While body positivity and acceptance is extremely important, there’s no denying that obesity increases your risk of a number of life-threatening health conditions. In fact, there has been a 20 percent increase in hospital admissions in the last five years directly linked to obesity. The NHS has been known to spend more than £9 billion on obesity-related ill health every year. Express.co.uk chatted to Dr Deborah Lee from Dr Fox Online Pharmacy to find out the six reasons why being obese is extremely dangerous.
Are YOU obese?
Obesity is defined as any adult who weighs at least 20 percent more than their ideal body weight.
A relatively simple way to estimate obesity is using the BMI calculation, in which the weight in kilograms is divided by the height in meters squared.
If this is too complicated, try using the NHS BMI healthy weight calculator.
Dr Lee said: “A BMI between 21-29.9 is considered overweight, and a BMI of 30 or above is obese.”
Everyone knows that being obese is bad for your health, but it should be stressed that being obese is strongly associated with a variety of poor health outcomes.
Dr Lee pointed out: “Obesity significantly increases the risk of heart disease (heart attacks and strokes), high blood pressure, type-2 diabetes, and cancer.”
Express.co.uk reveals the six reasons why obesity is so dangerous.
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A high-fat diet and atherosclerosis
Many people with obesity eat a diet high in saturated fat, which is known to be the major cause of raised cholesterol levels.
High cholesterol levels in the bloodstream cause fat to be deposited in arterial walls, as fatty plaques – this process is known as atherosclerosis.
These fatty plaques fur up the artery walls, narrowing the lumen of these blood vessels, and making it harder for blood to pass through to the distal tissue.
Atherosclerosis makes the arterial walls stiffer, making it harder for the heart to pump blood through them, Dr Lee explained.
The doctor said: “The arterial walls are also weaker and more susceptible to damage.
“Plaques can rupture, or entire vessel walls can rupture or become clogged, meaning blood cannot get through the distal tissue – this is what happens when you have angina, a stroke or a heart attack.
“So, raised cholesterol and atherosclerosis lead to high blood pressure, but other factors increase the risk of atherosclerosis.
“These include smoking, inactivity, stress and chronic systemic inflammation.
“Alcohol, and a high carb diet, lead to raised levels of triglycerides in the bloodstream, which also increases the risk of atherosclerosis.
“Although atherosclerosis is a natural feature of ageing, it is thought to start earlier in obesity.”
The direct effects of adipose tissue (fat) on the kidney
Being obese means you have increased amounts of visceral fat – deep fat – sequestered inside the abdominal cavity and stored around your internal organs.
The pressure this fat induces directly onto the kidneys can disrupt kidney function.
Dr Lee said: “The kidney normally regulates blood pressure via a sensitive mechanism called the Renin-Angiotensin System (RAS).
Sensitive kidney cells detect the level of sodium in the blood.
“When sodium levels are too low, RAS enzymes are stimulated, leading to an increase in the production of a molecule called angiotensin II.
“This causes vasoconstriction and hence raises blood pressure. It also stimulates the production of the hormone, aldosterone, which increases the amount of sodium absorbed from the urine, as it passes through the kidney tubules.
“In obesity, adipose tissue itself produces an excess of a protein called angiotensinogen, resulting in excess aldosterone – aldosterone also causes vasoconstriction, increases sodium reabsorption, and this raises blood pressure.
“In the kidney, as in every cell of your body, millions of cellular reactions take place every day, to release the energy needed for metabolic processes – this is called oxidation.
“As a result of this process, harmful molecules are produced called reactive oxygen species (ROS), which have the ability to disrupt cellular processes and damage DNA. This process is called oxidative stress.”
Oxidative stress occurs in the kidney as a direct result of obesity, meaning kidney function is increasingly susceptible to damage.
In addition, visceral fat is dangerous fat, because it actively secretes cytokines – chemical messengers – which can also cause further damage to the highly specialised cells in the kidney.
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Sympathetic tone
People suffering from obesity and high blood pressure have been found to have chronic overactivity of their sympathetic nervous system (SNS) – this is the body’s involuntary nerve pathway, that exists to prepare you for dealing with danger – ‘fight, fright and flight.’
One reason for this is obesity exerts chronic stress on the kidney – on the RAS.
Dr Lee explained: “A high-calorie intake – a high fat, high carb diet – stimulates β-adrenergic receptors (these are the specific sites where neurotransmitters such as adrenaline attach themselves to cells to activate metabolic processes).
“Activation of these receptors causes the heart to beat faster and increases contractility. It also causes vasoconstriction in peripheral blood vessels and raises blood pressure.
“In addition, your body normally adjusts your blood pressure according to your posture. But in those with obesity, there appears to be an exaggerated SNS response when standing upright.”
Leptin
Leptin is a cytokine (chemical messenger) – produced in adipose tissue – which helps regulate your appetite and help you feel full.
Paradoxically, in obesity, many people become resistant to leptin and have higher leptin levels than normal.
Dr Lee noted: “Leptin is also known to raise blood pressure and may do this by overstimulating the SNS.”
Insulin resistance
Obesity is also associated with high levels of insulin – the hormone that regulates blood glucose levels.
In obesity, the body’s cells become less sensitive to insulin – this is called insulin resistance – meaning the cells have trouble recognising insulin.
Dr Lee said: “More and more insulin is produced to try and overcome the problem.
“High levels of insulin have been shown to raise blood pressure, due to stimulation of the SNS, but also due to a direct effect of insulin to increase sodium retention in the kidney.”
Your heart is having to pump harder
Being obese leads to an increased blood volume so the heart has more fluid to pump around the body.
This puts stress on the heart muscle, causing it to thicken.
As it tries to keep up, you will feel out of breath more easily, and develop signs such as ankle swelling.
Fat deposited in and around the heart is damaging, as are the cytokines produced in visceral fat, which are damaging for heart health.
Dr Lee said: “Obese people often have raised levels of troponin – an enzyme that indicated heart damage – even when they have no symptoms.
“Heart failure is a serious medical condition and around 50 percent of those diagnosed are likely to die in the next five years.
“Around 30,000 UK adults die every year due to obesity. The most common causes of death are heart disease, high blood pressure and type-2 diabetes.”