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Carrying excess weight means increasing the risk of health problems, either as a direct result of being heavier or from the likelihood of developing diseases in later life. Being aware of this is the first step to feeling more in control of your weight and your health.

must know

Stop smoking

Smoking is a bigger hazard to health than being overweight, yet some people - especially women - smoke to help keep their weight down. Giving up smoking does not mean you will automatically put on weight but weight gains of 1.8–3.2 kg (4–7 lb) are common; this seems to be because food tastes better and people snack more rather than any physiological reason. Trying to stop smoking and lose weight at the same time is a big job. Tackle smoking first, aiming to minimize any weight gain by eating healthily and being as active as possible – and then make your weight a priority.

Awareness, not worry

Good health would be top of most people’s list of ingredients for a happy life, and in an ideal world, we would choose to avoid illness and disability if we possibly could. In the real world, of course, we have to play with the cards that life deals us, and many of the factors that determine our long-term health are beyond our control.

However, that does not mean that we should not try to change the odds in our favour whenever we can do so. The overwhelming evidence, from scientific research that has been carried out around the world, is that managing our weight is one of the optimum ways to give ourselves the best possible chance of living a long, healthy and active life.

Consumer studies suggest, however, that improving their health is not always the main reason why people start a diet or fitness regime. About half of slimmers, especially younger ones, say that they want to lose weight in order to look better in clothes, or for a special occasion such as a forthcoming holiday or wedding. And that’s absolutely fine!

It is fantastic to know that you look your best, and to be able to wear whatever you want and to enjoy looking at your holiday photos instead of dreading them.

All too often, for health to become the main motivator to embark on a slimming regime it takes a crisis: perhaps your doctor warns that your blood pressure is too high, or recommends you lose weight before trying for a baby, or you find that you are increasingly breathless and uncomfortable.

But health can be a positive motivator as well as a cause of fear and worry. Skim through this section, and you will see that while some of the health implications of being overweight are serious, it does not take a massive weight loss to reduce your risk of developing problems, or to improve symptoms that might be bothering you already. If you only have a little weight to lose, knowing that you are benefitting your health by reaching and maintaining your target weight can be a deep source of satisfaction – in addition to the joys of shopping for smaller clothes.

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Weight gain is easy

It takes about 3,500 surplus calories to put on 0.45 kg (1 lb) of fat, which sounds like a lot until you consider that eating just 80 calories more than you need each day (that’s only one chocolate digestive) could lead to a weight gain of 3.6 kg (8 lb) in a year!

Facts of life

Can you be overweight and healthy? The answer is yes – and no. Of course your overall health depends on many risk factors, such as your family history, whether you smoke or drink heavily, your fitness level, where you carry your weight and so on. If being overweight is your only risk factor, then you have more chance of remaining in good health than someone who ticks a lot of ‘risk’ boxes. And there will always be overweight people who reach a hale and hearty old age without losing a pound.

Unfortunately, however, statistics show that if you are overweight you are unlikely to be one of those people – they are the exception that proves the rule. Here are five disturbing facts, which come from UK National Health Service-endorsed studies:

If your BMI is 24 or more, your risk of dying within a 26-year period increases by one per cent for every pound put on between the ages of 30 and 42, and by two per cent for every pound gained between the ages of 50 and 62.

Deaths linked to obesity, of which there are about 30,000 a year, shorten the life of the deceased by nine years on average.

Your risk of coronary heart disease doubles at a BMI of over 25, and nearly quadruples at a BMI of 29 or more.

The risk of developing type 2 diabetes is 40 times greater at a BMI of 35 or more.

III health linked to obesity is responsible for 18 million days off work a year and costs the NHS at least £500 million a year in treatment.

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Being underweight

Being underweight (BMI of 18.5 or less) is a health hazard, and can lead to loss of fertility in women, lower resistance to infection, osteoporosis and a lack of vital vitamins and minerals. Extreme loss of weight can also indicate eating disorders, such as bulimia or anorexia nervosa, which require careful and specialized treatment.

Why weight is to blame

It is easy to imagine why being overweight can cause certain health problems – breathlessness or pain in weight-bearing joints such as the knees and lower spine. Some medical conditions, however, have a more complex relationship with weight. As we saw earlier, a BMI of between 18.5 and 24.9 is thought to be within the desirable ‘healthy’ range, so, in theory, any weight gain that takes your BMI above 25 is potentially a risk to your health. It is generally accepted though that the risk of serious conditions, such as diabetes and heart disease, rises significantly at a BMI of around 27 or above.

So why worry if you are only a few pounds overweight? The trouble is that extra pounds can have a habit of creeping up on us unawares. So if your BMI hovers around the 25 level, it makes sense to keep your weight stable or to lose a few pounds. And, of course, if your BMI is unhealthily high, slimming will quickly bring big benefits.

Weight-related health problems

Below is some background information to the most common weight-related health problems that may develop.

Coronary heart disease

One of the key aspects of heart health is the ability of the heart and its surrounding arteries to circulate blood strongly and freely round the body. Being overweight can damage heart health in a number of ways, mainly by raising the level of unhealthy fats, such as low-density lipoprotein (LDL) cholesterol and triglycerides, in the blood. A build-up of these fats over time can narrow or clog the arteries, a condition known as atherosclerosis, and this in turn can lead to chronic diseases such as angina, or acute conditions such as a heart attack.

Make the most of seasonal food like berries to give your health a boost.

Change the odds on good health in your favour by eating well.

High blood pressure, which is three times more common among overweight people than slim people, is also a big risk factor. And even where there are no problems with blood fats or blood pressure, just carrying excess weight, especially around the middle, seems to increase the likelihood of developing heart disease.

