When does excess weight begin to negatively affect your health?  How much weight do you have to lose to improve your health? 

Is it better for a person to resign themselves to a lifetime of being overweight or obese than to struggle with the challenges associated with trying to lose weight?

What does the current research tell us about the effects of excess weight and the benefits of healthy weight loss?

Excess weight and health effects

Numerous studies using various study methodologies have repeatedly linked excess weight to an increased risk of death and cardiometabolic disease. 

While this is not surprising, what is surprising is these increases are consistently noted starting when a person’s body mass index (BMI) rises above as little as 25.  

If you are curious regarding your current BMI, the Centers for Disease Control and Prevention (CDC) offers a free tool to quickly calculate your own BMI here.

At a BMI of 25 to 30, you are considered “overweight” according to the CDC.  When your BMI climbs above 30, you are considered “obese.”  

As BMI rises above the normal healthy weight BMI ranges of 18.5 to 25, your risk also rises for:

• Diabetes 
• Stroke
• Heart disease
• Cancer: at least 13 different cancers increase in frequency in overweight and obese individuals, including breast, thyroid, colon, kidney, brain, esophageal, pancreatic, ovarian, endometrial, blood, and other cancers
• Asthma
• Fatty liver disease and non-alcoholic related cirrhosis
• High blood pressure
• High cholesterol
• Joint pain and arthritis
• Infertility and irregular menses
• Gallstones
• Blood clots
• Gout
• Hormone level abnormalities
• Chronic inflammation (CDC, 2010; Cancer.gov, n.d.; Cox et al., 2015; McTiernan et al., 2006)

The higher your BMI climbs above the healthy range, the higher your risk for these diseases.  

Excess body fat and how body fat specifically affects your health 

Body fat in excess can directly harm us due to leakage of fat into our blood stream from the fatty tissue, increasing inflammation levels, & placing strain on our joints

Excess body fat undermines your health through a variety of mechanisms.  These include:

• Four fold increase of pressure on the knee with each daily step for each excess pound, contributing to the development of osteoarthritis and joint pain
• Fat cell hormone secretion includes pro-inflammatory cytokines, as well as pro-thrombotic (blood clotting) molecules
• Secretion of fatty acids from fat tissue into the bloodstream infiltrate the liver cells and muscle cells, creating a state of insulin resistance and elevated serum cholesterol (Ryan & Yockey,  2017)

How much weight do you have to lose to experience health improvements?

It can be discouraging when our BMI reaches numbers well above the optimal range of 18.5 to 25.  Getting our weight down to that range can feel overwhelming and impossible.  However, we have shown many clients that such goals that seemed impossible are in fact possible with a comprehensive program (outlined below).  

For those who are not ready for a comprehensive program, achieving optimal weight is not necessary to achieve significant improvements in your health status and to reduce your risk for disease. 

Losing 5% of your bodyweight improves liver function and decreases insulin resistance 

The ultimate liver cleanse, losing weight purges the liver of accumulated fats and boosts insulin sensitivity.

Research has shown that losing as little as 5% of your total body weight can lead to significant improvements in:

• Blood sugar levels improve due to fat cell and liver cell insulin sensitivity improvements
• Liver enzymes (which can become elevated due to damage to liver cells when exposed to excessive levels of fatty acids)
• Triglyceride levels begin to fall, reducing the amount in the liver by 13%
• Improved fertility in females with polycystic ovarian syndrome (Ryan & Yockey,  2017)

11% weight loss builds on these improvements

• At 11% weight loss, insulin sensitivity improves in muscle tissue.
• HDL cholesterol begins improving when more than 5% body weight is lost.
• Diastolic blood pressure begins improving when more than 5% body weight is lost
• Knee pain begins to improve significantly when more than 5% body weight is lost
• When body weight loss exceeds 20 lbs obstructive sleep apnea symptoms begin to improve
• Reductions can be noted in IL-6, an inflammatory cytokine, when weight loss is paired with exercise
• Liver triglycerides clear by 52%!!
• Further fertility improvements in women with polycystic ovarian syndrome
• 21% reduction in serious cardiovascular events (Ryan & Yockey,  2017)

16% weight loss lowers inflammation levels and insulin sensitivity continues to improve

Cool the flames of inflammation: losing weight significantly reduces markers of inflammation in the body!!

At 16% weight loss:

• C-reactive protein (a measure of body-wide inflammation) improves significantly
• Pancreatic beta cell functionality improves (these cells produce insulin)
• Muscle cell insulin sensitivity continues to improve further reducing diabetes risk/ severity
• Liver triglycerides clear by 65%!!!  Talk about a true liver cleanse! (Ryan & Yockey,  2017)

Other benefits noted in study participants who lost weight

Those following a lifestyle improvement plan including weight loss and an emphasis on greater than 175 min walking/ moderate exercise per week experienced:

• Sexual function improvements
• Urinary incontinence improvements 
• Slowing in the rate of decline experienced with aging over the study period
• Reductions in hospitalizations and associated costs for participants 
• Reductions in prescription medications and associated costs for participants 
• Improvements in self reported quality of life (Look AHEAD Research Group et al., 2006)

How Lancaster Wellness can help

Similar to the research cited above which combines lifestyle interventions with weight loss, Lancaster Wellness provides the following services to help you on your weight loss journey:

• A progressive fitness program provided by certified personal trainer personnel
• Meal planning and nutrition guidance/ coaching using evidence-based foods and strategies
• Medication as appropriate under physician supervision
• Clients frequently lose 20-40 lbs in the first 3 months of care (10-15% or more of their bodyweight in just 3 months!) and many go on to hit their ultimate goals of 50, 60, 70…100+ lbs off with Lancaster Wellness
• Proven track record of weaning clients off the medications for those who desire to use lifestyle measures to manage their weight long term
• Maintenance program for those that need / desire ongoing support after hitting their goals

Summary: You don’t need to get down to a BMI of 25 to benefit!

The major takeaway from the research?  You do NOT have to get down to a BMI of 18.5-25 to experience the benefits of weight loss!!!

Losing 5% of your body weight creates measurable improvements in our body’s health.  These improvements climb as weight loss increases, and disease risk or burden decreases!!

Unsure how to get started?  Reach out!  We can help!!  Live well!

-Written by Donovan Carper MSN RN CPT CHC

References

Cancer.gov. (n.d.). Cancers associated with overweight and obesity. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/overweight-cancers-infographic

CDC. (2010). Vital signs: adult obesity. Retrieved from https://archive.cdc.gov/#/details?q=obesity&start=0&rows=10&url=https://www.cdc.gov/vitalsigns/adultobesity/index.html

Cox, A. J., West, N. P., & Cripps, A. W. (2015). Obesity, inflammation, and the gut microbiota. The lancet. Diabetes & endocrinology, 3(3), 207–215. https://doi.org/10.1016/S2213-8587(14)70134-2

Look AHEAD Research Group, Wadden, T. A., West, D. S., Delahanty, L., Jakicic, J., Rejeski, J., Williamson, D., Berkowitz, R. I., Kelley, D. E., Tomchee, C., Hill, J. O., & Kumanyika, S. (2006). The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it. Obesity (Silver Spring, Md.), 14(5), 737–752. https://doi.org/10.1038/oby.2006.84

McTiernan, A., Wu, L., Chen, C., et al. (2006). Relation of BMI and physical activity to sex hormones in post-menopausal women. Obesity. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2006.191

Ryan, D. H., & Yockey, S. R. (2017). Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Current obesity reports, 6(2), 187–194. https://doi.org/10.1007/s13679-017-0262-y