What Does Obesity Mean for Your Health—Heart, Thyroid, Diabetes?

With Luke Laffin, MD, and Matthew J. Budoff, MD

Most adults admit to having concerns about weight yet fail to make a much-needed connection between excess weight and increased risks of developing the major chronic diseases: Heart disease and related conditions, thyroid disorders, and type 2 diabetes,1 according to findings from the Cleveland Clinic Heart Health Survey.  

"The most surprising finding to me was that only 22% of those surveyed said they talked to their physician about the cardiovascular consequences of carrying too much weight," says Luke Laffin, MD, preventive cardiologist at the Cleveland Clinic Foundation, who participated in the survey. That is shocking, he says, because there is such a close connection.

Overweight couple eats fast food, raising their risk of diabetes and heart disease.Consider making 3 changes: drink seltzer, swap the burger for grilled chicken w/salad, and have fresh fruit instead of chips to reduce your risks of heart disease, diabetes, obesity, Photo: 123rf

"The impact of weight is more than a number on the scale or about fitting into that outfit for the next big event," Dr. Laffin says. Carrying excess weight worsens glucose tolerance and also increases the risk of developing certain cancers.  And individuals with hypothyroidism, especially before this condition is diagnosed, tend to experience unintended weight gain, he says, making them vulnerable to these other troublesome health problems.1

Survey Reflects Attitudes about Obesity and Overall Health

Nearly three-quarters of the individuals surveyed said they were concerned about their weight and nearly the same percent mentioned being concerned about developing heart disease due to excessive body mass index (BMI).1 Dr. Laffin and his team found that the vast majority, 88% of those surveyed, recognized a connection between heart health and maintaining a healthy weight; and three in four people agreed that improving their heart health is a major reason to try to lose weight.

There is some positive news in that more than half of the respondents acknowledged a link between being overweight and having high blood pressure as well as developing type 2 diabetes (T2D). However, several equally important connections were missed.

Many adults are unaware of the very strong connection with high cholesterol, particularly low-density lipoprotein cholesterol (LDL), heart disease, and an even higher risk of heart failure and obesity.1

Also, the vast majority of adults have little to no idea about the role of triglycerides and how this type of cholesterol is related to heart disease. Then comes the real disconnect—While almost half of those surveyed said they are overweight or obese, most attribute the weight gain to their slow metabolism, ''working against them'' despite their efforts to trying to lose weight.1 Women were more likely to blame their metabolism than men.

The survey did not delve into thyroid disease specifically, but Dr. Laffin says, low thyroid function, or hypothyroidism, can lead to weight gain in some people, which can raise their risk of heart disease just as it does with T2D.

Simple Fix—Losing Just 10-15 Pounds Can Reduce Disease Risks 

While many of those surveyed are aware that their excess weight could lead to multiple health risks, less than half of them report having made any dietary changes in an effort to shed the extra pounds. Just two in five responders admitted they aren't careful about what they eat, even though they should lose weight. Only 13% of the individuals acknowledge having joined a weight loss program to help reduce their disease risks.1

Many people don’t seem to realize that it doesn’t require having to lose all the excess weight to reduce chronic disease risks, such as developing diabetes or reducing their high cholesterol. Even a loss of just 5-10 % of your current weight is enough to results in health benefits, he says. Only one in six surveyed said they knew losing 5% of their starting weight can help their health.

The main barriers to failing to lose weight, the report says, are a dislike of exercise and lack of time. Those who started a weight loss plan only stuck with it, on average, less than 8 weeks. And 13% admitted they typically quit weight loss efforts after less than a week.

Another shocker: Only about one of four surveyed told their doctor they want to lose weight; only a fifth discussed heart health in relation to their weight with their doctors.1

Survey Details

In conducting the survey, which was done online in September 2018, the researchers gathered insights about these health issues from 1,002 adults, ages 18 years and old; they were equally split between women and men (504 and 498 respectively). The survey sample is nationally representative for age, sex, ethnicity, and level of education based on current Census data.1

The researchers also broke down the data by generations:

  • Gen Z (18-21 years old): 81
  • Millennials: 322
  • Gen X: 266
  • Baby boomers: 302
  • Silent Generation (Over 72 years): 31

Time to Evaluate How Your Weight May Be Impacting Your Health 

The survey findings mirror the observations seen in clinical practice, says Matthew Budoff, MD, FACC, FAHA, professor of medicine at the University of California-Los Angeles and the Endowed Chair of Preventive Cardiology at the Los Angeles Biomedical Research Institute who reviewed the findings for EndocrineWeb.

"This is entirely consistent with most people who have T2D. They simply have no knowledge that there is a strong relationship between what they eat and their diabetes or their heart health, or that the longer they have diabetes, the greater their risks for cardiovascular disease," says Dr. Budoff

More information needs to be disseminated, he says. "There has been too little education about the risks associated with overweight and obesity compared to things like smoking."  

If some of these survey answers are shockingly similar to the responses you might give, the experts offer some tips on what you can do now:

  • Commit to Eating Better for the Long-Term.  "Start thinking about dietary patterns that are sustainable for the long term," Dr. Laffin says. Many people jump at the diet plan of the day or a weight loss plan embraced by celebrities. Instead, he says, think about settling on some new eating habits that you’ll be able to stick with for 30, 40, or more years.
  • A Little Goes a Long Way. He suggests that when you are ready to lose weight, take the slow and steady approach, with reasonable expectations. “Aim to lose 5 to 10% of your weight over six to 12 months," he says. Think about how long it took to gain the weight, then realize that by taking it off gradually, you’re more likely to keep the lost weight off.
  • Let the Scale Guide You. Don't keep that scale hidden under the bed. "What I tell my patients is, the scale shouldn't be your enemy, it should be your friend."  When you begin a weight loss regimen, weigh-in at least once a week, a couple times a week, even daily, he says. It will help you track your progress and stay on course, he says.

Knowing your numbers—body weight (ie, from the scale, waist circumference, and BMI). Blood cholesterol (LDL, HDL, TGs), blood pressure, and blood glucose—and your disease risks can provide motivation as you lose the weight, Dr. Budoff says.  

"We have demonstrated that by showing patients their disease risk—such as a coronary artery calcium score—helps our patients with weight loss, encouraging them to keep at their efforts to lose weight, by knowing that they are having a positive effect on their heart disease."2 The coronary artery calcium score provides a measure of the amount of plaque build-up, which causes a narrowing in the key arteries going to your heart; it is used to determine how advanced your heart disease is, and what your risk of 

None of these doctors have any relevant disclosures.

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