Looking at weight loss beyond the scales

Weight is a sensitive topic for many people, and getting to that optimal weight is much easier said than done. However, once you get onto the weight loss journey that suits your lifestyle and start seeing results, there’s way more to the benefits than meets the eye, from reducing your risk of serious complications to finding more energy to do the activities you love. 

While jumping on the scales and watching the numbers go down is a sure way of keeping on top of your weight loss, there may be times when weight loss plateaus, but that doesn’t mean the benefits to your insides have also halted. Hence, monitoring your internal health using other biological metrics can keep you motivated and give you insight into how your body is improving. But to understand just how these mechanisms work, let’s first look at how excess body weight can negatively impact your health.

How excess body weight increases health risks

Excess body fat can increase health risks in several ways. Carrying extra weight puts additional strain on your body, especially your joints and lower limbs, which can lead to conditions like arthritis and sleep apnea. For instance, if you have knee osteoarthritis, each pound of extra weight adds four times the pressure on your knees with every step you take.

Additionally, fat tissue acts like an endocrine organ, producing harmful substances that lead to inflammation and blood clotting.¹ Fat from the abdomen releases fatty acids directly into the liver through the portal vein, leading to issues like abnormal cholesterol levels and insulin resistance, which are key features of metabolic syndrome.² These fatty acids can also reduce insulin sensitivity in muscles, and fat build-up in the liver and muscles, which can further contribute to health problems.²

The other harmful substances released by fat tissue are called adipokines, which include leptin, chemerin, resistin, and cytokines like TNFα and IL6, some of which can contribute to cardiovascular diseases.³ 

Obesity increases blood volume, which causes the heart to pump more blood to meet the needs of extra fat tissue.³ This causes the left ventricle of the heart to expand, raising blood pressure.³ The increased blood volume and pressure can enlarge the left atrium, raising the risk of heart failure and atrial fibrillation. Additional fat buildup in the heart can also lead to structural changes, increasing the risk of heart rhythm problems and heart failure.³

How weight loss improves health

Even a small amount of weight loss can greatly benefit your overall health. In one study, participants with obesity and insulin resistance were divided into groups aiming for 5%, 10%, and 15% weight loss. The results showed that losing just 5% of body weight led to a significant reduction in body fat, especially adipose fat tissue found around the abdomen and liver, which restores metabolic function and improves overall health.

Moreover, the study found that even modest weight loss can lower several risk factors for heart disease and diabetes. For instance, losing 5% of body weight improved blood sugar and insulin levels, and reduced triglycerides and certain liver enzymes. However, for more significant improvements, like reducing inflammation or improving cholesterol levels, greater weight loss was needed. 

Weight loss and HbA1c

If you're concerned about prediabetes, it's a good idea to take a blood test. The most common test for this is the HbA1c test, which measures your average blood sugar levels over the past two to three months. If your HbA1c level is between 42mmol/mol (6%) and 47mmol/mol (6.4%), it means your levels are higher than normal, putting you at risk of developing type 2 diabetes. 

Hearing that you have prediabetes can be worrying, but it's important to know that developing type 2 diabetes is not inevitable. Many people successfully reduce their risk and can even prevent or delay the onset of the condition by adopting various lifestyle changest.⁴ One study showed that every 1kg of weight loss equates to a reduction in HbA1c by 0.2mmol/mol, increasing up to 0.6mmol/mol in people with diabetes.⁴

Weight loss and cholesterol

Losing around 5-10% of weight can significantly lower your cholesterol and triglyceride levels, which in turn reduces your risk of certain cardiovascular diseases.⁵ High cholesterol doesn’t often present in symptoms, so it can be difficult to track how your new lifestyle is benefiting your heart. 

A simple blood test is used to measure cholesterol levels. Having your levels checked on a 6-monthly basis is a good way of keeping track of your heart health. If levels are still high despite weight loss, it may be due to the choice of foods you eat. Replacing foods full of salt and saturated fats with healthier alternatives is one sure way of reducing the strain on your heart and keeping your cholesterol levels at bay.

Weight loss and overall wellbeing

While reducing the risk of diseases is the overarching goal, it's equally important to improve how good you feel and function. Weight loss through lifestyle changes has been shown to enhance quality of life. In the Look AHEAD study, participants who changed their lifestyle to one that included healthier habits reported better quality of life after just one year compared to those in a support group.⁶ Fewer people in the lifestyle group developed significant depression symptoms, indicating that weight loss can protect against depression and other mental health conditions.⁷

The study also found that participants in the lifestyle intervention experienced less decline in mobility with age compared to those in the support group.⁸ For overweight and obese women and men with type 2 diabetes, urinary stress incontinence improved significantly with lifestyle changes, which when left unmanaged can hinder your quality of life.⁹ 

Moreover, both men and women in the lifestyle intervention group saw improvements in sexual function, with men experiencing better erectile function and women reporting less sexual dysfunction.^10,11

Weight loss and movement

As previously mentioned, losing weight can significantly reduce the amount of blood your heart needs to pump around your body. As you start to move more and find enjoyment in your activities, you'll notice your resting heart rate dropping, which means you'll have better endurance and it will take longer for you to be out of breath.

