How Obesity Can Affect Your Heart
If you're above your ideal body weight and worried about your health, you aren't alone. In 2010, there were more than 78 million adults in the U.S. alone with obesity. And it's estimated that more than two-thirds of the U.S. adult population is either overweight or obese.
Obesity is associated with a variety of health problems, such as arthritis, gallbladder disease, lung disease, cancer and several forms of heart disease. People with obesity tend to have worse quality of life and die at younger ages when compared to those with an ideal body weight.
What Is My Ideal Body Weight?
Your ideal body weight is calculated based on your height. Physicians use body mass index, or BMI, to see whether their patients are overweight or obese. You can calculate your own BMI using this simple formula: BMI = weight (in kilograms)/height 2 (in meters). The National Institutes of Health offers a free online BMI calculator that can be found here.
An ideal BMI is between 18.5 and 25. A BMI of 25 to 29.9 puts you in the overweight category, and a BMI of 30 or more puts you in the obese category. Among those with obesity, there are subclasses, with individuals with a BMI of 35 or more being classified as having severe obesity and those with a BMI of 40 or greater as having extreme obesity.
This distinction is important, as not all obesity carries the same health implications. Studies have shown that the more obese you are, the greater your risk for poor health. The longer you remain obese, the greater your chances of developing an obesity-related health problem.
Another measure of obesity that factors into your health is your waist circumference. A waist circumference greater than 102 centimeters or 40 inches in men and greater than 88 centimeters or 35 inches in women increases your health risks. If you are overweight or obese and have a large waist circumference, you are at even higher risk of developing heart disease. Ask your doctor to measure your waist circumference.
[See: The Most Common Patient Complains.]
How Does Obesity Affect My Heart Health?
While obesity can lead to many diseases, one of the greatest concerns is your heart. It's long been known that people with obesity tend to have higher blood pressure, higher levels of bad cholesterol and lower levels of good cholesterol. Obesity also leads to insulin resistance -- when your body becomes partially resistant to the glucose-lowering effects of insulin. Insulin moves sugar in the form of glucose from your blood into your body's cells to be used as energy. Over time, insulin resistance causes higher blood sugar, which leads to prediabetes and eventually diabetes. High blood pressure, high cholesterol and diabetes are all known risk factors for heart disease, and the more of these risk factors you have, the higher your risk for heart disease. In fact, studies show that having more of these risk factors almost fully explains why people with obesity have a higher risk of heart attacks and stroke.
Even if you don't have any of the risk factors mentioned above, your heart may still suffer. People with severe obesity have almost four times the risk of developing heart failure than those with an ideal body weight. Studies also show that the link between obesity and heart failure persists even after accounting for the other risk factors. This means that if you are obese, you're still at increased risk for heart failure even if you don't have high blood pressure, high cholesterol or diabetes.
[See: 17 Ways Heart Health Varies in Women and Men.]
Wait! Heart Failure?
Yes. Heart failure is a growing health problem in the U.S. and worldwide. People who suffer from it feel short of breath and are unable to perform their usual daily activities. They tend to accumulate excessive fluid in their bodies, which leads to swelling around the ankles. Heart failure is a very serious condition that not only impairs your quality of life, but also threatens your life. About 50 percent of individuals diagnosed with heart failure will die within the next five years.
Obesity leads to heart failure in several ways. More body fat leads to higher blood volume, which in turn makes your heart work harder to pump all the extra liquid. Over the years, this causes harmful changes in the heart's structure and function that can eventually lead to heart failure. Fat tissue, particularly in the abdomen, also produces a number of toxic, inflammatory substances, like adipokines and cytokines, which damage heart muscle. Even obese people without any obvious signs of heart disease may have chronic damage to their heart muscle. We recently demonstrated this in a study that evaluated blood levels of the heart enzyme troponin among individuals without any current heart disease. We found that people with excessive fat had a greater chance of having elevated troponin levels in the blood, indicating silent heart damage. We also showed that the combination of elevated troponin and severe obesity carried a ninefold higher risk of heart failure over the next 10 years.
[See: The Best Foods for Lowering Your Blood Pressure.]
OK, This Is Bad. But What Can I Do? Losing Weight Is So Hard!
Yes, losing weight isn't easy. But here are a few encouraging facts:
1. Any weight loss is beneficial. In fact, sustained weight loss of 3 to 5 percent of your body weight can decrease your triglycerides, a type of bad cholesterol, as well as blood glucose levels. Greater weight loss can lead to a drop in blood pressure and LDL cholesterol (the bad cholesterol), an increase in HDL cholesterol (the good cholesterol) and may help decrease the number of medications you need. There's even some evidence that weight loss may help reverse some of the abnormal heart function and damage associated with obesity.
2. Be active. Physical activity can help you lose weight. Even if you don't lose weight, physical activity may still prevent some of the bad health outcomes that come with obesity. For example, studies suggest that individuals with obesity who exercise regularly have a lower risk of heart failure. Current guidelines from the American Heart Association recommend a minimum of 150 minutes of moderate or vigorous physical activity per week. Moderate physical activities can include brisk walking, water aerobics or gardening. Examples of vigorous physical activities are swimming laps, jogging or hiking up a hill. Being fit carries many health benefits.
3. A variety of weight-loss resources are available to you, from nutritional counseling to group interventions. With the growing pace of mobile technology, freely available apps can help you track calories, keep up with your physical activity and maintain your motivation. Some patients may also qualify for medications or bariatric surgery to help with weight loss. Even though surgery sounds scary, it can lead to significant weight loss and, more importantly, many health benefits. Most importantly, ask your doctor for help!
Take-Home Points:
-- Obesity is very common in our society. You are not alone.
-- Obesity can lead to many health problems, which can impair your quality of life and make you more likely to die at a younger age.
-- Obesity increases your chances of heart failure, a condition that can be life-threatening, even if you don't have other risk factors for heart disease.
-- Any sustained weight loss is helpful!
-- There are many resources available to help you. Ask your doctor!
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Dr. Roberta Florido is a postdoctoral clinical and research fellow in cardiology at the Johns Hopkins University School of Medicine. Her research interests are in preventive cardiology, with a special focus on the impact of physical activity and obesity on heart disease.
Dr. Chiadi Ndumele is the Robert E. Meyerhoff Assistant Professor of Medicine at Johns Hopkins University School of Medicine, and a faculty member within the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. His research is supported by the National Institutes of Health and the Robert Wood Johnson Foundation and is focused on the relationship between obesity and cardiovascular disease.
