Assumimg that being overweight is due to fat, not muscle.
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Simple answer for me at least. Being overweight can cause insulin resistance. And that’s still with healthy bloodwork. I’ve been body building on and off for 15 years and the constant calories to get huge and diet it off messed with my body.
I became type 2 diabetic a few years ago. I went to 3 specialists, and they all said the same thing. They all said *When you walked in I assumed you were diabetic from your size, but when I’m looking at your bloodwork, I’m not sure how*. I was above average on the good stuff and below average on the bad stuff. Doctors told me my bloodwork was fantastic, but I was still diabetic.
Being overweight isn’t itself the issue, it’s all the other things that being overweight predisposes you to. It’s like speeding on the highway. Speeding itself won’t hurt anything, but it makes any accidents that do occur worse, which is why you shouldn’t speed.
I have very good blood tests. I am also extremely overweight, 300+. I am NOT HEALTHY. I honestly don’t feel my weight very much, but I’m also relatively young. I know what this weight is doing to my bones, joints, organs, etc. long term.
I’m doing my best to get this weight off, but it’s a struggle especially when my blood tests are great.
Long before those metrics go out of whack, there are metabolic changes leading in that direction. First insulin resistance in muscles. Then liver. These metabolic changes cause all sorts of fuckery in the body. Once those metrics are out of whack, you really have problems.
Just from an orthopedic standpoint:
For every 10lbs you tack on, you increase knee joint compressive forces by 30-60lbs. If you’re adding muscle, assuming you’re not skipping leg day, the muscle gained can mitigate this by strengthening and protecting the joint…to an extent.
Fat though? It only hurts you.
This is why you see guys who are chronically overweight and obese with absolutely destroyed knees and backs, despite not doing anything physically strenuous their entire lives. By 40-45, sometimes earlier, they’re permanently fucked up.
As for your example with obese but with good labs…that doesn’t last long. For many, by the time they hit 30, the labs are already going to shit. They’ll have full blown T2DM with CVD and all the trimmings soon enough.
Joints, for one. I’m technically slightly overweight, but I’m not obese. Healthy otherwise. When I add just the extra load of carrying my 15 pound baby, my knees and hips immediately hurt.
You’ve had some excellent answers here. I just want to add my bit as a wound nurse. I have had some overweight people heal magnificently well. Some don’t. But what you *are* at high risk for is complications of almost every kind.
Need to have surgery? Your heart and lungs will have to work extra hard to get you through it. Your incision will have a lot of extra stress on it because of the weight. It might just bust open because of it. Worse, you’ll have a lot of adipose tissue beneath the incision. Adipose tissue doesn’t get the same amount of blood supply as do deeper tissues, so it’s more likely to die off. Dead tissue beneath an incision or in a wound makes you more prone to infection. After surgery, you are more likely to develop pneumonia or other respiratory complications because you can’t breathe as healthily as your skinnier comrades.
Your vascular system is probably a complete mess. You’re more likely to have issues with venous stasis, which means blood goes down into your legs and has a hard time getting back to your trunk. So while it’s struggling to return, your legs swell. The extra fluid makes you more likely to develop wounds (plural) that are painful and constantly weep. The only real treatment is compression therapy, which is often uncomfortable, hot, or just a pain in the butt (leg wraps from toes to knees, sometimes changed every single day because they get saturated within hours, and they smell too). But sometimes even compression therapy isn’t enough and you have wounds for the rest of your life. Forever.
You will probably have yeast in your abdominal and breast (yes, men too) folds and groin area. It noticeably smells. If the moisture is really bad, since your skin can’t air out and constantly rubs against the other side of the fold, you can develop wounds here too. Sometimes they also necrose (the tissue dies off) or get infected.
Honestly, I could go on. We should never shame people for being overweight, but the fact of the matter is that your body will absolutely struggle more than it otherwise would, and you are at increased risk for any number of things, some of them life-threatening. If your blood tests and blood pressure are “healthy” now, it’s because your body can still compensate. It won’t do that forever.
Most of the comments here refer to additional physical mass and the problems that arise from it. While additional mass will bring problems and lead to greater wear and tear of weight bearing joints it doesn’t greatly effect the working of organs. Human boday has great capacity and we see athletes with a lot of body mass that are otherwise healthy.
The problem with fat is multifactorial but the most important is the hormones it produces (this is an area of active research). These hormones have multiple detrimental effects on the over all health. Additionally, an obese person is most likely to have a sesentary life style and bad eating habits that lead to accumulation of fats in arteries and thus leading to heart disease and stroke. I would like to point out that a person with normal body weight with bad eating habits is equally at riak for this.
Lastly, we are still finding underlying mechanisms for the detrimental effects of obesity. Statistics show it is bad but we really don’t know all the mechanisms it leads to increased morbidity.
Worked with a woman, fluctuated between 375 and 415 pounds constantly, said she was healthy. These things I knew about her: she had a vein, not artery, spontaneously open up from her leg while sitting watching TV – the flow from the vein squirted 7 feet hitting her TV (she came into the ER where we both worked) when they unbandaged the wound it squirted across the room ( nurses were sure she was exaggerating), she had terrible bone spurs in both her feet from her weight apparently, and she got married and was really upset she couldn’t conceive: she told me later she had not had a period in a few years, this due to her obesity. But she swore up and down she was perfectly healthy. I never understood the denials. Last real story: she met her husband at an after hour class they were taking, she sat on a bench and it raised up and he slid down the bench into her: he was tall and very skinny and they were a real cute couple honestly.
Quick perspective from a doctor:
Blood tests and vital signs do not tell everything.
Sure we use parameters such as vital signs, blood cholesterol and fasting glucose levels for screening of certain certain diseases, but there are a whole host of conditions that obesity predisposes to that we would miss on routine tests.
Some examples:
– There is no blood test for obstructive sleep apnea. You need to do a sleep study.
– Coronary artery disease is ideally screened with an angiogram/stress test. Your normal cholesterol level will not rule this out.
– Increased cancer risk. Many different ways to screen for cancer but none/few that are done on routine checks in the younger population.
We already know obesity is associated with an increased mortality – anyone overweight (or under) should aim to bring their BW into normal BMI range even if their doctor tells them that everything is okay – because we will always miss things.
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