That was a problem with a widely reported study based on data from NHANES, which estimated relatively low numbers of excess obesity-related deaths. Findings from larger studies that have more accurately accounted for reverse causation and smoking clearly show that increasing weight increases the risks of dying from cardiovascular disease, cancer, and other causes.
In a year study of a million-person cohort, researchers restricted their analyses to initially healthy nonsmokers.
The risk of death from all causes, cardiovascular disease, cancer, or other diseases increased as BMI increased above the healthiest range of Obesity harms virtually every aspect of health, from shortening life and contributing to chronic conditions such as diabetes and cardiovascular disease to interfering with sexual function, breathing, mood, and social interactions.
Diet, exercise, medications and even surgery can lead to weight loss. Yet it is much much harder to lose weight than it is to gain it. Prevention of obesity, beginning at an early age and extending across a lifespan could vastly improve individual and public health, reduce suffering, and save billions of dollars each year in health care costs.
Skip to content Obesity Prevention Source. Harvard T. Obesity Prevention Source Menu. Search for:. Obesity and Diabetes The condition most strongly influenced by body weight is type 2 diabetes. These changes translate into increased risk for coronary heart disease, stroke, and cardiovascular death: Obesity and Coronary Artery Disease.
Numerous studies have demonstrated a direct association between excess body weight and coronary artery disease CAD. The BMI-CAD Collaboration Investigators conducted a meta-analysis of 21 long-term studies that followed more than , participants for an average of 16 years. Study participants who were overweight had a 32 percent higher risk of developing CAD, compared with participants who were at a normal weight; those who were obese had an 81 percent higher risk.
The investigators estimated that the effect of excess weight on blood pressure and blood cholesterol accounts for only about half of the obesity-related increased risk of coronary heart disease. Obesity and Stroke. Ischemic clot-caused stroke and coronary artery disease share many of the same disease processes and risk factors. A meta-analysis of 25 prospective cohort studies with 2. Overweight increased the risk of ischemic stroke by 22 percent, and obesity increased it by 64 percent.
There was no significant relationship between overweight or obesity and hemorrhagic bleeding-caused stroke, however.
Obesity and Cardiovascular Death. In a meta-analysis of 26 observational studies that included , men and women, several racial and ethnic groups, and samples from the U. Women with BMIs of 30 or higher had a 62 percent greater risk of dying early from CAD and also had a 53 percent higher risk of dying early from any type of cardiovascular disease, compared with women who had BMIs in the normal range Men with BMIs of 30 or higher had similarly elevated risks.
Obesity, Depression, and Quality of Life The high rates of obesity and depression, and their individual links with cardiovascular disease, have prompted many investigators to explore the relationship between weight and mood.
Obesity and Reproduction Obesity can influence various aspects of reproduction, from sexual activity to conception. Obesity and Other Conditions A number of additional health outcomes have been linked to excess weight.
Accessed January 25, Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med. Changes in body weight and body fat distribution as risk factors for clinical diabetes in US men. Am J Epidemiol. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis.
BMC Public Health. Rocha VZ, Libby P. Obesity, inflammation, and atherosclerosis. Nat Rev Cardiol. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
N Engl J Med. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a year follow-up study. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: a meta-analysis of 21 cohort studies including more than , persons.
Arch Intern Med. Excess body weight and incidence of stroke: meta-analysis of prospective studies with 2 million participants. McGee DL. Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies.
Ann Epidemiol. Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arterial destiffening with weight loss in overweight and obese middle-aged and older adults.
Effect of moderate diet-induced weight loss and weight regain on cardiovascular structure and function. J Am Coll Cardiol. The most widely used method to check if you're a healthy weight is body mass index BMI. BMI is a measure of whether you're a healthy weight for your height. BMI is not used to diagnose obesity because people who are very muscular can have a high BMI without much fat. But for most people, BMI is a useful indication of whether they're a healthy weight.
A better measure of excess fat is waist size, which can be used as an additional measure in people who are overweight with a BMI of 25 to Generally, men with a waist size of 94cm or more and women with a waist size of 80cm or more are more likely to develop obesity-related health problems.
It's very important to take steps to tackle obesity because, as well as causing obvious physical changes, it can lead to a number of serious and potentially life-threatening conditions. Obesity can also affect your quality of life and lead to psychological problems, such as depression and low self-esteem.
Obesity is generally caused by consuming more calories, particularly those in fatty and sugary foods, than you burn off through physical activity. The excess energy is stored by the body as fat. Obesity is an increasingly common problem because for many people modern living involves eating excessive amounts of cheap high-calorie food and spending a lot of time sitting down at desks, on sofas or in cars.
Find out why sitting too much is bad for your health. There are also some underlying health conditions that can occasionally contribute to weight gain, such as an underactive thyroid gland hypothyroidism , although these types of conditions do not usually cause weight problems if they're effectively controlled with medicines.
The best way to treat obesity is to eat a healthy reduced-calorie diet and exercise regularly. You may also benefit from receiving psychological support from a trained healthcare professional to help change the way you think about food and eating.
If lifestyle changes alone do not help you lose weight, a medicine called orlistat may be recommended. She could add a few hundred calories to her diet. Her period would come back. She would stay small, but without as much effort. And my doctor was congratulating me. But for fat people, they are a source of unique and persistent trauma. This phenomenon is not merely anecdotal. Doctors have shorter appointments with fat patients and show less emotional rapport in the minutes they do have.
In one study , researchers presented doctors with case histories of patients suffering from migraines. With everything else being equal, the doctors reported that the patients who were also classified as fat had a worse attitude and were less likely to follow their advice. Some of these doctors are simply applying the same presumptions as the society around them. Other physicians sincerely believe that shaming fat people is the best way to motivate them to lose weight.
