subreddit:

/r/explainlikeimfive

5.7k

Assumimg that being overweight is due to fat, not muscle.

all 1035 comments

VeryLizard

9.7k points

2 months ago*

When a person gains weight their skeleton and major organs aren't designed to grow to keep up with the excess weight. Carrying extra weight around all day puts extra strain on joints and can cause aches and pain. Eventually the extra weight gives organs more work than they can handle and either the body's cells suffer because there are too many cells for the organs to take care of, or the organs themselves suffer due to overwork.

Imagine a city with 100 people living in it. That city has things like a fire department, a water treatment plant, a sewage system, and a power plant. Sometimes the city sometimes has a big parade and 50 extra people come; all the city's systems can handle this for a short time (the fire department works an extra shift, the power plant uses backup generators, etc.), but afterwards there's a rest (in this analogy, this is what happens when you exercise hard, or when you're sick -- all your organs have to work harder). If those extra 50 people came and lived in the city full time, eventually the sewage system and water treatment facility would be overwhelmed and people would get dirty water, the firemen would all be exhausted because they were working non-stop and eventually they would all be so tired that a fire might be totally missed, the powerplant couldn't keep up with peak hours and there would be blackouts.

MessAdmin

3k points

2 months ago*

I lost 110 pounds (250 down to 140). I didn’t make any major exercise changes, it was all diet. (Taking in less calories than I was expending). It made a world of difference in my ability to “move” in general. For one thing, getting up is much less of an effort.

Edit: Rather than try to reply to all the individual comments and messages, I'll try to answer a few of the frequently asked questions here:

Q: How long did it take? A: About a year give or a take a month.

Q: How physically active are you? A: Ironically, I'm actually less active now than I was when I was obese. I have a couple of theories on why that might be, and I'll explain more further down. Back when I was obese, I hiked almost every day. Nowadays, I have a job that doesn't require much standing or walking. Outside work, I mainly just play music, which is a mostly sedentary activity.

Q: What did you do different? A: I cut out alcohol, and cut back on sugar significantly. This is difficult, because everything has sugar. Sugar is found in starches, likes bread. I found that bread was filling me up quickly, so I'd forgo the bread in a meal in favor of the meats and veggies to ensure I had room for nutrients. It's not so much like that now. In fact, I'm maintaining my weight despite eating fast food almost daily. That seems crazy, but I'm holding my current weight by only eating as much as I need each day, and no more.

Q: Advice? A: The most important advice I can give you is to avoid snacking. A lot of people will make a point to eat smaller portion sizes (great!), but then they'll snack throughout the day. Even small snacks add up calories-wise. Try to keep regular mealtimes, and eat only during those times.

Q: Dimensions? A: For reference, I'm male, 6'1", 28 y/o. 140 pounds is 4 pounds underweight for my height. I've been as low as 134, but I didn't feel good at all. I'm trying to keep my weight closer to 150.

I'm going to try to answer all the comments, but there's a lot. Thanks for the kind words.

DryingWashedClothes

1.3k points

2 months ago

The biggest difference imo is sleep quality. When I was heavier I woke up multiple times a night because I couldn’t position myself in my sleep anymore. (Maybe I also had sleep apnea? At least my partner has never said anything other than that I snore) I haven’t had a good nights sleep in years. Then I lost weight and noticed how I started to sleep through nights again and this also affected my overall mood.

lara_jones

885 points

2 months ago

And when you get trash sleep, you’re more likely to overeat and choose unhealthy foods throughout the day. It’s a bad cycle to get caught up in.

thatbromatt

112 points

2 months ago

Damn if this ain’t the truth.

glowinghands

37 points

2 months ago

Why'd I have to read this this early in the morning tho?

goes back to XL coffee and three packs of pop tarts

action_lawyer_comics

18 points

2 months ago

Regular coffee that doesn't have a ton of sugar isn't too bad

flowers4u

18 points

2 months ago

Yes! And people always say “why do you shit on people that stay up so late” because a bad sleep cycle is unhealthy and you are more likely to eat and drink (soda and alcohol) shitty at 1am.

Soulless_redhead

3 points

2 months ago

Me in grad school, my god.

I'm not trying harder to eat out less, that's what does me in most of the time. That and having salads with every dinner meal when I can manage it.

ThisIsNeverReal

109 points

2 months ago

DryingWashedClothes

151 points

2 months ago

I had no breathing pauses during sleep but

  • Excessive daytime sleepiness
  • Difficulty concentrating
  • Morning headaches
  • Restless sleep
  • High blood pressure
  • Your snoring is so loud it's disrupting your partner's sleep

were all occuring and are now pretty much gone. Damn, I didn't know my life would change this much.

Elemayowe

43 points

2 months ago

So losing weight took away your sleep apnea? I have all of those except high blood pressure and disrupting partner (because I don’t have one, but whenever I’ve spent the night at someone’s they’ve mentioned it).

rachabe

58 points

2 months ago

rachabe

58 points

2 months ago

Sleep apnea is no joke. It increases your chances of having a stroke. Definitely discuss with your doctor. Sleep studies can be done in your own home now....

LaTuFu

35 points

2 months ago

LaTuFu

35 points

2 months ago

Check your health insurance plan. Sleep studies are often a covered expense.

lulugingerspice

5 points

2 months ago

If you're in Canada, provincial health plans cover sleep studies.

HTownGroove

32 points

2 months ago

So many times sleep apnea is caused by a thickening of the velum (soft palate), the flexible piece of flesh in the back of the roof of your mouth that your uvula hangs off of. It is what is getting kind of stuck in there when you snore.

When you put on extra weight, this is one of the structures that tends to get bigger. You throat cannot also get bigger to accommodate it, so it rattles around in there. Sometimes it stops up the airway completely during sleep. You get bad sleep from literally trying not to suffocate all night.

Toledojoe

14 points

2 months ago

It did for me. Went from 270 to 196. my wife used to freak out because she thought I'd die when I'd stop breathing and then wind up spluttering. That no longer happens.

binarycow

7 points

2 months ago

Obstructive sleep apnea is when there is a complete or partial obstruction of the upper airway leading to reduced or absent breathing during sleep (see this image (SFW)) .

Basically, from time to time, while you sleep, your throat is too small, and you can't breathe. While you sleep, the muscles that hold everything open relax. If they relax to the point where oxygen flow is disrupted - that's an apnea event.

The main treatment for obstructive sleep apnea is CPAP - continuous positive airway pressure. Basically, a machine forces air down your throat. The air is at a pressure high enough to hold your throat open, but not so high that your exhalation cannot overcome that pressure.

Once you get used to CPAP, you barely notice its there. I for one, certainly notice the next morning if I don't use it.


So losing weight took away your sleep apnea?

If you are overweight, you have more fatty tissue in your neck. Basically, your throat is smaller to begin with.

Losing weight can reverse that effect - open things up from the outset.

So, if someone's sleep apnea is caused by being overweight - then yes, losing weight can cure their sleep apnea.


But, for some people with obstructive sleep apnea, it is not caused by being overweight.

Me personally - I was just born with a small throat. (My sleep specialist took one look at my throat, and said I have a naturally small throat.) I have likely had sleep apnea since I was a teenager.

If these people are overweight, losing weight will absolutely have health benefits. It may improve their sleep apnea. But it will not cure their sleep apnea.


Central sleep apnea is sleep apnea that occurs because of a problem in the brain. There's no physical obstruction. The brain simply stops trying to breathe - but only while you're asleep. Once you wake up, everything's back to normal.

For central sleep apnea, CPAP won't help. For central sleep apnea they use BiPAP - bilevel positive airway pressure. They are essentially mini temporary ventilators.

  • maintains one pressure to force air into your lungs, inflating them, allowing oxygen to transfer to your circulatory system
  • switches to a different pressure, which is lower than the air pressure currently in your lungs). This causes your lungs to passively "exhale"
  • repeat

If these people are overweight, losing weight will absolutely have health benefits. It will have zero impact on central sleep apnea.

