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Can You Be Obese and Healthy? Here’s the Truth

The “body positivity” message is gaining popularity as we are urged to embrace our current size. It’s good to accept ourselves as is, of course, and it’s great news when our medical numbers — blood pressure, blood sugar, cholesterol — are moderate. Still, excess fat surrounding your organs can affect your health even while you feel terrific.

Here’s how and why it’s worth shedding that extra bulk.

It’s Not About the Calories

You can be healthy in a larger body with a high BMI, but that will likely change over time. And there’s no simple way out.

Obesity is a chronic disease. It is not a choice. Only a small percentage of people with obesity who diet and exercise to lose weight are successful.

Obesity is caused by multiple factors, including:

  • The food and exercise choices you make
  • Genetics
  • Environment
  • Injury
  • Trauma
  • Social economics
  • Living in a food desert

Your body might be able to handle excess weight well for quite some time. Still, visceral fat is affecting you quietly. Visceral fat is what you can’t see in a mirror or feel by poking your belly: It’s literal fat that surrounds the organs in your midsection. This unwanted interior substance can eventually cause dysfunction in all of your systems.

Visceral fat is why 13 cancers are directly tied to obesity. It’s also why excess weight can lead to developing heart disease, diabetes, sleep apnea, and male and female infertility.

Tried-and-True Ways To Lose Weight

If you’re severely overweight, diet with exercise is unlikely to work as a route to thinning down. Once your internal regulator kicks in at a heavier weight, your brain will think your higher weight is your healthy weight. It will slow down your metabolism to keep you at that higher weight. It won’t let you easily burn fat because it will think it’s protecting you from starvation.

Once you’re at the point where standard actions aren’t allowing you to lose enough weight, you’ll likely need a medically based option. You have choices.

  • Bariatric surgery — Weight-loss surgery has the longest and strongest history of helping people take off large amounts of weight and keeping it off. You and your surgeon can choose from several types of bariatric procedures such as gastric bypass depending on your body and needs.
  • New medications — Fairly new pharmaceuticals on the market can curb your feeling of hunger or help you shed pounds in other ways. The FDA recently approved semaglutide for those at risk of heart issues in addition to people with diabetes, and it is often used to combat obesity. Many of these drugs must be taken for life, such as insulin for diabetes or other medications for high blood pressure; they might not be covered by insurance. Some might also help curb alcoholism.
  • A combo — In certain situations, doctors will recommend having bariatric surgery and later taking a weight-loss medication.

It’s Not All About the Scale

It’s crucial to realize that losing a large amount of weight alone is not enough to make you healthy. You will do a gross injustice to yourself if you have the surgery, or take a drug, without having nutritional, psychological and sports medicine professionals to help. Be sure to choose a medical practice that offers a full-team approach.

When you lose weight rapidly, you can lose muscle via not using it and/or not feeding it properly. To avoid that, you must do muscle-building exercises. In addition, it’s best to learn which types of foods you need and in what proportions, such as protein and carbohydrates. Food is fuel, not the enemy. Periodically, your care team can assess whether you’re losing fat but gaining muscle, which is good for your body composition.

With the right advisors, you’ll relearn eating habits and be educated about how to combat food addictions and incorporate coping mechanisms.

Finally, it’s important to figure out which exercises are best for you. Your body composition is not just about weight. It’s about muscle mass, body fat percentage, total body water and resting energy expenditure. The right athletic advisor can help you find the right exercises. The experts will be respectful of what you’re willing to do in public and will also consider your mobility concerns, what hurts and what indeed adds muscle while reducing fat. Think of it as an exercise prescription.

It’s all worth the effort. Once you attain a healthy weight the right way and maintain it with an appropriate diet and exercise routine customized for you, you’ll be at less risk for all those diseases and cancers. You’ll also be able to enjoy little wins in life: Strolling through the park with your family without concern about where rest areas are, flying in an airplane without requesting a belt extender and, by example, promoting healthier eating and activity habits to your loved ones.

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