If you are overweight, you are not alone. In 2007, 2 out of 3 Americans are overweight or obese. As a society, we are increasingly aware that increased activity coupled with increased caloric intake and poor nutrition slowly but inevitably overwhelm our body’s ability to maintain a healthy weight.

Being overweight or obese puts you at serious risk of developing many obesity-related diseases. That’s the bad new. The good news is that reducing your weight drastically reduces these very risks. For those patients who suffer from these conditions, weight loss can significantly improve or completely correct these conditions.

Insulin resistance and diabetes mellitus

Obesity leads to insulin resistance, a diminished biological response to the hormone insulin. This resistance is characterized by an elevation in circulating insulin, a reduced ability to store glucose, and a propensity to store fat.

In patients with non-insulin-dependent diabetes mellitus, serum glucose levels improve within a few days of starting a weight loss program. One study showed that average fasting blood glucose levels in people with type 2 diabetes decreased from 290 mg/dL to 110 mg/dL in 3 days in response to a very low-calorie diet. Medication (oral agents or insulin) can be greatly reduced or eliminated in such cases. Another study reported that after a weight loss of 23 kg (22% of baseline body weight), all patients taking oral agents and 82% of patients taking insulin were able to discontinue the medication. Similar results were reported with weight losses of 9.3 kg. In general, patients with a 15% reduction in total body weight may consider discontinuing oral agents. Smaller decreases in total body weight can even cure “prediabetes,” a significant cardiovascular risk.

Hypertension

Hypertension improves with weight loss in overweight people. In patients following very-low-calorie diets (VLCD), one study reported a significant decrease in systolic blood pressure in 81% of patients and diastolic pressure in 62% of patients (6). Patients receiving an 800 to 1200 kcal diet that averaged a weight loss of 10.5 kg showed decreases in systolic and diastolic blood pressure of approximately 20 mm Hg. In about three quarters of these patients, blood pressure returned to normal. Adding an exercise regimen to the weight loss led to even greater improvements in blood pressure.

dyslipidemia

Obesity is often associated with elevated serum triglycerides and total cholesterol. The ratio of LDL to HDL cholesterol is often elevated, resulting in an even higher risk of heart attacks and strokes. All of these values ​​generally improve with weight loss. Often, fasting triglyceride levels, which can be as high as 1,000 to 1,500 mg/dL, will return to normal (sleep apnea).

Obesity may be associated with mild to severe respiratory functional impairment. Increased obesity is associated with decreased oxygen saturation. Two primary disorders occur: obesity-hyperventilation syndrome and sleep apnea.

Patients with hypoxemia (low blood oxygen levels) and sleep apnea improve rapidly with weight reduction. For every 1 percent weight loss, sleep apnea patients decrease their apnea-hypopnea ratios (the amount they stop breathing at night) by 3 percent. In fact, many sleep apnea patients who sleep on CPAP machines are able to stop using their breathing machines at night after losing weight.

A ventilation-perfusion disturbance (a mismatch between breathing and circulation) is common in obese people. This alteration can result in heart failure. These conditions also improve with weight loss. With significant weight loss, essentially normal lung function can be achieved and heart function can normalize.

Metabolic syndrome

Intra-abdominal fat is metabolically active and is associated with a serious health risk. The metabolic syndrome describes a group of cardiovascular risk factors that combine to produce a proinflammatory and prothrombotic (hypercoagulable) state. This condition leads to vascular disease leading to heart attacks and strokes and a pro-inflammatory state associated with increased incidence of various types of cancer. It is estimated that more than 50 million Americans are currently at risk, but less than 5% are diagnosed.

To qualify for Metabolic Syndrome, 3 out of 5 of the following components are needed: 1. increased intra-abdominal fat defined by a waist circumference greater than 40 inches in men and 35 inches in women 2. high blood pressure 3. elevated triglycerides 4 .low HDL cholesterol 5. diabetes or prediabetes. Abdominal obesity is present in 84% of patients with Metabolic Syndrome.

In short, the location of fat matters. Intra-abdominal fat is metabolically active and dangerous and can lead to heart attacks, strokes, cancers, and more. Fortunately, the first-line treatment for metabolic syndrome is weight reduction and increased physical activity. Waist circumference and intra-abdominal fat decrease markedly with the type of weight loss Jumpstart Medicine patients typically experience.

Polycystic ovary syndrome

Polycystic ovarian syndrome (PCOS) affects 5 to 10% of women of reproductive age. It occurs in association with obesity, type 2 diabetes, and anovulatory infertility. As noted above, weight loss improves diabetes. Weight loss in PCOS patients can also significantly improve their reproductive potential (fertility).

degenerative joint disease

Low back pain and osteoarthritis of the knee are more common in obese people. Obese women are 4 times more likely and obese men 5 times more likely to develop osteoarthritis of the knees. Fortunately, associated knee pain and disability improves or resolves with weight loss. According to the Framingham Study, an 11-pound weight loss in women decreased the risk of knee osteoarthritis by 50%. The degree of improvement varies with the amount of structural damage, but relief can often be complete with moderate weight loss.

Social Stigma and Prejudice

In addition to suffering health risks, obese people also experience discrimination and decreased competitiveness in our society. Compared to a normal-weight counterpart with the same credentials, an obese person is less likely to be hired for a job and more likely to be paid less if she is given the job. Obese people are less likely to be admitted to competitive universities than their normal-weight applicants.

Other benefits

Because the risks of general surgical procedures are greater in obese patients, it is often beneficial to reduce the patient’s weight before attempting a major elective procedure, such as an orthopedic operation, cholecystectomy, or gastric bypass. A 5% to 10% reduction in body weight or a 5 unit change in body mass index (BMI) can reduce the length of hospitalization and the incidence of postoperative complications.