Obesity
Symptoms
Diagnosis
Management
Prevention
What to Expect
Living Well
Obesity affects more than 40% of U.S. adults, yet most people misunderstand it. It’s not caused by personal choices alone — it’s a long-term medical condition shaped by many factors like genetics, metabolism, stress, sleep, environment, and certain medications.
Carrying excess weight increases the risk of heart disease, stroke, diabetes, and certain cancers. But it also affects mental health, energy levels, and quality of life. Losing just 5–10% of your body weight can meaningfully improve blood pressure, cholesterol, blood sugar, and inflammation.
Obesity management works best when it focuses on steady, sustainable changes that support your overall health. It’s about understanding your body, building supportive habits, and creating a lasting relationship with food and movement.
Obesity is a long-term medical condition where the body stores more fat than it needs. The condition develops when the systems that regulate appetite, energy use, and metabolism become unbalanced. This imbalance often happens because of a mix of genetics, hormones, stress, sleep, and environmental factors.
Excess fat tissue, especially visceral fat around the abdomen, triggers inflammation and hormonal changes that affect blood pressure, cholesterol, and insulin sensitivity. These shifts can lead to metabolic syndrome, a group of conditions like high blood pressure, high blood sugar, and unhealthy cholesterol levels that raise cardiovascular risk.
Addressing all parts of your health—physical, emotional, and environmental—supports lasting change.
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How Obesity Affects Vascular and Heart Health
Adipose tissue (body fat) doesn’t just store energy. It also helps regulate metabolism and hormones. In healthy amounts, fat helps regulate energy, protects organs, and produces substances that support normal blood vessel function.
When fat tissue becomes excessive, especially around the abdomen, it changes it's behavior. Instead of producing protective signals, it begins releasing inflammatory chemicals and hormones that strain the cardiovascular system. This shift affects how blood vessels relax, how your body handles cholesterol and blood sugar, and how your heart works under stress.
Key impacts on vascular health include:
High blood pressure: Extra fat tissue increases the workload on the heart and raises vascular resistance.
Atherosclerosis: LDL (“bad”) cholesterol and triglycerides increase while HDL (“good”) cholesterol decreases.
Blood clot risk: Inflammation and slower circulation increase the chance of deep vein thrombosis (DVT).
Insulin resistance: Higher blood sugar levels over time raise the risk of type 2 diabetes.
Even modest weight reduction can improve circulation, lower inflammation, and help your heart function more efficiently.
Causes and Contributing Factors
Obesity develops from a mix of factors, not a single cause.
Biological Factors
Your genes influence how your body stores fat, how hungry you feel, and how easily you burn energy. Many people inherit a tendency toward weight gain because hundreds of genes affect appetite, metabolism, and how the brain regulates eating. Some health conditions that affect hormones or metabolism can also contribute to weight gain, including conditions that slow thyroid activity or disrupt the body’s normal hormonal signals.
Lifestyle & Behavior
Daily routines can influence how your body manages weight. Long hours of sitting, limited physical activity, high-calorie foods, unpredictable schedules, stress, and poor sleep all disrupt hunger hormones and increase cravings. Screens, late nights, and irregular eating patterns also shift the body toward storing more energy than it uses.
Environmental & Social Factors
Limited access to affordable, healthy foods, safe places to be active, or regular healthcare can make weight management difficult. Ultra-processed foods are widely available and heavily marketed. Work demands, financial stress, and family responsibilities add further strain.
Additional Contributors
Some medications—like antidepressants, steroids, or certain diabetes drugs—can cause weight gain. Chronic stress, trauma, and childhood experiences also shape eating patterns and metabolism. Emerging research shows that gut bacteria, hormonal changes, and even exposure to certain environmental chemicals may play a role.
Understanding Your Health Beyond the Scale
Body weight alone doesn't show the complete picture of your health. Many factors affect how well your heart, blood vessels, and metabolism are working. These factors give a clearer view of your overall health than weight alone.
Body Mass Index (BMI)
Body mass index (BMI) estimates body fat using height and weight. Clinicians use it as a screening tool to help identify whether someone may have weight-related health risks.
BMI has limits. It doesn't distinguish between muscle and fat, so someone with high muscle mass may be labeled "overweight." In contrast, someone with a normal BMI may still have unhealthy levels of body fat.
Waist Size
Waist circumference provides valuable information about abdominal fat, because it's more strongly linked to cardiovascular disease than total body weight. A waist size above 40 inches in men or 35 inches in women is linked with a higher risk for heart disease, diabetes, and metabolic conditions.
