Obesity

Obesity is more than just carrying a little extra weight. When you’re obese, it means your body carries so much excess fat that it alters your metabolism and affects the functioning of your immune system. It is strongly linked to a range of chronic diseases including heart disease, stroke, cancer, osteoarthritis, chronic respiratory diseases and diabetes – and it can reduce your lifespan.

Although it can be difficult to fight obesity, a vegan lifestyle offers the best tools and primes you for success. Read on to learn how and why.

What is obesity?

Healthcare professionals define obesity as having a body mass index (BMI) of 30 or more (being overweight is characterised by a BMI between 25 and 30). However, BMI cannot tell the difference between muscle and fat – if you have a lot of muscle, you may be classed as obese despite having low body fat. In which case measuring your waist-to-hip ratio may be a more useful way to determine obesity and your risk of related conditions.

Obesity means there are large areas of fatty (adipose) tissue in your body, not just under the skin but surrounding your organs and potentially interfering with their function and with your metabolism.

Obesity changes how your body works

Obesity is considered a disease because it alters the functioning of your whole body and can increase the risk of many other health conditions. Here’s a brief overview of the main issues it may cause.

1. Heart and blood vessels

Obesity increases your risk of heart disease and atherosclerosis (narrowing and hardening of blood vessels). It increases the fat levels in your blood, including cholesterol and triglycerides, increases blood pressure, promotes blood vessel inflammation and increased blood clotting. All these factors greatly increase the risk of heart disease but also the risk of serious events, such as heart attack or stroke.

Inflammation induced by obesity increases LDL (bad) cholesterol oxidation, which can lead to cholesterol plaque build-up and interfere with the normal functioning of blood vessels.

Abdominal obesity – large waist circumference – is considered a particular risk and is linked with fat storage in the liver and around the heart. The longer a person carries this excessive fat, the higher the risk of heart disease and related events.

2. Immune system

As fat cells (adipocytes) store more fat and grow bigger, fat mass increases but blood flow in the fatty tissue decreases, so less oxygen is available to the cells. At the same time, the fatty tissue starts producing its own hormones and these, together with the lack of oxygen, cause over-activation of the immune system and stimulate the body to trigger inflammatory reactions and release pro-inflammatory molecules. Some of these changes also inhibit the anti-inflammatory reactions that would normally be activated to combat inflammation.

To make matters worse, the whole situation may even be further enhanced by obesity-associated gut inflammation. This negatively affects your immune system and reduces your ability to fight both inflammation and infection.

In practice, it means infections may last longer and could be more difficult to treat, wounds can take longer to heal and there is an increased risk of skin rashes or lesions that may be easily infected.

3. Breathing

Too much fat in your body can put pressure on your airways and cause physical restriction leading to decreased airflow. This can make it more difficult for you to breathe and it may also increase your risk of developing some respiratory conditions. These may include high blood pressure in the lung blood vessels, blood clots that block the blood flow to the lungs, respiratory tract infections, obstructive sleep apnoea, asthma, obesity hypoventilation syndrome and chronic obstructive pulmonary disease (COPD).

4. Sleep

Not getting enough sleep can lead to a hormone imbalance in the body which makes you want to eat more and promotes weight gain. However, obesity itself negatively affects sleep and so it creates a cycle of poor sleep and excessive eating. On top of that, obesity often comes with obstructive sleep apnoea – a sleep disorder in which your airway partially or fully collapses, causing loud snoring and breathing issues.

5. Digestive system

Obesity creates vicious circle of eating too much and still not feeling full or satiated. This is mainly because the fatty tissue in your body starts producing its own hormone, leptin. This hormone binds to leptin receptors in the brain, which recognises it as ‘enough food, stop eating’ and would normally stop you from eating more.

However, if you’re obese, you have too much leptin all the time and your body may develop a defence mechanism – leptin resistance – it becomes insensitive to leptin. This means you want to carry on eating but at the same time, it also leads to poor absorption and metabolism of nutrients. Leptin also promotes the release of inflammatory molecules in your body and so contributes to the chronic inflammation associated with obesity.

As if that wasn’t enough, obesity increases the risk of several diseases of the digestive tract. One of them is gastroesophageal reflux disease in which the contents of your stomach leak into the oesophagus, causing heartburn. It’s not only troublesome, it can also disturb your sleep as lying down can trigger symptoms.

Some of the main digestive system diseases associated with obesity are non-alcoholic fatty liver disease, gallstones, inflammatory diseases of different parts of the digestive tract, haemorrhoids, colon polyps and cancer.

One of the characteristics of obesity is also gut dysbiosis, which is an imbalance in gut bacteria which can cause a whole range of issues from poor digestion to gut inflammation and altered appetite control.

6. Blood sugar and diabetes

The more fat you carry, the higher your risk of type 2 diabetes. This is because the accumulation of an excessive amount of body fat triggers a chain reaction of changes that greatly increase your chances of developing the disease. When the fat stored inside cells reaches a certain level, the cells stop being able to react to insulin, the hormone (produced by the pancreas) that allows sugar from your blood to enter the cells. This is called insulin resistance. When sugar cannot enter the cells, there’s too much of it in the blood and not enough in the cells where it’s needed as a source of energy.

High blood sugar levels can cause damage to blood vessels, which is dangerous particularly in organs such as eyes, kidneys and the heart. To restore some balance and lower blood sugar levels, the liver relays excess blood sugars to fat cells, which store it as body fat.

At the same time, the pancreas is producing more insulin to remedy the high blood glucose levels but over time, this over-production leads to the exhaustion of the insulin-secreting β-cells. This may result in a lack of insulin which only worsens the situation.