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Body fat

This is not always the bad guy! We need a certain amount of body fat to protect and insulate our organs; it also has a role in producing certain beneficial hormones, and protects against loss of bone mass (osteoporosis).

Type 2 diabetes

This condition affects 1.4 million people in the UK and possibly a further million who have not had their condition diagnosed, according to the charity Diabetes UK. Type 2 diabetes is sometimes called ‘late onset’ because, unlike type 1, it tends to develop in adult life, and being overweight is a big risk factor: over 80 per cent of adults with type 2 diabetes have a BMI of more than 25 when they are diagnosed. Children and teenagers are also being diagnosed more frequently as obesity rises.

Type 2 diabetes is caused when the insulin that the pancreas produces in the body fails to control blood sugar properly (insulin resistance) or when the pancreas fails to produce enough insulin for the body’s needs. Research shows that excess weight, especially around the waistline, increases insulin resistance so the pancreas has to work harder to get the same effect. Having too much sugar in the blood causes symptoms such as excessive thirst, blurred vision, fatigue and passing urine frequently. Having too much insulin in the blood causes other problems, such as increasing blood pressure and raising the level of various fats in the blood. This puts people with type 2 diabetes at high risk of heart disease and stroke; untreated diabetes can also cause serious damage to the eyes, kidneys, nerves and circulation.

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‘Syndrome X’

Also known as metabolic syndrome, this term refers to a collection of symptoms that include evidence of insulin resistance, fat carried around the middle (‘apple’ shape), high blood pressure and raised levels of unhealthy fats (LDL cholesterol and triglycerides) in the blood. Together, they represent an increased risk of heart disease, diabetes or stroke. Some diets claim to have specific benefits for people with Syndrome X, but any healthy eating and exercise programme, leading to a five or 10 per cent initial weight loss, should reduce all these symptoms without any special diets being needed.

Cancers

Cancer Research UK states that after smoking, obesity is the second biggest preventable cause of cancers. The links between being overweight and cancer are complex and not all of them are fully understood.However, it seems that obesity can unbalance the function of certain hormones, which could increase the risk of hormonally-sensitive cancers in women, such as cancer of the uterus, ovaries, cervix and endometrium (uterus lining). Excess abdominal fat (the ‘apple’ shape) has also been linked to a higher risk of breast cancer in women after the menopause. Cancers of the digestive system, such as colon or rectal cancer, may have more of a link to a high-fat, low-fibre diet, which is likely to lead to weight gain.

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Weight reduction benefits

Here is an overview of the average benefits of a 10 per cent (10 kg or 22 lb) reduction in weight of a man with a starting weight of 100 kg (220 lb) or just under 16 stone.

The risk of premature death is reduced by 25 per cent.

Systolic blood pressure is down by 10 points, and dystolic blood pressure down by 20 points.

The level of LDL cholesterol is down by 15 per cent.

The risk of dying from diabetes complications is down by 30–40 per cent.

The risk of dying from obesity-related cancer is reduced by 40–50 percent.

High blood pressure

Blood pressure is measured by taking two readings: the systolic pressure (the first, higher figure, taken when the heart contracts) and the dystolic pressure (the second, lower pressure, taken when the heart is relaxed). A normal level is 120/80, and a reading that is consistently over 140/90 is unhealthily high. Many people with high blood pressure have no symptoms, but that does not necessarily mean that there is no problem: untreated high blood pressure can cause a stroke, heart disease or damage to other organs in the body.

Being overweight is not the only cause of high blood pressure: eating too much salt, drinking too much alcohol and being inactive can also contribute. The good news is that as well as losing weight, changing your diet and lifestyle is a quick and effective way to reduce your blood pressure.

Gall bladder disease

One large study found that overweight women were 33 per cent more likely to develop gallstones than a similar group of healthy-weight women. Gallstones are a painful side-effect of the build-up of fats in the blood, as they are caused by clumps of cholesterol in the gall bladder, which plays a part in digestion. Cancer of the gall bladder is a rarer complication.

You lose, you win!

As we said at the beginning of this chapter, knowing the facts about the serious health consequences of being overweight is not all bad news. The flipside of the problems of gaining weight is that losing weight can bring quick and significant health benefits. A reassuring body of research has concluded that if you are seriously overweight (BMI of 30 or more), then losing just 10 per cent of your body weight can improve your health and even add years to your life.

Other health benefits

As well as the established evidence of improvements to these life-threatening aspects of obesity, successful slimmers often report that losing weight benefits their health and well being in many other ways, too. These can include improving the symptoms of asthma; less heavy or painful periods; reducing backache, arthritis pain and gout; improving digestive conditions such as irritable bowel syndrome; getting a better night’s sleep (being seriously overweight can lead to a distressing and dangerous condition called obstructive sleep apnoea); and a general lifting of mood.

Add to all these benefits the overall feel-good factor that comes from having more energy, feeling fitter and healthier, and experiencing the confidence that comes from knowing that you are looking good. It is hardly surprising that people who have lost weight successfully nearly always say: ‘I just wish I’d done it sooner.’

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Take it to the next level. . .

Cutting down on salt

Diabetes and the Glycaemic Index

Slimming clubs

Energy and fitness

Maintaining a healthy weight

Other sources

Consult your doctor if you have any symptoms of diabetes.

Check your blood pressure; many people don’t know that theirs is too high.

If you are very overweight, see your GP or practice nurse about slimming strategies. Some offer free or low-cost referral to local slimming clubs or leisure centres, for extra support.

For help on quitting smoking, call the NHS Smoking Helpline on 0800 169 0 169. www.quit.org.uk

For advice on eating disorders, contact the Eating Disorders Association helpline: 0845 634 1414. www.edauk.com