29 Jul Spotlight on Weight
Of all the health topics swirling around in American society and media today, weight captures more attention than almost any other issue. Currently, obesity is considered to be epidemic in our country, with childhood obesity rates more than doubling over the past 30 years (and with adolescent obesity rates quadrupling). In 2012, more than one third of Americans, both children and adults, were overweight or obese. There is no question that weight has become an issue worth addressing. However, I’ve learned that it is often addressed in ways that do not solve the problem or help people in the long term. Although there is merit to the concerns surrounding overweight and obesity, it can also be dangerous to focus on weight as a determinant of health.
Being overweight or obese puts people at higher risk for disease. According to the National Institutes of Health (NIH), people who are overweight have a greater chance of experiencing heart disease, stroke, high cholesterol, hypertension, type 2 diabetes, gallstones, sleep apnea, certain cancers, and joint problems. These associations are well documented and are important to take into consideration.
The fact that overweight promotes diseases makes sense when one considers the toll that excess weight takes on the body. For example, being overweight puts more stress on the weight-bearing joints because they must carry the extra weight of the body. Similarly, added weight of the chest wall squeezes the lungs and restricts the ability to breathe, which is what causes sleep apnea. Excess fat also brings about oxidative stress, a state of inflammation and imbalance between free radical production and antioxidant defenses. Being overweight also causes the body to need to work harder in general, increasing the effort that it takes to circulate blood or do physical activity.
Cardiovascular disease is perhaps the condition most commonly associated with overweight and obesity. People who are overweight or obese tend to have higher blood pressure, higher triglycerides, and higher cholesterol, all of which lead to atherosclerosis (hardening of the arteries) and cardiac events. As mentioned above, overweight or obese individuals’ bodies often need to work harder to circulate blood, causing high blood pressure and consequently putting added force against artery walls. Over time, this extra pressure can damage the arteries, and injured arteries are more likely to become narrowed and hardened by fatty deposits in the bloodstream.
Type 2 diabetes and obesity often go hand-in-hand as well. When fat builds up in the muscle cells, it interferes with the cell’s ability to respond to insulin. Dr. Neal Barnard explains this as the fat “gumming up the lock.” Usually, insulin attaches to receptors on the surface of the cell, essentially unlocking a door for the glucose to enter. But when there is too much fat in the cell, the fat gums up the lock so that the door can’t open to let the insulin in. So even though the body makes plenty of insulin, the fat inhibits the cell from properly responding.
According to the American Society of Clinical Oncology, obesity is overtaking smoking as the leading preventable cause of cancer. The most common weight-related cancers are endometrial (uterine) cancer, postmenopausal breast cancer, and colorectal cancer, but the effects of obesity appear to increase mortality of many other types of cancer including gallbladder, pancreas, kidney, esophagus, and thyroid. Being overweight also increases the chance of cancer recurrence and/or mortality from cancer. There are a number of possible mechanisms for the association between overweight and cancer, such as increased levels of estrogen and other hormones, increased levels of insulin and IGF-1 (insulin-like growth factor 1), and chronic low-level inflammation.
Given the numerous risk factors associated with overweight, it can be easy to fall into the trap of associating healthy body weight with good overall health. But the fact of the matter is that, while weight is indeed an important health marker, it is by no means the be-all and end-all indicator of personal health and well-being. On the contrary, maintaining a healthy body weight makes no guarantee of overall health, and putting the focus on weight can be dangerous. For those who are at a healthful weight, it can give a false sense of security about their overall health—and for those who are overweight, it can misdirect attention away from the source of the problem, as well as its solution.
The food that you put into your body is more significant than the shape of your body or the number on the scale. In fact, the risk for the majority of the diseases and ailments associated with overweight and obesity can be reduced or eliminated entirely by changing your diet—even if you are still overweight. Too often, weight is seen as the problem instead of what it truly is: a side effect. Weight is not the problem, what we eat is the problem. And, perhaps not surprisingly, what we eat is also the solution.
The reason that overweight and obesity are linked with conditions like hypertension, heart disease, and diabetes is because overweight and obesity are primarily caused by poor diet. It is the cholesterol, fat, animal products, and highly processed foods in a standard American diet that lead to these ailments. By addressing weight without addressing diet, we are only covering up a problem rather than fixing it.
As mentioned earlier, being at a “healthy weight” can be misleading. While some people are predisposed to gain weight more easily, others are predisposed to stay thin. Because we focus so much on outward appearance, someone who looks physically fit or thin is often seen as being healthy. However, this is often not actually the case. Being thin does not protect a person from developing conditions like heart disease or hypertension. In fact, being thin and/or fit can give people a false security that they are in good health when in fact, more important characteristics—such as cholesterol or blood sugar levels—indicate that they are at high risk for disease. People who are thin may put themselves in even more danger if they see no weight-gain repercussions of eating unhealthful and therefore receive no warning that something is wrong. With the first sign of heart disease being cardiac arrest for more than half of heart attack victims, viewing weight as the main indicator of health is not only misleading, but also life-threatening.
