7 new reasons to keep fat off

By Ginny Graves

We are in the midst of a fat epidemic: An astounding two-thirds of American adults, including 65 million women, are overweight or obese-a rise of 10% in just a decade. If we keep it up, according to a new study, all adults in the United States (yes, everyone) will be overweight or obese in 40 years.

What's with the huge numbers? In addition to our poor diets and sedentary lifestyles, one reason for the growing epidemic is that carrying extra pounds doesn't seem dangerous to us; we don't consider it life-threatening.

In fact, an American Diabetes Association (ADA) survey suggested that people are more afraid of shark attacks and snake bites than diabetes, even though diabetes contributes to more than 230,000 deaths every year-compared with 5 to 10 a year from sharks and snakes!

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"People don't take obesity or obesity-related illnesses like type 2 diabetes seriously enough because they don't realize that they can have dire consequences," says Ann Albright, PhD, RD, past president of health care and education for the ADA.

Being obese can lop as many as 20 years off your life and make the time you do have more painful (physically and emotionally), less healthy, active, productive, and sexy-and even less professionally and financially rewarding (thanks to weight discrimination). Even normal-weight people who have a high percentage of body fat are at increased risk of heart disease-related health problems like high blood pressure, high triglycerides, abnormal cholesterol levels, and insulin resistance, according to Mayo Clinic researchers.

In other words, fat is the problem. A big problem. It's so big that we came up with this comprehensive list of fat-related issues that everyone-especially women-should know about. Keep in mind that, in most cases, losing even a small amount of weight can reduce or even reverse the risks, so start fighting fat now!

1. Fat ratchets up your risk for cancer
"Obesity is the most preventable cause of cancer, but most people don't know it," says Barry Popkin, PhD, an obesity researcher and author of The World Is Fat. Although years of research have shown that obesity is a risk factor for breast cancer, for instance, just 54% of women were aware of the link, according to a recent study at the University of Texas M. D. Anderson Cancer Center in Houston.

Even fewer women knew that obesity boosts the risk of endometrial cancer. "Women who are overweight have four times the risk, probably for the same reason they're at increased risk of breast cancer: body fat produces estrogen, a hormone that fuels these cancers," says Pamela Soliman, MD, MPH, lead author of the study. Likewise, University of Minnesota researchers found that leptin, a hormone associated with weight gain, enhanced the proliferation of both normal and cancerous breast cells. Losing weight may help decrease the risk of both breast and endometrial cancers, as well as colorectal cancer.

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Researchers at the Medical University of South Carolina in Charleston recently found that people with metabolic syndrome (a combination of high blood pressure, diabetes, and high cholesterol that's far more common in overweight people) had a 67% higher risk of colorectal cancer than those without the problems.

2. It can make cancer treatment and recovery difficult
Not only do obese women have a higher risk of complications from breast reconstruction after mastectomy (the complication rate is close to 100% for women with a body mass index (BMI) higher than 40, M. D. Anderson researchers reported), but overweight women also appear to be less likely than normal-weight women to get the full benefit of presurgery chemotherapy, possibly because doctors (worried about drug toxicity) tend to give overweight women smaller doses of the medications than they really need. In a nutshell, "People who weigh too much are more likely than normal-weight people to die from many cancers," Dr. Soliman says.

3. It's hard on your heart
The fatter you are the more likely you are to have a heart attack earlier in life-12 years sooner for those who are the most obese, according to a study published in the Journal of the American College of Cardiology. One reason is that people who are overweight are more likely to have cardiac risk factors like high blood pressure, diabetes, and high cholesterol. But even after adjusting for those factors, being heavy in itself was a "considerable risk," according to Eric Peterson, MD, an author of the study and a professor of medicine at the Duke Clinical Research Institute and Duke University Medical Center.

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4. It makes exercise unappealing
Lycra tops. Itsy-bitsy running shorts. It's no wonder obese women say self-consciousness is a major barrier to exercise. But that's not the only thing keeping them out of the gym. "They also have more aches and pains than normal-weight women, worry they might get injured, and just feel too overweight to exercise," says Melissa Napolitano, a clinical psychologist and associate professor of kinesiology at the Temple University Center for Obesity Research and Education, who recently surveyed 278 women of varying weights on the issue. Her advice: If you feel too self-conscious to exercise in public, find a good exercise DVD; or go to a place like Curves or the local track, where you're more likely to see people exercising who look like you. Also, start slowly so you gradually build strength and fitness.

5. Fat is bad for your brain
Jiggly arms may be more than just a vanity issue. In a large study, researchers from the Kaiser Permanente Division of Research found that those with the fattest arms at ages 40 to 45 were 59% more likely to have dementia later in life. Another study found that obese people, particularly those with large bellies at midlife, were 260% more likely to develop dementia. "The biggest risk is the fat that hangs over your belt," says Rachel Whitmer, PhD, lead study author. "The bigger your belly, the greater the risk for dementia, perhaps because of hormones or inflammatory factors produced by the abdominal fat itself."

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6. It doesn't do much for your mood
Is being fat depressing or is depression fattening? Either way, there's an association between the two, according to a recent study of 4,641 women between the ages of 40 and 65. While just 6.5% of the women who had normal BMIs were depressed, 25.9% of those with BMIs higher than 35 were. In an earlier study of more than 9,000 people across the country, researchers found a 25% increase in the risk of developing mood and anxiety disorders among those who were obese. "Obesity could contribute to depression by limiting physical activity and through the stigma associated with being overweight," says Gregory Simon, MD, MPH, lead author of both studies and a psychiatrist at Group Health Cooperative in Seattle.

7. Fat takes a toll on joints
Arthritis cases attributed to obesity rose from 3% to 18% between 1971 and 2002, according to researchers at Beth Israel Deaconess Medical Center. "Extra weight seems to place stress on the joints, but other metabolic factors related to body fat and involving inflammation may lead to joint damage, too," study lead author Suzanne Leveille, PhD, RN, says. "Research suggests that modest weight loss combined with exercise-even just walking five days a week-can improve arthritis symptoms."

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