In the past few decades, the prevalence of overweight and obesity around the world has shot up exponentially. According to the World Health Organisation (WHO), about 39% of the world’s adult population is either overweight or obese. Experts have attributed the rise of Type 2 Diabetes, hypertension, cardiovascular diseases, and other chronic illnesses to an upsurge in obesity. Ever wondered why that is so? How are chronic disease and body weight connected? In this article, we discuss how obesity causes chronic disease and vice versa, with a few examples.
While both the terms “overweight” and “obesity” are used to refer to body weight that is greater than what is considered normal or healthy, overweight is a less severe condition than obesity. You are considered overweight if you have a BMI between 25.0 to 29.9 kg/m2.
Fat or adipose tissue has several functions in your body, the key ones being storing energy and insulating your body. It also secretes hormones (leptin, oestrogen, resistin, etc.) and proteins (like cytokines), which play a major role in regulating your metabolism and your body’s immune response.
Fat tissue is spread out in several regions of the body, like under your skin (subcutaneous), around your organs (visceral), and in the bone marrow, muscles, and breasts. As such, fat can directly affect the health of your bones, muscles, and major organs.
In individuals who are overweight or obese, the fat tissue releases cytokines, which cause chronic systemic inflammation throughout the body. This inflammation can damage the healthy cells in your body, which increases your risk of developing chronic disease.
Here are some chronic conditions that are linked to obesity:
Obesity is thought to be one of the most crucial risk factors and causes for Type 2 Diabetes. Excess fat, especially around the abdomen and liver, is thought to cause insulin resistance. The fat tissue around your liver releases cytokines that cause inflammation in your cells, which leads to them becoming unresponsive to insulin.
Obesity is also a risk factor for high blood pressure. The pro-inflammatory cytokines released by the fat tissue are thought to trigger the Renin-Angiotensin-Aldosterone System (RAAS), which retains excess sodium and water in your body. This could lead to elevated blood pressure.
Also, people who are overweight or obese are at an increased risk of having high cholesterol levels. Excess cholesterol can accumulate in the walls of your blood vessels, causing them to become stiff and narrow. This condition is known as atherosclerosis, which can further raise your blood pressure.
Cardiovascular diseases are a group of conditions that affect your heart and the blood vessels that are connected to it. When you are overweight or obese, excess cholesterol can accumulate in the arteries that supply blood to your heart. This can damage your arteries and reduce or cut off the blood supply to your heart muscle.
Metabolic syndrome usually refers to a cluster of conditions like abdominal obesity, high blood sugar levels, high blood pressure, high triglyceride (a fatty substance similar to cholesterol) levels, and low HDL (high-density lipoprotein or “good”) cholesterol levels.
This condition is associated with an increased risk of developing Type 2 Diabetes and cardiovascular diseases. Obesity is both a cause and a sign of metabolic syndrome, as the low-grade inflammation caused by obesity can lead to high blood pressure and high blood sugar levels.
Polycystic ovary syndrome or PCOS is a hormonal condition that occurs in women of reproductive age.
The low-grade inflammation and insulin resistance caused by excess fat are major risk factors for the development of PCOS.
Sleep apnoea is a sleep disorder where your breathing is shallow or starts and stops repeatedly. It occurs due to restrictions in your airways, which can be caused by fat deposits in your upper respiratory tract. These excess fat deposits can compress your throat muscles, which can cut off your breathing.
When you are overweight or obese, the excess weight can put more pressure on your joints, muscles and bones. This added pressure can lead to wear and tear in your joints, making you more likely to develop chronic pain or osteoarthritis.
The exact mechanism of how obesity causes cancer is still unknown. However, the American Institute for Cancer Research has concluded that there is a direct link between obesity and cancers of the breast, ovaries, endometrium, kidney, oesophagus, pancreas, colon, and rectum.
Most people consider overweight and obesity as caused by consuming more calories than you burn, but the condition is more complex than that. Several risk factors like genetics, stress, some medications, and medical conditions can also lead to the development of obesity.
Chronic illnesses, especially hormonal disorders, can affect your metabolism and the way your body functions. This can lead to weight gain, despite eating healthy and exercising regularly. Some chronic conditions can interfere with daily activities and disrupt your lifestyle, which can also lead to weight gain and increase your risk for obesity.
