What to Know About Obesity If You’re at Risk for Other Diseases

There are many ways that having obesity can affect your quality of life, from making it challenging to find clothing that fits comfortably to putting you at increased risk of depression, anxiety, and other mental-health issues. Then, of course, there are the well-documented health risks. Obesity—defined by the Centers for Disease Control and Prevention (CDC) as having a body mass index (BMI) of 30 or more, calculated using your height and weight—can also put you at higher risk of developing a wide variety of health problems, especially if you’re already at increased risk of developing a particular medical condition or chronic disease due to family history or your personal health profile. This is especially true if you tend to store excess weight around your midsection or have severe obesity (defined by the CDC as a BMI of 40 or higher). Here’s what to know about obesity and disease risk, including some of the health problems that carrying too much body fat can escalate your risk of getting—and what you can do about it.

Cancer

If there’s cancer in your family medical history, or your own, it is important to know that obesity likely compounds your risk. Scientists have found links between obesity and increased risk of many different types of cancer, and in some cases the risk is dramatically increased. “People with obesity are two times more likely to develop esophageal or gastric cancer,” says Dr. Supriya Rao, MD, a physician quadruple board-certified in internal medicine, gastroenterology, obesity medicine, and lifestyle medicine. They’re also at higher risk of developing breast cancer, ovarian cancer, colorectal cancer, liver cancer, gallbladder cancer, and pancreatic cancer, among others. Research indicates that excess body fat increases the risk of dying from cancer by 17 percent.

Type 2 diabetes

Type 2 diabetes is a disease that involves your blood glucose (also known as blood sugar) being too high, and obesity is a major risk factor that can make you more likely to develop it. “Insulin resistance is a hallmark of obesity,” explains Dr. Courtney Younglove, MD, a physician double-board-certified in obesity medicine and obstetrics and gynecology. “Over time, the pancreas struggles to keep up with the insulin needs of the body, leading to type 2 diabetes.” The high blood glucose levels associated with type 2 diabetes can eventually snowball into serious health problems like heart disease, stroke, and eye conditions like glaucoma.

Metabolic syndrome

Obesity also puts you at high risk of developing metabolic syndrome. Often a precursor to type 2 diabetes, metabolic syndrome involves having at least three of the following health conditions: high triglycerides, high blood pressure, high blood glucose, excess weight around your waistline, and low levels of “good” cholesterol (HDL). In addition to being overweight or obese, another factor known to contribute to developing metabolic syndrome is not getting enough physical activity.

High blood pressure

If you’re already at risk of high blood pressure, also called hypertension, a larger body size puts you at higher risk. Just like it sounds, high blood pressure simply means that blood is flowing through your blood vessels with an above-normal level of force. When you have obesity and are carrying excess body fat, your heart may have to pump blood more powerfully just to effectively circulate it to cells throughout your body. Having high blood pressure ups your chances of experiencing a heart attack, stroke, and kidney disease.

Cardiovascular disease

There are many ways in which carrying excess weight can put added stress on the systems in your body, and these factors can lead to a higher risk of cardiovascular disease. Obesity contributes to not just high blood pressure but high blood glucose, high cholesterol, and high triglycerides, as well as insulin resistance, all of which contribute to the development of heart disease. “It also promotes chronic inflammation, which plays a key role in plaque buildup in the arteries,” says Dr. Younglove. These cardiovascular issues can lead to life-threatening health conditions like coronary heart disease—where the arteries leading to your heart become blocked—heart attack or congestive heart failure, where your heart can no longer pump blood effectively.

Fatty liver disease

Fatty liver disease involves fat building up in your liver, so it’s no surprise that obesity can make you more likely to develop this health condition—which can become quite serious, leading to severe liver damage or even liver failure. “Fatty liver disease, with the resulting development of cirrhosis, has become the leading reason for liver transplant,” Dr. Rao notes.

Gallbladder disease

Obesity can cause you to have higher levels of cholesterol in your bile—the yellowish fluid made by your liver and stored in your gallbladder—which can contribute to gallstones and other forms of gallbladder disease. People with obesity may also have an enlarged gallbladder that doesn’t function properly. It’s important to note that rapid weight loss can also exacerbate the risk of gallstones, so it is best to worth with your healthcare provider to do it in a gradual, healthy way.