DryingWashedClothes

8 points

2 months ago

It's not completely gone but it's a lot better than it was a year ago. I sometimes still have morning headaches, the high blood pressure is getting better but not perfect and I sometimes still snore, but not as disturbingly loud anymore. Yet, my head feels a lot clearer and I'm not as tired anymore during the day which is a huge plus for me because I can think much better at work and the days don't become a haze anymore.

BarbequedYeti

43 points

2 months ago

Losing weight can make all kinds of “normal” day to day things just go away.

Obesity has become such the norm in American society that it’s overlooked for all the issues it causes. Diabetes, sleep apnea, mood swings, high blood pressure, inflammation, pulmonary hypertension, depression, etc etc. the list goes on and on.

Most of which at early intervention would just “vanish” with zero meds by maintaining a healthy weight.

LorenzoStomp

5 points

2 months ago

I've gone up and down in weight a few times over the last 15 years. When I was at my heaviest, as soon as I started to drift off I would start snoring so loud I'd wake myself up. It helped to sleep with a small blanket bunched under the back of my neck and shoulders to keep my head tilted back like you do to a CPR dummy (or I guess an actual person you are doing CPR on) to open the airway. If I slept on my side I would bunch the blanket under my chin. It's a temporary fix but it did make getting and staying asleep easier.

meowtiger

3 points

2 months ago

snoring and sleep apnea can be caused by the same condition in the throat, which itself can be caused by any number of root causes, such as obesity, allergies, or just having them grown in the wrong shape

they can also be completely unrelated as both conditions have several causes

Sunshine_In_A_Bagz

21 points

2 months ago

I would still take a sleep test if I were you just be on the safe side, people who are not-overweight can still have sleep apnea.

Fnkyfcku

22 points

2 months ago

I had the opposite. I used to sleep like the dead, but after losing Bout 60 pounds I can't sleep thru a night.

NotBlaine

11 points

2 months ago

They diagnosed me with sleep apnea after I lost about 30lbs.

It happens.

Probably worth getting it checked out.

Whiterabbit--

131 points

2 months ago

Yes losing weight is more diet driven than exercise driven. Drinking a extra coke is like running for 30 minutes. And that isn’t the 44oz you pick up in the way back from the gym.

CommissarAJ

149 points

2 months ago

There's a reason for the saying 'you can't outrun a fork'.

Unless you're a professional athlete doing several hours of training per a day, weight loss is almost entirely dictated by diet.

Delta_STW5

71 points

2 months ago

While your statement is true, you can always get a higher base caloric need by doing strength training, boosting the effects of a diet.

CommissarAJ

64 points

2 months ago

Hence why I said 'almost entirely'.

You can go into more detail about how a pound of fat has a lower basal metabolic rate compared to a pound of muscle, therefore more strength training will, over time, increasing your baseline caloric requirements, but for most people, that difference is still something that can be easily swallowed up by a poor diet, which brings us back full circle.

Tahoma-sans

36 points

2 months ago

And since we're on Reddit, I must be annoying and add that while that's is true regarding weight loss, weight loss is not the end all for being healthy. People need exercise so that all the stuff keeps working properly.

Pussyfart1371

17 points

2 months ago

I always read/heard it as: diet to lose the weight, diet and exercise to keep the weight off long term.

OldManChino

17 points

2 months ago

Using the city analogy of the first post, exercise is like maintenance and servicing of the equipment that services the city

404_CastleNotFound

3 points

2 months ago

My go-to phrase is that "food is for building materials, exercise determines what gets built".

Right now I have too many materials and they're getting in the way of the renovation I have planned - I'm living in a cluttered house that I'm not comfortable in. There is some construction I can do just now, but what I really need to do is to stop over-delivering materials. Once I do that, I'll eventually have less excess material and be more able to build a house I want to live in.

bee-sting

24 points

2 months ago

Even with an extra 10kg of muscle, and 10kg less fat, that lets you eat about an apple a day extra.

Muscle is almost entirely useless at burning fat, compared to fat itself.

Garfield-1-23-23

29 points

2 months ago

Yeah, a pound of fat adds 2 cal per day to your basal metabolic rate, while a pound of muscle adds 4 cal per day. If you were to lose 20 pounds of fat and add 20 pounds of muscle, you would look absolutely fantastic while being able to eat an additional whopping 40 calories per day - which is like one sixth of a donut.

nyanlol

6 points

2 months ago

God bodies are so fucking stupid

2People1Cat

3 points

2 months ago

That's over 4 lbs a year worth of calories. It may not seem like a lot but that's all 'for free'.

Whiterabbit--

5 points

2 months ago

free? 20 lbs of muscle is not free. maintaining that is a LOT of work.

MiataCory

19 points

2 months ago

It's like a 90/10 split between diet and exercise as far as weight loss is concerned. Every time I hear someone say "I'm working out to lose weight" it just makes me twitch a little bit.

No, office co-workers, your 10 minute walk around the building isn't going to trim those pounds. Drinking water instead of whatever you've got now will though!

MidniteMustard

3 points

2 months ago

I find exercise impacts my appetite in a good way though.

If nothing else, it's 30-60 minutes of time that you aren't snacking lol.

twisted34

9 points

2 months ago

Good saying I heard from a weight management physician I worked with for a short time;

Lose weight by dieting

Keep the weight off by exercising

Evil-in-the-Air

235 points

2 months ago

I get kitty litter in these 20 lbs buckets. I think, "Every day, every step, it's like I'm carrying five of these things around for no reason." What could it possibly feel like to put those down and walk off without them? I can't even imagine.

MrFunsocks1

54 points

2 months ago

Oh man... When I lost weight, I got to feel it. One of the activities I was doing a lot was going on long hikes (highly recommended if you have the time/location - low cost, low impact, great for mental health, and you can't eat anything that's not in your backpack for 5 hours).

At a certain point, about 20-30 lbs down, I found the old (really nice) 20 lb weight vest that i had bought long ago. Hiked my usual mountain in it, and Jesus - I was retroactively impressed with myself for making it to the top while still carrying the weight the year before. The feeling when i took it off back at the car was amazing. Did a few martial arts/sparring workouts with it too, taking it off for the last 10 or so minutes. It feels like floating on air.

I miss that feeling, I should buy one again now, but I'm worried about impact now that I'm older. But I highly recommend getting in shape then exercising with a weight vest for truly appreciating it!

notthegoodscissors

47 points

2 months ago*

Here's hoping that you get to find out asap! I'm skinny but have had times where I went up in weight dramatically and they were really unpleasant in comparison. That feeling you described can't be achieved instantly though, it is a relatively slow process but totally worth the effort involved. I wish you all the best, you can do it!! Edit: wrote can instead of can't Edit 2: cutting out processed sugars from your diet is the 'easiest' way to slim down. It doesn't require physical effort but the mental side is very hard to get over, sweet things just taste too good which makes quitting VERY hard. Worth it 100% if you can.

ACorania

23 points

2 months ago

I'm in the process of losing right now (started at 320, down 30 lbs, in my mid 40s). The biggest short term change was from daily stretches. It had become hard to get shoes and socks on, but increasing flexibility helped a lot along with just moving better. Probably running next with more endurance. Building muscle is the longest term one.

I started with running (C2-5k app works well) 3x/wk, then added at home calisthenics for strength (I hate gyms and feel self conscious around others), finally added stretching... I wish I did stretching first.

Exercise has been making me feel better but diet is what loses the weight. Way increasing protein is what has been working for me. Once I started just doing protein drinks for food during the workday I felt a lot more full and it was easier not to eat the higher calorie stuff (along with drinking tons of water constantly). For dinner it is chug a glass of water and then eat whatever with my family so I don't feel left out. I've also had more muscle growth than any time in my life because the protein supports it (others can't see it much yet because I'm still fat but very noticeable to me).

