Severe excess weight and the conditions linked to it, such as heart and circulation problems, diabetes and some cancers, can shorten life expectancy. The OECD has described the health and economic effects of obesity several times in its reports. According to these, it is above all the number of people with severe obesity that has risen in recent years.
What is severe obesity?
Severe (morbid) obesity is a level of excess weight that can shorten life expectancy through serious related conditions. People affected often find it hard to lose weight for good, despite diet, exercise and psychological support. Possible health effects include type 2 diabetes, heart disease, stroke, sleep apnoea and some cancers.
Obesity and type 2 diabetes
Too much fat stored in the body upsets the balance of hormones, and the cells respond less well to insulin. This insulin resistance can lead to type 2 diabetes. According to the WHO, a large share of type 2 diabetes cases in Europe are caused by obesity. The main cause of insulin resistance is stored fat, especially around the waist. The risk of diabetes rises when the waist measures about 80 to 90 cm in women and about 100 cm in men.
Obesity and heart disease
Obesity can change the structure and function of the heart. The main obesity-related heart and circulation conditions include:
- coronary heart disease,
- peripheral arterial disease (narrowed arteries in the legs),
- venous insufficiency (weak veins),
- high blood pressure,
- heart failure,
- obesity-related heart muscle disease (cardiomyopathy),
- heart rhythm problems.
The amount of fat around the waist is usually directly linked to the amount of fat stored in internal organs such as the heart and liver. This encourages atherosclerosis (hardening of the arteries). Research shows that fat cells in the abdomen are different from fat cells elsewhere in the body and can damage the inner walls of blood vessels.
Studies suggest that repeatedly losing and regaining weight (yo-yo dieting) is also linked to a higher risk of heart disease, even in people of normal weight.
Obesity and stroke
Obesity is a major risk factor for stroke in both women and men. Excess fat tissue causes inflammation in the body, which can raise the risk of stroke: blood flow in the vessels is hindered and the risk of blood clots rises. There is a clear link between more fat tissue and the risk of stroke.
In an ischaemic stroke, a blood clot in a vessel in the brain reduces or cuts off the blood supply to the brain. About 85% of all strokes are of this type.
Obesity and sleep apnoea
With obesity, the uvula and palate can become slack or enlarged, the airways can narrow, and breathlessness can occur. As a result, breathing can stop for short periods during sleep: this is called sleep apnoea. Obesity is both a cause and a result of sleep apnoea. If you do not reach deep sleep, your body releases less growth hormone, your metabolism slows down and your body stores more fat. This creates a vicious circle: lack of sleep increases appetite, and the hormones that control eating can get out of balance.
Obesity and some cancers
As fat tissue around the waist and hips increases, so does the risk of cancer. Research shows a link between obesity and cancers of the breast, bowel, oesophagus, stomach, kidney and gallbladder. In women, the risk of breast cancer is raised especially after the menopause; this is put down to higher oestrogen levels. In women who are overweight or have obesity, breast cancer is also often found at a later stage, because the breast tissue is denser and larger.
What you can do
- Change your eating habits: professional support helps here. A dietitian can work out what your body needs and support you on the way to a healthier weight.
- Keep moving: a first goal can be to lose about 10% of your body weight. Be active regularly for at least 30 to 45 minutes every day.
- Use medical support: some people with obesity can lose weight with the help of medicines. But medicines do not work on their own: they must be combined with diet and exercise.
- Look at surgical options: if you do not lose weight despite changing your diet, exercise and medicines, obesity surgery may be an option. Read more about bariatric surgery.