In a journal article , bioethicist Daniel Callahan argued for more stigma against fat people. Shame helped him kick his cigarette habit, he argues, so it should work for obesity too. This belief is cartoonishly out of step with a generation of research into obesity and human behavior.
Plus, rather obviously, smoking is a behavior; being fat is not. Jody Dushay, an endocrinologist and obesity specialist at Beth Israel Deaconess Medical Center in Boston, says most of her patients have tried dozens of diets and have lost and regained hundreds of pounds before they come to her. Telling them to try again, but in harsher terms, only sets them up to fail and then blame themselves.
Not all physicians set out to denigrate their fat patients, of course; some of them do damage because of subtler, more unconscious biases. According to several studies , thin doctors are more confident in their recommendations, expect their patients to lose more weight and are more likely to think dieting is easy. Sarah not her real name , a tech CEO in New England, once told her doctor that she was having trouble eating less throughout the day.
Then there are the glaring cultural differences. When Joy Cox, an academic in New Jersey, was 16, she went to the hospital with stomach pains. Many of the financial and administrative structures doctors work within help reinforce this bad behavior.
The problem starts in medical school, where, according to a survey , students receive an average of just 19 hours of nutrition education over four years of instruction—five hours fewer than they got in Then the trouble compounds once doctors get into daily practice.
Primary care physicians only get 15 minutes for each appointment, barely enough time to ask patients what they ate today, much less during all the years leading up to it.
Failing to do that could result in poor performance reviews, low ratings from insurance companies or being denied reimbursement if they refer patients to specialized care. Another issue, says Kimberly Gudzune, an obesity specialist at Johns Hopkins, is that many doctors, no matter their specialty, think weight falls under their authority.
Gudzune often spends months working with patients to set realistic goals—playing with their grandkids longer, going off a cholesterol medication—only to have other doctors threaten it all. One of her patients was making significant progress until she went to a cardiologist who told her to lose pounds. And so, working within a system that neither trains nor encourages them to meaningfully engage with their higher-weight patients, doctors fall back on recommending fad diets and delivering bland motivational platitudes.
Ron Kirk, an electrician in Boston, says that for years, his doctor's first resort was to put him on some diet he couldn't maintain for more than a few weeks. In a study that recorded interactions with doctors, only 13 percent of patients got any specific plan for diet or exercise and only 5 percent got help arranging a follow-up visit. Should he go on a low-fat diet? Become a vegetarian?
Should he do Crossfit? Should he buy a fucking ThighMaster? Instead of a conversation, I got a sound bite. It felt like shaming me was the entire purpose. All of this makes higher-weight patients more likely to avoid doctors.
Three separate studies have found that fat women are more likely to die from breast and cervical cancers than non-fat women, a result partially attributed to their reluctance to see doctors and get screenings. Erin Harrop, a researcher at the University of Washington, studies higher-weight women with anorexia, who, contrary to the size-zero stereotype of most media depictions, are twice as likely to report vomiting, using laxatives and abusing diet pills.
Thin women, Harrop discovered, take around three years to get into treatment, while her participants spent an average of 13 and a half years waiting for their disorders to be addressed. The rest of it, she says, is helping them heal from the trauma of interacting with everyone else. If Sonya ever forgets that she is fat, the world will remind her.
She has stopped taking the bus, she tells me, because she can sense the aggravation of the passengers squeezing past her. Sarah, the tech CEO, tenses up when anyone brings bagels to a work meeting. Sam, the medical technician, avoids the subject of weight altogether. Jessica has four kids. Every week is a birthday party or family reunion or swimming pool social, another opportunity to stand around platters of spare ribs and dinner rolls with her fellow moms.
After a few intrusive comments over the years— should you be eating that? She nibbles on cherry tomatoes, drinks tap water, stays on her feet, ignores the dessert end of the buffet. Then, as the gathering winds down, Jessica and the other parents divvy up the leftovers. She wraps up burgers or pasta salad or birthday cake, drives her children home and waits for the moment when they are finally in bed.
Then I have to go to the store to buy it again. This is how fat-shaming works: It is visible and invisible, public and private, hidden and everywhere at the same time. Research consistently finds that larger Americans especially larger women earn lower salaries and are less likely to be hired and promoted. In a survey , hiring managers were given a photo of an overweight female applicant. Twenty-one percent of them described her as unprofessional despite having no other information about her.
Paradoxically, as the number of larger Americans has risen, the biases against them have become more severe. More than 40 percent of Americans classified as obese now say they experience stigma on a daily basis, a rate far higher than any other minority group.
And this does terrible things to their bodies. According to a study , fat people who feel discriminated against have shorter life expectancies than fat people who don't. And, in a cruel twist, one effect of weight bias is that it actually makes you eat more. This is not an abstract concern: Surveys of higher-weight adults find that their worst experiences of discrimination come from their own families.
By the time Erika was 11, she was sneaking into the woods behind her house and vomiting into the creek whenever social occasions made starving herself impossible. And the abuse from loved ones continues well into adulthood. A survey found that 89 percent of obese adults had been bullied by their romantic partners.
Sex was a good way to do that. Eventually, she ended up with someone abusive. He told her during sex that her body was beautiful and then, in the daylight, that it was revolting. Emily finally managed to get away from him, but she is aware that her love life will always be fraught. A study found that African-American women are more likely to become depressed after internalizing weight stigma than white women.
Hispanic and black teenagers also have significantly higher rates of bulimia. And, in a remarkable finding, rich people of color have higher rates of cardiovascular disease than poor people of color—the opposite of what happens with white people.
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