Polycystic ovary syndrome (PCOS) and fertility/pregnancy problems

“Insulin resistance and hormonal imbalances linked to obesity can worsen PCOS symptoms and fertility challenges,” Dr. Younglove says. “It’s becoming more and more common as women’s metabolic health deteriorates, which wreaks havoc on many facets of women’s lives.” In other words, the prevalence of obesity is having a real impact on our fertility and pregnancy outcomes. If you’re having trouble conceiving or know you’re at risk of pregnancy complications, know that obesity is a serious risk factor that’s best addressed before you try to become pregnant.

Sleep apnea

Some people notice that gaining even a moderate amount of weight makes them snore more; this ties into how obesity can cause people to develop sleep apnea, where breathing during sleep becomes irregular, sometimes dangerously so. “Excess weight and inflammation can mean airways get blocked during sleep, leading to low oxygen levels and increased cardiovascular strain. This is often ignored in women,” Dr. Younglove says.

Mental health conditions

If you’re susceptible to mental-health conditions, obesity can put you at higher risk. Feeling defeated about weight loss, constantly thinking about your body weight, experiencing social anxiety and body-image issues, even thinking about your disease risk—there are so many ways in which obesity’s negative effects can go beyond physical health. “Depression, anxiety, and eating disorders often coexist with obesity, making a comprehensive approach to treatment essential,” Dr. Younglove says.

Intense perimenopause symptoms

If you know your mom really struggled during perimenopause—with symptoms like hot flashes, itchy skin, sudden weight gain, difficulty sleeping, mood swings—there’s a higher chance that’ll you experience the same symptoms. And all the more so if you have obesity. “Having excess weight during the menopause transition typically means the symptoms of perimenopause are worse,” Dr. Younglove says. “Long-term obesity risks are also typically worsened during menopause, including increased incidence of cardiovascular disease, insulin resistance leading to diabetes, etc. Menopause often puts significant pressure on an already-stressed system.”

Osteoarthritis

Carrying excess weight increases inflammation in your body while also putting extra stress on your joints, especially your knees, hips, and lower back. This is why obesity poses an increased risk of osteoarthritis, a chronic health condition involving joint pain, swelling, and stiffness, as well as reduced motion.

What you can do

Obesity is a complex and frustrating disease that we now know involves much more than poor diet and lack of exercise. Genetic, physiological, socioeconomic, and environmental factors beyond our control can all come into play. That said, the worst thing you can do if obesity is putting you at increased risk of health problems is give up and do nothing. Any additional weight gain will only compound your increased risks, while on the flip side, any weight loss can significantly reduce the health risks associated with obesity. “Even a modest weight loss of 5 to 10 percent of body weight can lead to improved blood pressure, cholesterol levels, and blood sugar control,” Dr. Rao says. “Fatty liver can also improve. Small, sustainable changes are powerful and can decrease your risk for developing other conditions.” Rather than go it alone when it comes to improving your lifestyle habits, the best starting point is to sit down with a healthcare provider and come up with a holistic plan involving doable and sustainable changes that will begin to decrease your waist circumference if you stick with them. Your healthcare provider can also address obesity and disease risk and discuss weight loss medications, teach you how to monitor your blood glucose/blood sugar to aid with weight loss and help prevent type 2 diabetes, and, if you have severe obesity, discuss interventions like bariatric surgery. It’s also important to recognize that you may need additional help; obesity is a health condition that can often respond best when addressed from several different angles. The good news is that, if you’ve struggled to achieve a healthy weight on your own, specialized help is out there, and often covered by insurance. “Your primary care physician can refer you to an obesity medicine-certified physician to have further discussions,” Dr. Rao says. “Sometimes, it takes a village—a team of physicians, nutritionists, behavioral health specialists, bariatric endoscopists, etc.—to provide a safe, supportive, and respectful environment to achieve a healthier lifestyle.”