makes very little insulin. Approximately 5-10% of the people who have diabetes have type 1. Type 1 Diabetes is usually diagnosed in children, teens, and young adults. Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake) that stops your body from making insulin.

If you have type 2 diabetes, your cells don’t respond normally to insulin. About 90-95% of people with diabetes have type 2. It develops over many years and is usually diagnosed in adults (but more and more in children, teens, and young adults). Type 2 diabetes can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy food, and being active.

You’re at risk for developing type 2 diabetes if you:

• Have prediabetes
• Are overweight
• Are 45 years or older
• Have a parent, brother, or sister with type 2 diabetes
• Are physically active less than 3 times a week
• Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed more than 9 pounds
• Are African American, Hispanic/Latino American, American Indian, or Alaska Native (some Pacific Islanders and Asian Americans are also at higher risk)

Special Highlight: Fitness vs. Fatness

While obesity is associated with increased risk for many chronic diseases and conditions, emerging research highlights the critical role of physical fitness in mitigating these risks. The concept of "fitness vs. fatness" suggests that an individual's level of cardiorespiratory fitness (CRF) can significantly influence overall health outcomes, independent of their BMI.

Studies have shown that overweight and obese individuals who maintain a moderate to high level of physical activity have a similar mortality risk to their normal-weight, physically active counterparts. Conversely, unfit individuals—regardless of their BMI—are at twice the risk of mortality compared to fit individuals. This underscores the importance of physical fitness as a protective factor against chronic diseases and early death.^[1]

Public Health Implications

These findings suggest a shift in focus for public health interventions:

• Emphasis on Physical Activity (PA): Encouraging 150 minutes of moderate-intensity PA per week, as recommended by the U.S. Department of Health and Human Services (DHHS), can significantly improve CRF. This amount can be accumulated in short bouts of 10 minutes or more, making it achievable for most people.
• Prioritizing Fitness Over Weight Loss: While weight loss is often a focus in obesity management, promoting consistent physical activity and improving fitness levels may yield more substantial benefits for reducing mortality risk and enhancing quality of life.

Moving Forward

By prioritizing fitness and physical activity, individuals and communities can work toward reducing the prevalence of chronic disease and mortality associated with obesity. Public health programs should aim to integrate evidence-based strategies for increasing physical activity into everyday routines, ensuring accessibility for all population groups.

Citations: 

• Barry, Vaughn W., et al. "Fitness vs. fatness on all-cause mortality: a meta-analysis." Progress in cardiovascular diseases 56.4 (2014): 382-390.