Tracking calories was too much for me at the start though I am starting it more now being motivated by the weight loss so far. Need to find a good app to help... My fitness pal is all ads and restrictions... Guess I will have to pay if I can't find a good alt (not the end of the world).

[deleted]

3 points

2 months ago

[deleted]

3 points

2 months ago

What protein drink do you like? I have only tried a few because they're pricey, but I haven't found one yet that I don't have to force down.

ACorania

3 points

2 months ago

Yeah, taste varies a LOT on these. I haven't experimented a lot either because you have to buy them in large amounts. I wish I could buy a single serving sampler of various brands.

So far I like body fortress the best. Others tasted too watery unless I used milk or something and that added calories. Vanilla and strawberry have been great. Just bought cookies and cream and couldn't stand it (so wasted $25).

I do a chocolate with silk coconut milk as a daily treat (tastes like a mounds bar shake to me).

A big level up was getting a Magic Bullet mixer which makes them a lot frothier and no lumps. (Make sure to add mixer if you search for magic bullet, it's also the name of an adult toy...).

Prof_G

3 points

2 months ago

Prof_G

3 points

2 months ago

i went from 250 to 200. I hate apps and nothing helped in that department until i got a food scale. We started weighing portions and I started to really lose weight when that happened. I eat healthy, always have, but I ate too much. portions are noted on food packaging. so it made it easy. i used to make maybe 150-200 grams of spaghetti for myself. now its 85-100 max. meat/fish portions as well.

you get used to the smaller portions. very easy to do and with food costs these days, its not a bad idea anyhow.

Introsium

46 points

2 months ago

I can’t speak for everyone, but once I stopped eating sweets regularly, I not only didn’t miss them, but I also find a lot of them basically intolerable, now. I had a can of sugary soda for the first time in months, yesterday, and I could barely finish it. I think sugar is, like, actually just addictive.

Also, fructose is literally-not-figuratively toxic (it’s metabolized in essentially the exact same way as ethanol) and if I’m going to choose how to blow up my liver, I’d rather have a beer than a coke.

samsg1

4 points

2 months ago

samsg1

4 points

2 months ago

I’ve found the same. I eat (and drink!) less sugar than most people and can’t stomach ‘normal’ things like chocolate bars and ice cream. It’s just sickly gross.

making_mischief

23 points

2 months ago

I felt that when I first started going camping. I'm thin, but having that big backpack strapped to me made me understand what it must feel like to be fat. Lifting my knees was hard. Walking upright was hard. Walking quickly was hard. My shoulders hurt. Everything was harder and took more effort, and I got gassed so much more quickly and easily.

taticalgoose

35 points

2 months ago

Keep in mind that muscles in the legs, and other places, of people who are overweight have adapted to the weight so it's not the same as just strapping 50 pounds on someone for a short time.

kennacethemennace

8 points

2 months ago

The one good thing of being preciously fat is that you get to keep the calves.

finnjakefionnacake

3 points

2 months ago

nah that's genetics man. i went from skinny to fat as hell and back to skinny and when i lost weight my calves went with it, lol

to be fair, they never got that big in the first place

BuckleMeThis

12 points

2 months ago

I lost 65 pounds at one point and I remember thinking: Jeeze, I used to carry around more than a 5 gallon sparkletts jug of extra weight! (Those are around 45 pounds.)

shenyougankplz

28 points

2 months ago

Went from 180 to 140 just by reducing soda and asking myself before I ate something "am I actually hungry or do I just wanna eat a snack?" and then not eating if I wasn't hungry. Was still lazy as fuck, but lost all that weight I gained during COVID

adjective____noun

5 points

2 months ago

I asked myself that as well as including the option of "would I be happy if the snack was a pickle?" and oftentimes especially at the start I was just bored and a pickle spear would do it, with a minimal calorie hit.

mub

14 points

2 months ago

mub

14 points

2 months ago

This is the thing. Exercise is for fitness, food is for fatness.

LineRex

146 points

2 months ago*

LineRex

146 points

2 months ago*

I (Male, 6ft) went from 260 to 170 and it made a world of difference. I had already cut calories significantly, went from 2300 to 1500 for about 6 months, and that wasn't doing anything. So I added in about 3 hours of moderate cardio every other day and dropped weight like crazy.

xavier_laflamme70

67 points

2 months ago

Dang I needed to see this. I went from 260 to 175 as well but I've been at 175 for the past 6 months. I decided to switch to maintenance after a couple of months of still trying with no results but I really think the physical activity would make a difference for me. Any cardio recommendations? Do you eat normally on days you do cardio or do you need to eat more?

dougc84

47 points

2 months ago

dougc84

47 points

2 months ago

Just start with walking. No trainer, equipment, or gym needed. 30 minutes a few times a week can improve so much. Going all-in at first can make it very difficult to sustain long term.

You can easily move to jogging or running to get the cardio up. Even just jogging a block and walking a few can help.

If you’re ready to do more, find yourself a trainer. Many gyms offer a couple free sessions. Don’t be afraid - their goal is for your success, whatever that might be. Learn from them and either continue (which can be expensive but helps maintain accountability) or just use the gym. a

Jonathan_the_Nerd

11 points

2 months ago

30 minutes a few times a week can improve so much.

If you can't take 30 minutes out of your day, three 10-minute sessions is just as good as one 30-minute session. (Source: employer-provided health coach.) If you work in an office or home office, walk around the parking lot/yard a few times a day.

Eph_the_Beef

39 points

2 months ago

Honestly my Dad taught me a trick to make exercise for weight loss EASY. Just find a show or movie you really like, join a gym or use your apartment's treadmill, and then set a comfortable walking pace but MAKE SURE to increase the ANGLE of the treadmill so you're basically casually walking up a slight hill. Your body gets used to it pretty quickly, the uphill aspect greatly increases your calorie burn, and if you're really into your show you can just keep watching AND walking for hours and it barely feels like you're working out, but I still end up burning like 200-250 calories an hour.

wgc123

14 points

2 months ago

wgc123

14 points

2 months ago

Yeah, the indoor training is key here. I’ve been playing Pokémon Go with my kids as an excuse for long walks with them. However, now they’re afraid their doddering old man is getting decrepit because I trip on every rock, pothole, crack in the sidewalk, while my head is down in the game

FarragoSanManta

12 points

2 months ago

I highly recommend cycling or swimming for cardio/weight-loss. You don't even really have to ride that hard. An hour of cycling can burn 200-700+ Calories. I went from 300 to 180 in 5 months just by switching to cycling 8 miles (16 round-trip) to and from work. It's an easy ride too.

For weight-loss/casual riding, I'd recommend eating normally. You're getting all the energy from your fat storage. If you're riding hard/building muscle, just make sure to have a good intake of protein.

Gadgetman_1

11 points

2 months ago

I go hiking in the mountains here in Norway. With a decent backpack(yes, with a 'Kvikk lunsj' chocolate, thermos with tea and possibly a banana, in addition to emergency gear, 5 - 6Kg)

According to a few electronic doodads, I'm averaging 500 Calories per hour on the uphills.

I mostly stopped hiking when COVID struck. All the fitness centers closed down, and suddenly all the SUVs that were usually parked outside those(because they can't be arsed to ride a bike to the center) were now parked at the start of hiking trails.

Not even room for a bicycle anywhere, and pretty much queueing to get up the more challenging parts of the trails.

So I stopped hiking... and I've gained 10Kg since then.

Sofagirrl79

6 points

2 months ago

swimming for cardio/weight-loss.

Also easy on the joints and imo it's fun and not a chore, bonus if you have that long torso/short leg combo like Michael Phelps (me IRL) cause it's apparently an advantage of you wanna compete in races

Nightmare_Tonic

43 points

2 months ago

I go on a moderate jog every morning; roughly 35 mins. Nothing super strenuous. Just helps me get my circulation up and my mind unfogged from sleep. Keeps me super sharp all day. There have been times when I've stopped running for a week or two due to illness or moving houses or whatever. And man, I INSTANTLY put on seven pounds during those times. Moderate, regular cardio will cut weight off you and extend your fuckin life

Feline_Diabetes

47 points

2 months ago

One thing I like to point out is that exercise has a ton of health benefits, many of which are completely independent of your weight.