Body Composition
Body composition describes how much of your body is fat compared to muscle and bone. This matters because two people with the same weight can have very different health risks depending on their body fat levels. Some medical tests can measure this more accurately than BMI.
Weight-Related Health Conditions
Some health issues become more likely as body fat increases. These include high blood pressure, abnormal cholesterol, insulin resistance or diabetes, sleep apnea, joint pain, and fatty liver disease. These conditions provide more specific information about health risk than weight alone.
Daily Functioning and Well-Being
How you feel day to day matters. Your energy levels, ability to move comfortably, sleep quality, and emotional well-being all give important clues about your health.
Treatment Options
Obesity is a chronic medical condition. Treatment can involve one or more options based on your needs and goals.
Lifestyle Changes
Small, realistic adjustments make the most significant difference over time. Examples include:
Adding short walks throughout the day
Preparing simple meals with balanced portions
Creating a regular sleep routine
Finding physical activities that feel comfortable and sustainable
Medical Nutrition Therapy
Registered dietitians can help you create a personalized eating plan that fits your health needs, preferences, and daily life. This approach focuses on nourishing foods, steady energy, and long-term habits rather than restriction.
Medications
Several FDA-approved medications can help regulate appetite, improve insulin sensitivity, or support metabolic health. Options like Ozempic® (semaglutide), Wegovy® (semaglutide), Mounjaro® (tirzepatide), Zepbound® (tirzepatide), or Contrave® (bupropion/naltrexone) work best when paired with lifestyle changes. A clinician can help determine whether medication is appropriate and monitor how well it’s working.
Bariatric and Endoscopic Procedures
For people with severe obesity or obesity-related health complications, procedures such as the gastric sleeve, the gastric bypass, or newer endoscopic approaches may be options. These treatments can improve metabolic health, reduce hunger hormones, and support significant weight loss under medical supervision.
How Mental Health and Stress Affect Weight
Mental and emotional health play a major part in weight and metabolism. Stress, depression, anxiety, trauma, and emotional eating patterns can all affect how your body regulates hunger, stores energy, and responds to food.
When you’re under stress, your body releases cortisol—a hormone that increases appetite and encourages fat storage, especially around the abdomen. Stress can also affect sleep and motivation, making it harder to maintain routines that support your health.
Addressing the emotional side of weight is just as important as nutrition and movement. Therapy, mindfulness practices, and support groups can help you understand patterns like emotional eating, chronic stress, or negative self-talk. Approaches like cognitive behavioral therapy, acceptance-based strategies, or intuitive eating can support long-term weight management.
Preventing and Managing Complications
Managing obesity can lower the risk of many serious health problems—and in some cases, improve or reverse them.
Complications linked to obesity include:
High blood pressure
Type 2 diabetes
Sleep apnea
Fatty liver disease
Heart failure
Certain cancers (including breast, colon, and pancreatic)
Ways to lower your risk:
Get regular checkups and lab work
Monitor blood pressure and blood sugar each year
Stay active most days of the week
Choose meals with more fiber and less sodium
Keep track of weight trends without focusing on perfection
Address concerns early, before symptoms progress
Small changes made consistently can protect your heart, improve energy, and reduce long-term complications.
Progress Over Perfection—Every Step Counts
If you’re ready to make a change, start with one small, sustainable step today — an extra walk, a balanced meal, a conversation with your provider.
You don’t have to do it alone. Support, education, and compassion make change possible.
References
Emmerich SD, Fryar CD, Stierman B, Ogden CL. Obesity and severe obesity prevalence in adults: United States, August 2021–August 2023. NCHS Data Brief. No. 508. September 2024.
National Institute of Diabetes and Digestive and Kidney Diseases. Understanding adult overweight & obesity. Accessed December 4, 2025.
Niculescu R, Stoian A, Arbănași EM, et al. The dual role of perivascular adipose tissue in vascular homeostasis and atherogenesis: from physiology to pathological implications. Int J Mol Sci. 2023;26(17):78320. doi:10.3390/ijms26178320
Lustig RH, Collier D, Kassotis C, et al. Obesity I: Overview and molecular and biochemical mechanisms. Biochem Pharmacol. 2022;199:115012. doi:10.1016/j.bcp.2022.115012
Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2021;143(21):e984-e1010. doi:10.1161/CIR.0000000000000973
World Health Organization. Obesity and overweight. WHO website. May 7, 2025. Accessed December 4, 2025.