The following are some conditions that can cause weight gain and obesity:
Insulin is a hormone that regulates the uptake and storage of glucose (sugar) in your cells. It works to preserve energy and thus prevents fat burning. In people who have insulin resistance, the cells do not respond properly to insulin, which prevents sugar from entering the cells.
The resulting high blood sugar levels trigger more insulin release from the pancreas, leading to high insulin levels in your body. Thus, people with insulin resistance are unable to burn fat and lose weight due to the presence of excess insulin in their bodies.
Hypothyroidism is a hormonal condition where your thyroid gland is not as active as it should be, leading to a lowered production of thyroid hormones (T3 and T4). These hormones are responsible for regulating your metabolism and body temperature.
When you have low levels of thyroid hormones, it can cause your metabolism to slow down, which results in your body not burning as many calories as it should. This can result in weight gain and may lead to obesity.
Cushing’s syndrome is yet another hormonal disorder that is caused by long-term exposure to the stress hormone cortisol. Cortisol is generally released by the adrenal glands in times of distress. However, overuse of steroidal medication, tumour of the pituitary gland, or abnormal functioning of adrenal glands can also lead to an overproduction of cortisol.
Cortisol can impair your metabolism by causing insulin resistance in your cells, which results in weight gain. Chronic high levels of cortisol also redistribute fat in your body, leading to increased abdominal obesity.
Depression is a mental health disorder that can cause a lack of interest in daily tasks and activities. This most often presents as a lack of physical activity or exercise in individuals with depression.
Emotional numbness is also commonly seen in individuals with clinical depression. This could cause them to resort to unhealthy coping mechanisms like binge eating, excessive alcohol consumption, smoking, and substance abuse. These unhealthy lifestyle habits can lead to the development of obesity in individuals with mental health disorders like depression and anxiety.
Insomnia is a sleep disorder that is characterised by difficulty in falling or staying asleep. Most experts recommend 7 to 9 hours of sleep for optimum health.
Disturbed sleep can result in an increase in the levels of the stress hormone cortisol and hunger hormone ghrelin. Thus, insomnia can result in insulin resistance and overeating, both of which can contribute to weight gain.
Menopause is a period that marks the permanent end of a woman’s menstrual cycles. Women in menopause experience a decline in the levels of reproductive hormones like oestrogen and progesterone, which can lead to several changes in their bodies.
Some of these changes include an increased appetite, fat redistribution around the abdomen, and increased insulin resistance, all of which can lead to weight gain and obesity.
People who experience chronic pain and problems associated with conditions like arthritis often have limited mobility, which may prevent them from exercising and being physically active. This results in a sedentary lifestyle, which can lead to obesity.
Prader-Willi syndrome is a genetic disorder which causes poor muscle development and affects feeding in newborns. Children with this condition are constantly hungry, which results in the consumption of more energy than they can burn, resulting in weight gain and obesity.
As seen above, chronic disease and weight are closely intertwined, and managing one can help improve the other, along with your overall health outcome. The following measures can help you manage obesity as well as chronic illness.
When it comes to managing any illness, medication is key and often highly effective. Especially in the case of chronic disease, medications are crucial for preventing further health complications.
Medication can also help you manage obesity by treating underlying medical conditions like hormonal imbalances or abnormal metabolism, which impede weight loss.
Diet is a direct and significant contributor to your health. What you eat can have a direct effect on your weight. Similarly, in most chronic diseases, diet is a primary factor in management.
Limiting your consumption of empty calories and simple carbohydrates with little to no nutritious value, and replacing them with protein, fibre, and nutrient-rich food is one of the easiest ways to lose weight and manage chronic lifestyle disorders like Type 2 Diabetes, Hypertension, PCOS, metabolic syndrome, cardiovascular diseases, etc.
Regular physical activity is essential for maintaining optimum health. As the human body is designed to move, a sedentary lifestyle with little movement or exercise can result in several chronic illnesses.
Experts recommend at least 150 min of moderate-intensity physical activity every week to prevent lifestyle disorders. Exercise helps you burn calories and boost your metabolism, which helps in weight loss.
Smoking, alcohol consumption, long-term stress, and improper sleep can contribute to weight gain as well as the development of lifestyle disorders.
Hence, positive lifestyle changes are important for managing obesity and chronic diseases.
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