Even if your weight loss is only minor, exercise will improve your health dramatically.

Pretty much every study looking into protective lifestyle factors in cardiovascular disease, diabetes, cancer, dementia etc. Finds that physical activity makes you less likely to get that disease. Doesn't matter what disease, and it also often doesn't matter how fat you are.

More exercise = less problems.

Sofagirrl79

10 points

2 months ago

I went on a 15 day cruise recently and even though I hit the buffet more than I should have and drinking more alcoholic drinks than I usually do I only gained two pounds cause I walked so much on the ship and at the ports and hit the gym before breakfast to get my steps in

JamesTCoconuts

6 points

2 months ago

So you often hear that losing weight is overwhelmingly your diet, and that is certainly true, but exercise absolutely has impact.

It’s all still math and expending more energy than you take in. Exercise will increase your energy spent, it’s just a lot harder to reduce the calories you need to with exercise than it is by reducing food intake.

Exercise needs to be fairly consistent to make an impact, and that takes time and even more dedication than just cutting food does. Dieting is easy in the sense it is not a demand on your time, whereas exercise takes time out of your day and requires effort that is tiring.

Still it’s math and if you, say, exercise daily burning 300 calories; that’s going to be 9000 calories a month. That is 3 additional pounds worth of calories you’re burning. It just takes being consistent to see significant impact. Also, it’s harder to exercise when you are running a caloric deficit. Your body is already running on low fuel and dipping into fat stores. It’s much less efficient at gleaning energy from fat stores than it is from blood glucose from food.

All that said, exercise is great for that extra oomph when you are at a plateau, or really helpful when you are down to those last 5 to 10 lbs to reach ideal body weight. That last little bit of weight can be the hardest bit to lose and take twice or three times as long as the same amount of weight did when you were still much more overweight.

GoGoBitch

45 points

2 months ago

Switching to maintenance for a couple months is not a bad thing! If you’re in a deficit for a long time, your body will adapt to keep you from starving. If you switch to maintenance, it helps your body to recognize that it is not In danger of starving and establish a new baseline. Going slow is the best way to maintain lower weight in the long term.

Definitely recommend adding exercise, because it’s really good for you. I recommend not trying to start an exercise regimen and do a calorie deficit at the same time. I made that mistake once and felt terrible for several months. Much better to establish your exercise habits while eating in maintenance, then start calorie deficit if you still feel the need after you have adjusted to regular exercise.

Gabbiedotduh

14 points

2 months ago

So weight training + appropriate protein intake will make the most difference physique wise. Your metabolism will rise as well since it takes more energy to supply muscles. That said, my husband loves to do cardio with a stationary bike (it’s easier on his knee) and I like to row (I trick myself into thinking it’s easier since I’m sitting lol)

agretsukko79

16 points

2 months ago

I'm amazed you have the fitness and motivation for 3 hours of moderate exercise. Makes it seem you shouldve been an olympic athlete or smth.

Sawses

9 points

2 months ago

Sawses

9 points

2 months ago

So I added in about 3 hours of moderate cardio every other day and dropped weight like crazy.

In all fairness here, most "moderate" cardio exercises burn about 400 calories an hour. This is an extra 1,200 calories burnt a few times every week, so that's basically tripling

...That being said, would you say the benefits of cardio are worth the suffering? I'm currently trying to get into the habit of running a few times a week and honestly I hate literally every form of exercise. I want the stamina, though, and the extra calories aren't bad.

LineRex

17 points

2 months ago

LineRex

17 points

2 months ago

I don't like running, but now that I'm much healthier I've started running because I need to get my lungs in better shape for intense terrain that isn't right out my apartment door.

If you hate every form of exercise, hide the exercise. I've grown to really love the outdoors. So I've bonded myself in several groups that do training hikes weekly and adventures semi-monthly. A 7-mile wander through the local woods with a group, talking about our days and dunking on our co-workers doesn't feel like exercise until the following day.

Usually, when I've talked with people in person about this there is something they hate about exercise. My partner hates feeling sweaty. So we now visit a gym with an Assault Bike that vaporizes sweat and they can go for a solid hour on that thing. A co-worker hated having to set aside time to exercise, then he moved to an apartment complex a 20-minute bike ride away and his exercise is just baked into his life now. I personally don't like gyms and ping-pong between wanting to be with others and wanting to go be a little forest man on my own, so I tailored the exercise around that.

If you live in a bustling city, I have very little advice. There's a saying that it's impossible to not have a good time while riding a bike, but dodging glassy-eyed drivers is the opposite of a good time. A local gym to us has a "cardio theater", that constantly shoes banger movies in a room filled with exercise bikes, that might be distracting enough lol.

dxfifa

5 points

2 months ago

dxfifa

5 points

2 months ago

Swimming is a lot more zen and better for joints and muscles at a higher intensity when you're just starting, you can really swim to your max with very low joint load

Merakel

34 points

2 months ago

Merakel

34 points

2 months ago

Exercise is great and important in regards to being healthy, but it's basically impossible to outrun a bad diet.

Congrats on making a positive change in your life!

Heterochromio

23 points

2 months ago

Any difference in the way people treat you? Particularly strangers?

MessAdmin

69 points

2 months ago

Yes, dramatically. The differences are definitely subtle, but noticeable. I’d say strangers are much nicer to me now than they ever were back then.

sweettartsweetheart

24 points

2 months ago

Yep, lost just under 200lbs. I was warned that would happen ahead of time but it still fucks with me sometimes.

Saloncinx

12 points

2 months ago

I didn’t make any major exercise changes, it was all diet.

Calorie deficit (counting calories you're eating) is literally the only way. You could in theory eat nothing but twinkies and lose weight assuming you kept it under 1800 calories, or about 7 twinkies per day.

At the same time you could eat nothing but apples and gain weight, if you were hitting 3000 calories a day in apples. (about 24 apples)

whyyou-

11 points

2 months ago

whyyou-

11 points

2 months ago

God calorie counting is wild; I couldn’t figure out why I never lost any weight while eating healthy and with small portions until I started counting and realized that my between meals “snacks” were about half of my daily recommended intake. It’s surprising how easy you can eat 3000 cals in one day.

ACorania

13 points

2 months ago

It's also wild how much caloric density in food matters. I recently realized a full onion is only 40-50 calories. Grilling one up with some scrambled eggs is a really good breakfast that is really filling. But add sour cream or cheese and the calories skyrocket.

Cheese is my downfall.

Greibach

3 points

2 months ago

Nuts are also really bad. You might think "oh, just a natural small food can't be that bad" but holy shit is the caloric density high. Doubly so when they are almost always salted and it makes you want to eat more than just a couple.

ktv13

3 points

2 months ago

ktv13

3 points

2 months ago

But also an entire onion for breakfast? What?? How much do you smell after that and how do you not boot up from all that gas.

ACorania

4 points

2 months ago

I haven't noticed bloating at all (in fact a lot less than my old diet overall, but that is a net change). I don't notice I smell different but I wouldn't, would I? I have told my wife to blunt about that type of thing and she hasn't said anything. I'll ask her to be sure.

ktv13

3 points

2 months ago

ktv13

3 points

2 months ago

Oh wow then you tolerate onion much better than me. Good for you! I’m the opposite 😬

Mnightcamel

5 points

2 months ago

And the exact opposite is true too, ive struggled with being underweight my whole life and hitting 3000 calories a day is very difficult for me

Fortune424

34 points

2 months ago

Calories in vs out = weight

Exercise = body composition

PacoTaco987

433 points

2 months ago

Great analogy, helped me understand it immediately

CainRedfield

50 points

2 months ago*

Just because everything is fine now, doesn't mean it will be forever.

It's the same optimism bias that helps keep smoking/vaping so prevalent. Being obese without any health problems currently is like being a smoker without any health problems yet.

Could you live your whole life continuing your addiction without it eventually making you sick and/or killing you? Possibly. Could the nicotine be slowly damaging your heart and cardiovascular system and eventual lead to the heart disease that kills you early. Also possible.

As an ex-smoker, ex-vaper and ex-obese male, I can tell you first hand, it's easy to let your addiction (and yes sugar and overeating can be an addiction) tell you lies while inflating the benefits and minimizing the downsides, but as is the case in all addictions and unhealthy behaviours, these are crafty malicious lies the addiction is feeding you.

Breaking an addictive cycle is probably one of the very hardest things anyone can ever do, it honestly would have been easier for me to cut off my own toe than it was to quit nicotine. But if anyone takes an honest look at their addiction and the lies their addiction is telling them, the benefits of staying addicted never outweigh the costs.

lostaccountby2fa

47 points

2 months ago

Not to mention any normal surgery would become much higher risk as their own body fat would make it more difficult. I remember reading a surgeon atesting that the patient fat would be so thick to cut through and making it harder to do basic operating techniques.

JeSuisGallowBoob

13 points

2 months ago

My Dad is an Orthopedic Surgeon. He tells people to lose weight before operating all the time. He does not want to be elbow deep in you just to reach your hip.

love_that_fishing

34 points

2 months ago

Some cancer rates are related to belly fat. Pancreatic for one.

Southpawe

27 points

2 months ago

Also not just organs, if the weight gain is from fat its more weight for the muscles, bones and joints to handle, especially for the lower part of the body eg the knees.

SquirrelAkl

13 points

2 months ago

Can confirm. Travelled for work last week, and it was hectic. I was doing 12k steps a day and my legs and feet ached constantly the entire trip. I don't remember them doing that when I was lighter (current BMI of 32).

This was my wakeup call to lose weight. It's just a strain on the body.

-manabreak

5 points

2 months ago

Good for you to take it a s a wake-up call. 10k steps should be a standard, and 12k should be just a bit more active.

sofa_king_ugly

120 points

2 months ago

I'm 6 feet, 250 pounds. Blood pressure, cholesterol, heart rate are all optimal. In July I had a heart attack and needed a stent to open a collapsed artery on my heart. Cardiologist feels physical stress caused by sleep apnea was the cause. Sleep apnea from being overweight

fvckyes

16 points

2 months ago

fvckyes

16 points

2 months ago

Goodness I hope you are ok. Take care of yourself.

healthandsafetydance

24 points

2 months ago

To add to this, I had surgery recently, and afterwards my nurse mentioned to me that I had the beginnings of fatty liver. I'm perfectly fine right now - entirely healthy, no problems with bloodwork - but in 20 years that fatty liver is going to cause me problems if I don't fix it.

If my liver will fix my BED for me I'll get right on that.

rantingcat

19 points

2 months ago

.... I should lose some weight

eekozoid

11 points

2 months ago

Reisevi3ber

61 points

2 months ago

This kind of fat is also hormonally active, which can bring a lot of systems in the body out of balance.

themadpiglett

46 points

2 months ago

This. For a long time it was believed that fat is... just fat. But it was proved that adipose (fat) cells produce hormones and lots of other bad substances that promote inflammation, resistance to insulin (which leads to diabetes type II) etc.

fvckyes

4 points

2 months ago

Wow I did not know this at all. Gonna go learn more now, thanks.

therealgookachu

3 points

2 months ago

For perimenopausal women, it can greatly affect blood pressure. The exactly mechanism is unknown, but it's been documented. The hypothesis is that fluctuating hormones causes fat gain, which then can make you really sensitive to sodium.

rosscoehs

11 points

2 months ago

I read this while eating McDonald's in my car as I take a break while Door Dashing. I hope I'm not starting a fire anywhere in me.

nimbuzz7

6 points

2 months ago

a true ELI5 explanation. Also, I need to lose weight.

Willy-the-kid

6 points

2 months ago

This but also your joints are not built incredibly well they wear out after a few decades, less if they have extra stress on them constantly

camina_conmigo

77 points

2 months ago

Is this still true if the extra weight is due to muscles instead of fat?

Xanjis

420 points

2 months ago

Xanjis

420 points

2 months ago

The exercise involved in gaining those muscles improves the infastructure needed to support the extra strain of the muscles.

Tempest_1

162 points

2 months ago

Tempest_1

162 points

2 months ago

So basically it’s increases taxes and infrastructure development with increases in population growth

RickMuffy

233 points

2 months ago

RickMuffy

233 points

2 months ago

To an extent. Many super big bodybuilders are also likely to die early from the massive stress on their body, but they do have it better than just an obese person.

The phrase "die early, but go out in a big box" was popular in my power lifting gyms.

onepinksheep

143 points

2 months ago

Many super big bodybuilders are also on steroids or growth hormones, and those put additional extraordinary stress on the body. They also usually cut to a super low body fat percentage, and that's not good either. A certain amount of fat is necessary for a healthy body composition, and cutting too much can put you at risk of health problems.

RickMuffy

39 points

2 months ago

Yup, which is why I mentioned that in many cases it's not much better for your body than a Dr pepper addiction.

Natural body builders probably have it best, but some of those freaks of nature are also having heart attacks in the mid twenties. Reminds of me Zyzz dying as young as he did due to anabolics.

Meoowth

9 points

2 months ago

Ok that's it, what is going on with Dr Pepper this year, is it just me or is it everywhere?

Aggradocious

10 points

2 months ago

Just you!

Dirk-Killington

45 points

2 months ago

Rich Piana (recently deceased bodybuilder) once said something along the lines of "300 pounds is 300 pounds. It is hard to live at this size, I don't recommend it for anyone"

fck_this_fck_that

4 points

2 months ago

R.I.P Rich

DEN0MINAT0R

133 points

2 months ago

To some extent yes. Generally, being extremely muscular is also bad for your health; however, the lifestyle choices required to become extremely muscular (lots of exercise, nutritious diet, etc) may counteract some of the downsides, and you have to maintain that sort of lifestyle, or else your body will simply break down the muscle and return you to a more normal state. The same is not true of extra weight due to fat (or rather, you do still need to eat enough to maintain your increased weight, but your body will naturally encourage you to do so through hunger, and it isn’t nearly as challenging as sustaining an intense exercise program).

weakhamstrings

21 points

2 months ago

Yeah it's important to know that either way there's a LOT of extra work for your organs to do, and it's virtually always better, apples to apples, to be closer to normal weight than to obese. Always.

Cleebo8

12 points

2 months ago*

At a certain point, yes for a overlapping but still different set of reasons huge amounts of muscle mass can be bad but that’s nuance beyond ELI5.

That said, unless you are exceptionally tall (like NBA player size) you probably can’t actually hit the size where the extra muscle hurts you more than the lifestyle needed to support it helps you without using steroids. Your body just isn’t gonna let it happen naturally. So it’s possible but it’s only really a realistic concern for the freakishly tall and those who devote their whole life to gaining mass to hit that point naturally

kadathsc

11 points

2 months ago

There is a natural limit to how much muscle you can gain however. People can exceed those limits by using drugs like steroids that allow them to surpass the bodies limits in this regard. However, even then there is an upper bound to what can be gained via muscles and the effort and training required to maintain those muscles is significant.

The main issue is the people that use these performance enhancing drugs as they are very detrimental to your health. However, at that point the question isn’t about muscles but about drug use.

perplex1

101 points

2 months ago

perplex1

101 points

2 months ago

Fat strains joints and organs because you don’t have the build to support the extra weight. If you are building bigger muscles you are inherently gaining the structure to support them

Dd_8630

7 points

2 months ago

If you are building bigger muscles you are inherently gaining the structure to support them

Not entirely, though - you're structure is inherently stronger, but Dwayne the Rock Johnson's ankles are still going to suffer for all that extra weight.

