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Atherosclerosis: What’s Weight Got to Do With It?

It should come as no surprise to hear that being overweight is bad for you. The majority of us could stand to lose a little -- or a lot -- of weight. More than half of Americans are overweight or obese.

Most of us know we'll look and feel better at a more healthy weight. But did you know that losing weight can help keep your arteries clear?

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Excess weight contributes to atherosclerosis, the No. 1 cause of death in the U.S. Fortunately, taking the weight off can slow down or prevent atherosclerosis as well. Read on for the skinny of how weight and atherosclerosis are linked.

The Link Between Atherosclerosis and Obesity

It's hard for researchers to nail down precisely how much being overweight causes atherosclerosis. That's because obesity often "runs with" other problems that cause atherosclerosis. Diabetes, high cholesterol, and high blood pressure are the prime examples.

Nevertheless, it's clear that excess weight itself can hurt you.

Obesity is an independent risk factor for cardiovascular disease.
Excess weight increases your chances of developing diabetes, high cholesterol, and high blood pressure -- all three of which are causes of atherosclerosis.

Excess risk comes with being overweight (body mass index, or BMI, greater than 25), but particularly with obesity (BMI greater than 30).

Atherosclerosis and Fat

For decades, fat bored most researchers. Excess fat was always felt to somehow contribute to disease, but not by actually doing anything.

In recent years, it's been discovered that fat actually lives a very active life: Fat secretes hormones and other messenger chemicals. These messages play a significant role in the "conversation" going on in our bodies.

The messages that fat sends out, though, are generally not helpful. Fat secretes cytokines (messenger chemicals) that create constant, low levels of inflammation in the body.

The hormones and cytokines that fat secretes contribute to atherosclerosis in several ways:

Resistance to insulin and poor regulation of glucose. This can cause diabetes or make it worse.
Reduced function of the endothelium, the lining of arteries. This makes them less "toned," inflamed, and more prone to atherosclerosis.
A greater tendency to clot. Blood clots are the ultimate cause of heart attacks and strokes.

Today, fat is seen as an active and important contributor to atherosclerosis.

Atherosclerosis and Abdominal Fat

Where the fat is matters, too. Abdominal fat -- the old spare tire -- may be the worst kind of extra pounds.

The next time you're at the tailor's, ask for your waist and hip measurements. Having a waist-to-hip ratio greater than 0.80 for women and 0.95 in men significantly increases your risk of atherosclerosis. So does having a waist larger than 35 inches for women and 40 inches in men.

Lose Weight, Lose Risk for Heart Disease

The good news is, losing the weight means losing some of your risk for atherosclerosis and heart disease. Experts agree that weight loss lowers your chances of having a heart attack, stroke, or circulation problems.

Excess weight increases the risk factors for atherosclerosis. Fortunately, this works in the other direction too. Lower, healthier weights lead to: