Key Differences and Health Risks Explained


How Weight Impacts Long-Term Health

“Obesity isn’t just excess weight,” says Christopher McGowan, MD, an obesity medicine specialist and the senior vice president at Everself, a weight care company with locations throughout the United States. “It’s a chronic inflammatory disease affecting the entire body.”

The Role of Inflammation

The trouble with overweight and obesity isn’t just that one carries excess body fat, but rather the type of fat that accumulates.

Visceral adipose tissue, the belly fat that can appear as you gain weight, develops deep in the abdomen and encases vital organs, including the kidneys, liver, and pancreas. Visceral adipose tissue is metabolically active. It causes inflammation throughout the body that increases one’s risk of weight-related health issues, like diabetes and heart disease.

Systemic Impact

As a person’s weight increases, so does their risk of a wide range of weight-related issues, including:

  • Heart Disease Excess fat can affect blood vessels and lead to high blood pressure. It also contributes to other heart disease risk factors, such as high cholesterol, type 2 diabetes, and sleep apnea.
  • Type 2 Diabetes Excess fat makes cells more resistant to the effects of insulin, a hormone that moves sugar (glucose) from the bloodstream into cells. It also damages beta cells in the pancreas, which are responsible for making insulin. As a result, blood sugar levels rise.
  • Obstructive Sleep Apnea (OSA) Excess fatty tissue in the throat can cover the airway during sleep, leading to repeated pauses in breathing and increasing the risk of OSA. And because a lack of sleep increases levels of the appetite-stimulating hormone ghrelin in the body, OSA can lead to even more weight gain.
  • Joint Health Overweight and obesity can also contribute to osteoarthritis, a painful joint condition, in two ways: Fat releases inflammatory chemicals that can cause pain and swelling, and excess weight puts added pressure on the joints.

Metabolic Health

Most people who are overweight or have obesity also exhibit signs of metabolic health issues, such as high blood pressure, high blood sugar, and high cholesterol, all of which increase the risk of chronic disease. Some people manage to avoid these health problems, which doctors sometimes refer to as “metabolically healthy obesity.”

“Metabolically healthy obesity refers to people who have a higher BMI but normal blood sugar, cholesterol, blood pressure, and no clear signs of inflammation or insulin resistance,” says Lopez-Jimenez. “This state is often temporary. Over time, many will develop metabolic abnormalities.”

Even if you’re considered metabolically healthy and feel fine, it’s still important to lose weight, because obesity is a progressive disease, says Lopez-Jimenez.



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