But weight loss helps more than just your stamina. Certain musculoskeletal conditions like osteoarthritis of the knee are common and often linked to obesity. Studies show that losing weight through diet and exercise can greatly improve knee pain, function, and overall quality of life. For example, losing just 5.7% of body weight can reduce the strain on your knees, making activities like walking and climbing stairs easier.¹² Greater weight loss, around 11%, can further reduce pain and inflammation. 

The numan take

Weight loss isn't just about the numbers on the scale; it's about improving your overall health, reducing disease risk, and promoting longevity. If diet and exercise alone haven't worked for you, consider health coaching. Our team is here to support you, helping you develop healthy habits and a positive relationship with food and exercise, so you can enjoy a healthier future.

References

1. Sikaris, K. A. (2004). The clinical biochemistry of obesity. The Clinical Biochemist Reviews, 25(3), 165.

2. Bays, H. (2014). Central obesity as a clinical marker of adiposopathy; increased visceral adiposity as a surrogate marker for global fat dysfunction. Current Opinion in Endocrinology, Diabetes, and Obesity, 21(5), 345–351. doi:10.1097/med.0000000000000093

3. Javed Ashraf, M., & Baweja, P. (2013). Obesity: The ‘huge’ problem in cardiovascular diseases. Missouri Medicine, 110(6), 499.

4. Morris, E., Jebb, S. A., Oke, J., Nickless, A., Ahern, A., Boyland, E., … Aveyard, P. (2021). Effect of weight loss on cardiometabolic risk: observational analysis of two randomised controlled trials of community weight-loss programmes. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 71(705), e312–e319. doi:10.3399/bjgp20x714113

5. Brown, J. D., Buscemi, J., Milsom, V., Malcolm, R., & O’Neil, P. M. (2016). Effects on cardiovascular risk factors of weight losses limited to 5–10 %. Translational Behavioral Medicine, 6(3), 339–346. doi:10.1007/s13142-015-0353-9

6. Williamson, D. A. (2009). Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Archives of Internal Medicine, 169(2), 163. doi:10.1001/archinternmed.2008.544

7. Faulconbridge, L. F., Wadden, T. A., Rubin, R. R., Wing, R. R., Walkup, M. P., Fabricatore, A. N., … Look AHEAD Research Group. (2012). One‐year changes in symptoms of depression and weight in overweight/obese individuals with type 2 diabetes in the Look AHEAD study. Obesity (Silver Spring, Md.), 20(4), 783–793. doi:10.1038/oby.2011.315

8. Rejeski, W. J., Ip, E. H., Bertoni, A. G., Bray, G. A., Evans, G., Gregg, E. W., & Zhang, Q. (2012). Lifestyle change and mobility in obese adults with type 2 diabetes. The New England Journal of Medicine, 366(13), 1209–1217. doi:10.1056/nejmoa1110294

9. Phelan, S., Kanaya, A. M., Subak, L. L., Hogan, P. E., Espeland, M. A., Wing, R. R., … The Look AHEAD Research Group. (2012). Weight loss prevents urinary incontinence in women with type 2 diabetes: Results from the look AHEAD trial. The Journal of Urology, 187(3), 939–944. doi:10.1016/j.juro.2011.10.139

10. Wing, R. R., Rosen, R. C., Fava, J. L., Bahnson, J., Brancati, F., Gendrano, I. N. C., III, … Wadden, T. A. (2010). Effects of weight loss intervention on Erectile Function in older men with type 2 diabetes in the Look AHEAD trial. The Journal of Sexual Medicine, 7(1_Part_1), 156–165. doi:10.1111/j.1743-6109.2009.01458.x

11. Wing, R. R., Bond, D. S., Gendrano, I. N., III, Wadden, T., Bahnson, J., Lewis, C. E., … the Sexual Dysfunction Subgroup of the Look AHEAD Research Group. (2013). Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes. Diabetes Care, 36(10), 2937–2944. doi:10.2337/dc13-0315

12. Messier, S. P., Loeser, R. F., Miller, G. D., Morgan, T. M., Rejeski, W. J., Sevick, M. A., … Williamson, J. D. (2004). Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: The arthritis, diet, and activity promotion trial. Arthritis and Rheumatism, 50(5), 1501–1510. doi:10.1002/art.20256