Just as being at a healthy weight does not necessarily mean that a person is healthy overall, being overweight does not necessarily mean that a person is unhealthy in every regard. We all have to start the journey to health somewhere, and for some people, they start at a high weight. As dietary changes are made, weight loss will be gradual—which is healthy. But although weight loss is a relatively slow process, many of the health improvements that come with a plant-based diet happen rather quickly. Accordingly, as an individual’s weight gradually declines, or even reaches a plateau, he or she may be in excellent overall health despite being overweight. Even type 2 diabetes can be completely reversed in someone who is still overweight or obese—if they are eating a plant-strong diet.
Focusing too greatly on weight can also lead those who are overweight or obese to use extreme and/or expensive means to lose weight, which are often unsuccessful anyways. Procedures such as gastric bypass surgery can not only drain one’s bank account, but it also doesn’t address the root of the problem, therefore offering no protection from recurrence of weight gain and disease. Fifty percent of people who undergo gastric bypass surgery become overweight or obese once again in the years following the procedure, and one third experience a relapse of type 2 diabetes within 5 years of remission following the surgery. Other common weight loss strategies such as calorie counting, fad diets, and diet pills can also be quite dangerous and lead to their own set of health complications, as well as promote an unhealthy mental relationship with food. Such measures do not fix the problem—on the contrary, they often just create more (and sometimes severe) issues.
I would also like to note that being overweight or obese does not come from lack of willpower. As mentioned earlier, some people gain weight easily and others do not, even if both groups are eating a diet consisting of the same foods. This is due to genetic variation—some people’s bodies are hardwired to store fat more easily. Back in our ancient hunter-gatherer days where food was sometimes scarce, this was favorable. But in today’s world of artificially concentrated “food” full of excess fat and refined carbohydrates, the caloric density of our diet has been significantly raised, and some bodies do not accurately assess the amount of calories in such foods. When we raise the fat content and lower the fiber content in our diet, our bodies are fooled. Switching to a whole food, plant-based diet, however, eliminates this problem entirely.
Focusing on weight takes attention away from the real problem(s). As with all health conditions, we need to address the root cause, not just the symptom. The way to achieve optimal health is not through weight loss, but through dietary change. Going plant-strong is the number one thing that you can do to protect yourself from disease and promote the best of health. To quote Dr. John McDougall, “It’s the food. The food is the problem. We have to fix the food!”
Love your body and feed it well. Here’s to health!
*To learn more about social issues with focusing on weight, read posts by Natala Constantine on the Engine 2 Daily Beet blog.
National Institutes of Health (NIH). What are overweight and obesity? http://www.nhlbi.nih.gov/health/health-topics/topics/obe/
Borrell LN, Samuel L. (2014) Body mass index categories and mortality risk in U.S. adults: the effect of overweight and obesity on advancing death. Am J Public Health. Published online January 16, 2014.
Ogden, C., Carrol, M., Kit, B., & Flegal, K. (2014). Prevalence of Childhood and Adult
Obesity in the United States, 2011-2012. Journal of the American Medical Association, 311(8), 806-814.
May, A., Kuklina, E., & Yoon, P. (2012). Prevalence of Cardiovascular Disease Risk
Factors Among U.S. Adolescents, 1999-2008.
Renehan A. (September 2009). Obesity and overall cancer risk. Presented at the Joint ECCO 15-34th ESMO Multidisciplinary Congress. Berlin, Germany, September 20-24, 2009. Abstract I-327.
Magro, D. O., Geloneze, B., Delfini, R., et al. (June 2008). Long-term Weight Regain after Gastric Bypass: A 5-year Prospective Study. Obesity Surgery, 18(6), 648-651.
Christou, N., Look, D., & MacLean, L. (2006). Weight Gain After Short- and Long-Limb Gastric Bypass in Patients Followed for Longer Than 10 Years. Ann Surg, 244(5), 734-740.
Arterburn, D.E., Bogart, A., Sherwood, N.E., et al. (2013) A Multisite Study of Long-Term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass. Obesity Surgery, 23(1), 93-102.
Higdon, J. & Frei, B. (2003) Obesity and Oxidative Stress: A direct link to CVD? Arteriosclerosis, Thrombosis, and Vascular Biology, 23, 365-367.
Lisle, D. and Goldhamer, A. (2003) The Pleasure Trap: Mastering the Hidden Force that Undermines Health and Happiness. Healthy Living Publications: Summertown, Tennessee.