The Real Risks of Being Overweight

Being overweight comes with many risks and many prejudices. We're all too aware that it's not healthy to be overweight, yet so many people are. What we often don't consider is the emotional and psychological factors involved in a person becoming overweight  this is something that I'll discuss in an upcoming blog. However, no matter how 'happy' a person is being overweight, no matter how much they disregard the judgmental looks and prejudices that they face on a day-to-day basis, being overweight carries several serious, often life-threatening, risks. 

The most dangerous risk of being overweight is the development of heart conditions such as coronary heart disease. When a person is overweight, their heart will often be enlarged, putting them at risk of congestive heart failure and coronary heart disease. Coronary heart disease causes 82,000 deaths per year in Britain, with one in five men and one in eight women dying from the disease. It is caused by the heart’s blood supply being blocked or interrupted by a build-up of fatty substances in the coronary arteries. This can lead to a condition called atherosclerosis which involves the blood vessels narrowing and becoming ‘furred’, making it much harder for blood to flow efficiently through the body, particularly a poor blood supply to the heart which could result in angina. Atherosclerosis also increases the chance of blood vessels becoming blocked, resulting in a stroke or heart attack. Atherosclerosis is most often caused by smoking, high cholesterol, high blood pressure (hypertension) or diabetes.

Nerve damage is also a risk when a person is overweight. High blood glucose levels can damage the tiny blood vessels in nerves, causing a tingling or burning pain that spreads from the fingers and toes up into the limbs. Numbness may also occur which may lead to ulcerations on the feet. If the nerves in a person’s digestive system are affected they will likely suffer from nausea, vomiting, diarrhoea and constipation. This can cause malabsorption of nutrients and an imbalance in electrolytes.

A very common risk in overweight people is Type 2 diabetes. This occurs when the body doesn’t produce enough insulin, affecting the amount of glucose available to cells to convert into energy (known as insulin deficiency), or the body’s cells don’t react to insulin (this is known as insulin resistance). Type 2 diabetes is more common than Type 1 diabetes in which the body doesn’t produce insulin at all, and around 90% of diabetes sufferers in Britain have Type 2 diabetes (NHS, 2012). In insulin deficiency, not enough insulin is produced and therefore the body’s blood-glucose concentration cannot be maintained at a normal level. In insulin resistance, the body is unable to use the insulin that is produced effectively. In each of these situations, the Type 2 diabetes sufferer will experience energy spikes and dips as their body struggles to cope with the consumption of sugar and the process of converting that sugar into energy.

Another risk of being overweight is kidney disease. In an overweight person, it is more likely that the small blood vessels of the kidneys become blocked causing the kidneys to work less efficiently. This disease is normally associated with high blood pressure and can often be treated and managed through a healthy diet and sustained weight loss. In severe cases, kidney disease can result in kidney failure and a kidney transplant or dialysis will be necessary. However it is possible for the body to survive and function with only one kidney.

Being overweight increases the risk of some cancers including oesophagus, pancreas, colon, breast (after menopause), kidney, thyroid, endometrium (the lining of the uterus) and gallbladder. It is possible that obesity contributes to breast and endometrial cancer due to fat tissue producing excess amounts of oestrogen, high levels of which have been associated with these cancers. Insulin resistance, a result of Type 2 diabetes, may also contribute to the growth of certain tumours due to increased levels of insulin and insulin-like growth factor-1 (IGF-1). It is also possible that the immune system is severely impaired in obese people, meaning their immune response to cancerous cells is below optimal, putting them at increased risk of developing tumours. 

It is very important that an overweight person doesn't feel guilt or shame because of their size - obesity is often caused by psychological factors, trauma, shame and emotional issues. These are primarily the same issues that lie at the heart of commonly known eating disorders such as anorexia nervosa and bulimia nervosa. These disorders are most often treated with psychotherapy, CBT and/or counselling as well as adjustments to diet and lifestyle. So why do we not treat obese people in the same way, and with the same care and compassion? This is not to say that everyone who is overweight is suffering from a disease, psychologically traumatised or mentally unstable, but it is vital that both physical risks and psychological triggers are considered if we are to improve the health of our nation and if we are to lead happier, healthier lives. In an upcoming blog I'll be discussing the prevalence of eating disorders, what we can do to help those who suffer and how physical risks and psychological contributors can be managed.