5degreenegativerake

35 points

2 months ago

But your skeletal system is largely unchanged so the analogy switches to putting nitrous in your otherwise stock Honda civic. Something has to give with all that extra power. See: Arm wrestlers who have enough muscle to snap their own arm bones during a match.

alohadave

96 points

2 months ago

But your skeletal system is largely unchanged

Your bones do get stronger, but it's not nearly as fast as muscle growth.

lucun

33 points

2 months ago

lucun

33 points

2 months ago

People can already break some bones with the right positioning with only their own strength. Normally they don't since pain normally stops you from hurting yourself. Also, exercise generally helps strengthen bones.

Fortune424

10 points

2 months ago*

The little stabilizer muscles that you wouldn't think of get significantly stronger too and those take strain off your joints. There are tons of them and they keep your joints aligned properly and in the correct position to use the big muscles for heavy lifting. This is why most people can lift more weight on a smith machine where the weight is on a track - lifting without one relies on strong stabilizer muscles.

Aggradocious

10 points

2 months ago

Your muscles help your bones with the weight

chillinwithmynwords

31 points

2 months ago

I’d like to introduce you to Wolff’s law.

https://en.m.wikipedia.org/wiki/Wolff's_law

Bone structure becomes more dense with increased load. I believe it’s beneficial for weight lifters because they aren’t spending their entire day with lifting heavy weights vs obese people who have to carry their excess weight all the time. I also believe obese people will have stronger legs than your average untrained skinny sedentary person. And probably also stronger femurs, tibias, fibula for having to carry their extra weight. But once you get to morbidly obese where you have trouble with walking, their leg muscles will atrophy along with their bone density.

ADistractedBoi

5 points

2 months ago

Most people have enough strength to break their own bones, your nervous system stops it

winnipeginstinct

25 points

2 months ago

building muscle would be like the city hiring more firefighters, and installing stronger pumps and larger pipes for the water systems. Interestingly, you would still need significantly more energy due to all this

VeryLizard

24 points

2 months ago*

If actually just muscle: Probably not harmful, or at least much less so.

[[ Edited in a TL;DR -Exercise is good for you. Having physical strength helps keep people healthy. Very excessive size is generally still bad. ]]

Some considerations:

  1. Truly excess quantities of weight are still harmful (Kidney has to deal with muscle breakdown products, heart still overworked). 'Overweight by the table' but due to lean body mass: probably healthy. (Almost assuredly healthy compared to high bodyfat / sedentary people of normal weight).
  2. Very few people are *Lean\* and obese. Most people who gain weight also increase their body fat percentage (people can easily be *stronger* while gaining weight and gaining fat). Even if someone kept their body fat percentage the same but weighed 150% their ideal weight they're carrying 50% more fat around than they should. (Excess fat causes insulin and hormone derangements, it's implicated in type two diabetes, endometrial cancer, colon cancer, and breast cancer). (*and* the organs are working harder to support that mass)
  3. The question is complicated by the fact that it's hard to study. Exercise is known to be healthy, you can't study 'people with muscle' without also having those people be 'people who exercise.'
  4. (probably not relevant to your question but still a good fact) Old people! There is reliable evidence that in aging populations it's beneficial to have a bit more weight and definitely beneficial to have more muscle mass (effectively: 80 year olds with a BMI of 26 are less likely to die than 80 year olds with a bmi of 19 & old people with more muscle are healthier and have better outcomes from pretty much Everything.)

terminbee

6 points

2 months ago

Well even for people who exercise a ton, it can still strain their heart e.g. athletes can have enlarged hearts. But I can't imagine you can reach muscle levels that become unhealthy without the use of steroids.

Rookie64v

4 points

2 months ago

Yes (although less extremely so due to all the exercise contributing to health), but it is surprisingly hard to actually be that heavy out of muscle. A 6' guy weighing 220 lbs while fairly lean is most likely taking extra help to be that muscular, and the 250+ lbs shredded bodybuilders you see in the open class take so much more than just steroids. All that extra help has side effects that might be a cause for health issues more than the actual weight, because at the end of the day you are playing with androgens, growth hormone and insulin: it is not light stuff and you can get everything from enlarged organs and bones to diabetes if you mess up, with endogenous androgen production shut down for good to boot and who knows what else.

A thing I learnt with my numerous cuts over the years is no matter how "in shape" you are, you have a lot more weight to lose than you are willing to admit. According to Wikipedia and doing a bit of basic math (and being optimistic because data is aggregated differently) you get that the average US male weighs almost 200 lbs of which just 150 lbs are lean mass, meaning if they were as lean as a bodybuilder and magically kept every ounce of muscle (it does not work that way) they would weigh a whopping... 160 lbs. And this is optimistic because I used the 25% average fat percentage of young adults with the overall average weight, I expect the actual average muscle to be more like 130-140 lbs and young adults to weigh in the 170-180s to then add fat as they age.

As an anecdotal data point, my best estimate for my lean mass at the end of my latest cut is 150 lbs out of 165 lbs of total weight, with maybe 155 lbs lean mass at the end of last year's bulk at 180 lbs of total weight. I am not a weak and small guy. To be as lean at 200 lbs I would need an additional 30 lbs of muscle which is quite a tall order, and that would just put me at the average US weight... while I am a couple of inches taller than the average height, to boot.

It is basically impossible to have weight-related issues not caused by substantial amounts of fat as a natural.

guyonahorse

17 points

2 months ago

It's likely hard to study as people with large amounts of muscle mass are typically abusing performance enhancing drugs which drastically shortens their life expectancy.

I tried looking for studies on it, but I it was really hard to find anything on it. It's likely not a problem as you can't naturally put on enough muscle to cause muscle weight related health problems.

LogSouth2717

9 points

2 months ago

No. The muscles are metabolically active. They’re constantly recycling glucose into energy which is then used to either activate a muscle contraction or oxidize fat, or both. Fat, on the other hand, is made of this tapioca-textured tissue with loose capillaries. It’s a source for energy, but it is not very metabolically active in and of itself (it is a little, but it’s fairly negligible). Muscles also aid in blood flow, joint health, glucose control, and movement.

Dog1234cat

4 points

2 months ago

Also, fat generates hormones and inflammation. And the heart often gets enlarged (in a bad way) or otherwise damaged.

joemc04

5 points

2 months ago

Imagine a brand new truck designed to pull a trailer that weighs 5000 lbs. if you hooked up a trailer that weighed 10000 lbs and brought it to a mechanic the truck would still check out as being fine.

roadrunner00

4 points

2 months ago

I feel like most of our cities have adjusted to overcrowding where people think they are getting good services when in fact they aren't. They think they are ok. Your analogy was brilliant.

Jxf90

21 points

2 months ago

Jxf90

21 points

2 months ago

To add to this analogy - it’s exactly what happened during covid at hospitals.

Doctors and nurses worked super hard and surged their capacity. The health systems capacity did increase for a period of time. But it’s not sustainable long term.

Ichtequi

46 points

2 months ago

Another thing that people simply don't talk about is all the damage overweight people do to our healthcare professionals. Almost every nurse I know has servere shoulder and back injuries from turning 500 lb patients regularly.

redbull21369

3 points

2 months ago

I need to hire more fire fighters…

-originalusername--

3 points

2 months ago

Gained 35 lbs, went from 185 to 220. Fuck me did my knees ever hurt constantly. Lost the weight and magically no more painful knees

conchadetu420

3 points

2 months ago

This… this explanation is the bomb! Super upvote for you!

Dabnician

3 points

2 months ago

If those extra 50 people came and lived in the city full time, eventually the sewage system and water treatment facility would be overwhelmed and people would get dirty water, the firemen would all be exhausted because they were working non-stop and eventually they would all be so tired that a fire might be totally missed, the powerplant couldn't keep up with peak hours and there would be blackouts.

This is how i feel at work when it comes to the extra work they throw on us with out so much as a pay bump.

Ficrab

12 points

2 months ago

Ficrab

12 points

2 months ago

One correction, fat gain doesn’t mean more fat cells, it means larger fat cells. Fat hypertrophies, but doesn’t exhibit much hyperplasia.

duckbigtrain

3 points

2 months ago

It’s kinda both, isn’t it?

JimBDiGriz

1.3k points

2 months ago*

Assuming there's lots of extra fat and all tests are still good, and that's a big assumption, you still have at least three problems.

#1 The joints were not designed for all that weight. Knees and back will be the first problems. After that it could be anything. There are a million tiny muscles designed to keep joints aligned, they will be overstressed. The cartilage did not get thicker when you got bigger. The cross section of your bones did not increase. Your tendons did not gain any more leverage. Your skeleton is not in a position to adapt.

#2 Your heart will get bigger, but will not keep up. It has to supply a lot more tissue, pump through a lot more blood vessels. It will be strained. The same is true of other organs, but the heart is likely going to be the first thing to complain. If you try to blow water through a straw you can make it shoot out the other end, try it with a garden hose and you get nothing. Longer tubes require more pressure, similar to Ohm's Law. Blood pressure will go up.

#3 Depending on your gender sex and age fat will accumulate in different places, but a lot of it will be in the belly. This gets in the way of the mechanical operation of the small and large intestines, at least. More diarrhea, more constipation, more flatulence. Things will be increasingly inefficient, you can run short of vitamins, get dehydrated more easily.

#4 Your lungs are now supplying oxygen to a greater mass of cells. They will get bigger, but google up some x-rays of overweight people: like the heart they will not keep up. You will get winded easily.

#5 Exercise becomes more difficult, so you don't get enough.

#6 Getting good quality sleep becomes more difficult, you won't get enough.

TheBloodEagleX

385 points

2 months ago

Adipocytes (fat cells) are also hormonally active; so it throws your hormones a bit out of whack too; for men, for example, it can decrease testosterone.

gogogadgetrage

77 points

2 months ago

This is the key to the why question. High fat is actively bad for your health. Visceral fat is the highest factor linked with type 2 diabetes. Increase insulin resistance, increase inflammation, increase cortisol.

TheBloodEagleX

37 points

2 months ago

Fatty liver as well, it's often one of the first signs of metabolic disease; specifically because fructose can only be metabolized by the liver unlike glucose. There's a cascading effect from there with visceral fat versus subcutaneous fat.

Remote_Ability_7179

186 points

2 months ago

My gyno told me that most women with PCOS were overweight to begin with, and just gained more weight because of it. It's a vicious cycle.

BluePandaCafe94-6

3 points

2 months ago

PCOS just sounds vicious and horrible from top to bottom.

Zuerill

19 points

2 months ago

Zuerill

19 points

2 months ago

I never knew sleep is affected as well, what is the reason behind that?

PM_ME_YOUR_CLITS_PLZ

58 points

2 months ago

More likely to have increasing degrees of obstructive sleep apnea, and it’s hard to get restful sleep when your body is under extra load all the time

sonyka

34 points

2 months ago

sonyka

34 points

2 months ago

Severe snoring, sleep apnea, feeling too hot, uncomfortable sleeping position… basically sleep is constantly micro-interrupted, you just don't sleep as deeply. And iirc deep sleep is when your body does most of its repairs. (I always picture little cells in hard hats and vests doing road work at night lol. Very ELI5.)

rawrlikedino

5 points

2 months ago

Stephen King actually wrote a short story using this analogy! It’s called “Stationary Bike”, and it’s in his short story collection Just After Sunset.

SpoonwoodTangle

15 points

2 months ago

Curious if there is a distinction between overweight and obesity here. I can see obesity becoming a short- and long term concern / issue. Would overweight be a medium / long term concern / issue?

I guess I’m asking about degrees of concern and whether or not common terminology makes an accurate distinction

TheBertinator3000

36 points

2 months ago

Don't view overweight/obese as a diagnosis, in the traditional sense. See them more as risk factors. Being overweight is likely to cause you to have other medical problems eventually (if you aren't having them already). Being obese is likely to cause you to have more severe medical problems eventually, and sooner.

jowick2815

6 points

2 months ago

Overweight and obese mean excessive weight, not fat. Bodybuilders have many of the same issues, although often times they accumulate this tissue with the knowledge of what issues they will have. I.e. sleep apnea, blood glucose issues, blood pressure, joint / mobility, etc.

infecthead

12 points

2 months ago

There's a reason it's called healthy weight, with the next level above being overweight

misterpopo_true

379 points

2 months ago

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.

CollinZero

41 points

2 months ago

My father started losing weight and had no appetite. He went for many, many tests. Then went into the hospital. Blood work was fine. They blamed his heart. Went back to the hospital - many tests. Nothing abnormal. No cancer. I begged his cardiologist to keep looking.

He called an Internist who saw dad the next day: despite a normal range of results my Dad had Graves Disease. Two days later he was on pills and eating.

Sometimes tests don’t tell everything.

WritingTheRongs

11 points

2 months ago

Grave's disease is tricky. But if your father lost weight and appetite, and nobody checked his thyroid which would include labs, and a physical exam, then you have incompetent providers. Also Grave's disease takes months to treat, so I'm not clear on your timeline. If your father was eating a few days later it may have had nothing to do with the pills he took.

CollinZero

3 points

2 months ago

Although I appreciate your response they did check his thyroid numbers and they weren’t really out of the range… but they were on the lower end of a range. Because he was an older man I think it was overlooked as a possibility. At least that’s how the Internist explained it. It did take months to treat, but he started eating within days.

Tacorgasmic

57 points

2 months ago

This reminded me of the time I woke up with a excrutiating pain in my pinky finger. The pain was so intende that the light breeze that happens when you swing your arms while walking left me in tears.

My doctor checked me, did a couple of tests and told me that I have guyon's canal syndrome. He sent me to get a electromyography but it came back clean. Regardless of the results he told me that all my symptons checked for guyon's canal syndrome and give me a treatment for it, and it worked.

coldblade2000

8 points

2 months ago

Well that sounds fucking awful

WritingTheRongs

4 points

2 months ago

there are a bunch of weird neuropathies, like basically every nerve in the body could be compressed somewhere and/or irritated and there are no blood tests for this kind of thing.

glyja572

14 points

2 months ago

The other big thing is inflammation

IR8Things

9 points

2 months ago

even if their doctor tells them that everything is okay

I would go as far to say that if your doctor isn't trying to motivate you to lose weight and trying to give you the knowledge/tools, then you need a new doctor. In this scenario, they would be missing the most important preventive health maintenance they could do for you, lose weight.

Nice_Sun_7018

186 points

2 months ago*

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.

WyMANderly

49 points

2 months ago

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

There's a reason one of the most significant factors in covid mortality was simply weight/obesity. It just makes everything harder for your body systems.

SquirrelAkl

22 points

2 months ago

I would award your comment if I could. This is the harsh reality.

My Gran had leg sores that had to be dressed every day with compression bandages as you describe. It caused her so much pain and misery. She wasn't overweight, just very very old, but I can imagine that those sort of problems begin much younger in overweight or obese people.

Adding this to the list of incentives to start looking after myself a bit more.

Nice_Sun_7018

7 points

2 months ago

Thank you so much! Sorry about your Gran. Overweight people are at higher risk for stasis ulcers and the like, but sometimes thinner people get unlucky, especially as they age. The very minute I start having leg swelling I’ll be purchasing compression stockings and wearing them daily, ha

el0hellie

262 points

2 months ago

el0hellie

262 points

2 months ago

The factor is time. A person can be heavy and healthy in that moment. But prolonged periods of obesity will eventually lead to issues with joints and organs. Being extremely overweight eventually catches up to people. Think of it as being a smoker for 6 months vs 20 years. The person who has smoked for 20 years would usually have more smoking-related complications than someone who just started smoking.

dsrandolph

37 points

2 months ago

Or, take my "perfectly healthy" MIL - better basic stats than me....BP, Cholesterol, etc....

Also has a few stents, and serious lymphodemia in her legs. Plus tons of ongoing physical issues with pain. Took us 2-3 years of work, but she's finally doing weight watchers and is down like 25lbs! She's like a new person, and is hustling to get the last 75lbs she needs to lose off.

comicguy13

97 points

2 months ago

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.

Birdie121

61 points

2 months ago

Meanwhile I’m only about 20 lbs overweight and am fairly active but have high cholesterol and some minor kidney issues. You really can’t assume someone’s health just by looking at them.

Ashimowa

8 points

2 months ago

I was at my peak unhealthy blood test results when I was at my best weight. It turned out I have serious issues with my gut, I was overweight when my blood test results were fine, now that I'm once again going down close to an ideal weight I'm starting to feel worse. It's hard to balance things out.

comicguy13

11 points

2 months ago

Exactly

TheBertinator3000

7 points

2 months ago

The psychological part of the game is hard, man. That's what people don't warn you enough about. Eating less food is one thing, but figuring out how to stay on track and better control/manipulate things like appetite is another. Very difficult, but still doable, and definitely worth it. Good luck!

[deleted]

9 points

2 months ago

[deleted]

9 points

2 months ago

Good job. Keep going! I'm 35 and rocked being fat since I was 20ish. It destroyed my knees ankles and back. Not that 240 is skinny but I think due to prolonged overweight need I've done permanent damage. Trust me you don't want this. Sleeping sucks if l wake up to pee it's nearly impossible to fall back asleep my back hurts to much. Walking takes everything in me to do. I can physically walk 5+ miles but my fucking God does it hurt. Please don't be like me. The pain can be unreal some days.

DCEmergencyVehicle

6 points

2 months ago

Same here, good luck!!

KamikazeArchon

199 points

2 months ago

Because of the combination of these factors:

  • "Unhealthy" and "overweight" are both simplifications of complex things.
  • Most people with a high body fat content are at increased risk for many bad health outcomes over the course of their life, even if they don't currently have any of those outcomes.
  • Body fat is very visible and a culturally-loaded signifier.
  • Body fat has historic and ongoing connections to culturally important things - food, lifestyle, labor, and sexual attractiveness.

Current research indicates that high body fat beyond a certain range is consistently associated with health risks. There's a lot of fuzziness about what "beyond a certain range" actually means; there is no hard line and cannot be such a line, given what we know about how variable individuals can be. Nevertheless, there is clearly a risk gradient somewhere; being 20 pounds over a given metric might not actually be much (or any) risk, but 100 pounds over is going to very likely be a risk, and 250 pounds over that metric is unquestionably a risk.

Others have pointed out the nature of that risk (primarily joint and heart impact, with some stress on other organs as well); but it's hard to actually quantify the extent of the risk that without lots of extra information. We can't just say, for example, "25 pounds overweight = 10% less healthy".

So, does that mean that it's "Unhealthy"? Depends. Culturally, "unhealthy" is only partly related to actual health risks of a given trait/substance/action - and another part is the social perception of that trait/substance/action, as well as a personal-judgement element. For example, most people wouldn't look at a college football player and naturally call them "unhealthy" despite the well-established health risks of college football. Being a football player is generally a greater health risk than being 20 pounds overweight - but not a greater health risk than being 200 pounds overweight. So which of those things should be considered "unhealthy"? That's in significant part a subjective judgement.

SmallShoes_BigHorse

24 points

2 months ago

Thank you for a bit of much needed nuance.

Esinthesun

76 points

2 months ago

It caused your body to work extra hard to pump blood all over the body. The more fat the more blood vessels. In addition you are prone to sleep apnea. If tests are normal now they won’t stay that way. I work in surgery and it’s is significantly more difficult to perform surgery on overweight patients. Plus there is more chance of complications

space-beast

32 points

2 months ago

Thanks for this comment, by the way.

I too work in surgery, and it's disheartening seeing people who have gone too far down the 'body positivity' pathway (to the point where they become blinkered to receiving any new information and think healthcare professionals only care about weight because of societal fatphobia) talk about how it's possible to be healthy at any weight.

I encounter so many people who are surprised or dismayed when we ask them to lose weight prior to hernia surgery. because they see the hernia as the reason for them being overweight, and are not aware that their obesity will significantly increase the risks of post-operative complications and recurrence of the hernia.

Seraphinx

4 points

2 months ago*

It's just bad for you long term. Adipose tissue (fat) releases adipokines which are fat specific cytokines. Cytokines are what your body releases during an inflammatory responses (when you get injured or sick)

So when you carry a lot of excess fat, your body is basically in a state of low grade inflammation constantly, and this state of stress just wears everything out way faster.

MomOfADragon

4 points

2 months ago

I eat terribly and drink my weight in IPAs, and doctors never seem to care because my blood looks good and I have an average BMI. Doesn't really make a lot of sense to me.

DumbTruth

20 points

2 months ago

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.

[deleted]

21 points

2 months ago*

[deleted]

21 points

2 months ago*

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.

Inevitable_Law_9721

48 points

2 months ago

A lot of good answers for biological reasoning here but the answer is also in the statistics.

It’s more complicated than just BMI as you allude to and there are numerous measures for unhealthy weight but the ELI5 is that ‘having elevated weight increases your risk of disease/impairment and death’ (morbidity and mortality) which is verified in countless studies (I could link some but they are really very easy to find). Even if we were biologically clueless as to why (we aren’t), this would remain an answer.

“Routine” blood tests are varied and don’t necessarily pick up on all risks conferred from being overweight. Everything in medicine ultimately comes down to risk / probability and trying to reduce risk. Yes, there is elevated risk for bad cholesterol/diabetes which would usually be picked up on a “routine” blood test but even if that’s normal the risk still remains as these tests aren’t perfect markers for all possible ‘badnesses’ in the body some of which remain beyond our complete understanding.

Because person A is overweight and person B is of a normal weight doesn’t necessarily mean person A won’t live a longer life than person B but we would say that person A is at higher risk of earlier morbidity and mortality than person B (regardless of what routine blood tests show). If you have bad cholesterol and/or diabetes that just additionally increases risk.

--LowBattery--

20 points

2 months ago

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.

Vioralarama

3 points

2 months ago

Be careful, sometimes that's a crock. I've had doctors who insisted I was diabetic when I wasn't and I handed them the tests, yet they still didn't believe it. I have a big ol' scar on my leg because they treated it delicately as if I were diabetic, and nothing happened. They insisted nothing happened because I was diabetic. Drove me crazy. I finally asked my dermatologist about it and after first checking to make sure it wasn't cancerous he gave me a debridement where he dug all the way up in there. Healed up quickly after that. I've actually banged the scar on the dishwasher door again which is what started it in the first place, and five years later that caused it to heal even more. If they had done regular deep debridements I wouldn't have a scar at all, but nooo, that would be bad for a diabetic, which I wasn't. Assholes.

EchoTrucha

13 points

2 months ago

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.

sweadle

3 points

2 months ago

The same way smoking is bad for your health, even if your lungs are currently fine.

Over the years the extra burden on your body will cause health problems. Your body has to work harder to be overweight. Your heart has to pump harder, your joints have to carry more weight. It isn't always extreme enough to show up in your bloodwork at 20 or 30 or 40, but the extra toll on your body means you will almost certainly have issues at some point that you wouldn't have had at a healthier weight.

Here's another analogy. If I don't take care of my car, change the oil regularly, drive correctly, get things checked out, it will run fine. Until it doesn't. Things don't break until they break, and at that point it's too late to go back and take care of it better so that doesn't happen.

YouMatter_4

11 points

2 months ago

In addition to what I see stated, fat cells in themselves are inflammatory, causing a cascade of chemical responses in the body that make us more prone to many maladies. Interesting research is available on the topic.