It’s been shown many times that when people change their diet and lifestyle and manage to lose some excess fat, their insulin sensitivity can be restored and type 2 diabetes may even be reversed. A healthy vegan diet has been particularly effective at that.

7. Fertility

Obesity carries a high risk of reproductive health issues in both men and women. In women, obesity is often associated with menstrual cycles and ovulation problems and may increase the risk of complications during pregnancy. Obese women also have lower conception rates and a higher risk of miscarriage.

Obese men may have reduced sperm quality, low testosterone levels and erectile dysfunction. The relationship between obesity and testosterone appears to be inverted – the more weight you carry, the lower your testosterone levels – this is likely the result of other hormonal changes in the body (including insulin and leptin production, described above).

When it comes to sperm quality, researchers suggest this may be reduced due to obesity-induced increased oxidative stress, inflammation and sperm DNA damage. Higher temperature in the scrotum, caused by increased body mass has also been shown to have a negative effect on semen parameters.

These changes, however, are not irreversible and weight loss can achieve significant improvements in reproductive function in both sexes.

8. Mobility

Being obese puts a lot of pressure on your joints and together with obesity-induced inflammation, can lead to joint pain and stiffness. You may also experience balance and coordination problems as well as a reduced range of motion due to increased body mass – all these issues can then lead to reduced mobility, sometimes also called mobility disability.

In practice, it means that moving about hurts and you’re less stable. You may also be more likely to develop osteoarthritis in your knees, for example, than non-obese adults which causes pain, swelling and slow degeneration of the joints. When you experience pain, you’re likely to move less and may alter the way you move and that, in turn, can cause more pain in different areas.

While all this sounds depressing, weight loss achieves relief from most symptoms. It’s important to be active but also to adapt the type and level of activity to your needs so you achieve success instead of disappointment. Walking more can be enough to start with.

9. Cancer

Obesity is associated with an increased risk of a number of cancers. These include cancer of the uterus (endometrial cancer), oesophagus, stomach, liver, kidneys, pancreas, colon and gallbladder. In postmenopausal women, it also increases the risk of breast cancer. It is thought that it’s because fatty tissue produces its own oestrogen, which increases the risk of hormone-sensitive cancers, such as breast or endometrial cancer.

Another possible reason is that obese people often have increased levels of insulin and insulin-like growth factor-1 (IGF-1) and these may promote the development of colon, kidney, prostate and endometrial cancers. At the same time, high levels of leptin – produced by fatty tissue – may also promote abnormal cell proliferation.

Add to that the weakened immune system and chronic inflammation and it becomes clear why obesity may increase your risk of certain cancers. The good news is that reducing your body weight will also reduce your risk of all these cancers.

What makes you more likely to be obese?

There are many factors that might increase your chances of putting on too much weight, such as socioeconomic status, community environment, your upbringing, genetics, stress and overall health (both physical and mental). However, your diet and lifestyle choices are the main factors by far and are also the ones you have control of.

Eating habits

When it comes to diet, eating large amounts of food high in fat and sugar (junk or fast food and processed foods), frequently eating out or buying take-away food (which tends to be higher in fat and sugar than home-cooked meals), drinking too much alcohol and sugary drinks and comfort eating increases your risk of putting on too much weight.

You probably know that and perhaps some of these bad habits run in your family but – with enough willpower – you can change it. You may even be addicted to certain foods or sugar and you can also break out of that. Give any change four weeks and it becomes your new normal – smaller, partial goals are better than one unreachable big goal.

Being inactive

Lack of physical activity is another factor that often contributes to obesity. Many of us have desk jobs or work where we don’t move much during working hours. If you also sit during your commute and relax by watching TV or spending time on your computer or phone, you can easily become much less physically active than what’s considered healthy. A sedentary lifestyle is also suited to snacking more and so it may create a vicious cycle of eating too much while moving too little.

You don’t need to live on salads and run marathons to be healthy. In fact, that combination is certainly not a good idea. But having a balanced diet is important and so is engaging in physical activity, even if it’s just a daily walk. It supports both your physical and mental health. See more on gentle exercising below.

Why and how a vegan diet helps

Diet and lifestyle modifications, along with mental health support, are paramount to treating obesity and reducing the health risks associated with it. A wholesome vegan diet can be a true life-changer for obese people because it not only makes us healthier and achieves gradual weight-loss, it does that without portion restriction and cake isn’t off limits.

Across scientific studies, vegan diets are the most successful in achieving healthy weight loss – more effective than vegetarian and other diets. For example, in a 16-week trial of a low-fat vegan diet in overweight and obese people, participants lost around six kilograms (just under one stone), their metabolism slightly increased (so they would naturally burn more energy), they reduced the amount of fat inside their livers by a third and lost 10 per cent of fat from their muscles, their insulin sensitivity improved (important for diabetes prevention) and their cholesterol levels dropped.

Perhaps you’d want a more rapid weight loss, but that wouldn’t be healthy or sustainable. Most people who lose large amounts of weight quickly end up with the yo-yo effect – putting weight back on because their diet and lifestyle changes weren’t sustainable for them.

Because a healthy vegan diet is based on wholefoods, it improves how your body works and regulates your energy intake:

Plant-based foods are rich in fibre – plentiful fibre intake increases food bulk in the digestive system and makes you feel fuller for longer; it also ensures slower energy release from foods so you don’t experience sudden energy highs and lows (as you would after eating sugary foods and/or refined carbohydrates such as white bread, cakes and biscuits).
Most plant-based foods are lower in fat than animal products and contain healthier fats – that not only naturally reduces your fat intake but also makes your body work better. Plants mostly contain healthy unsaturated fats and are low in cholesterol-raising saturated fats – this scenario helps reduce your risk of heart disease.
Plant wholefoods are nutrient-rich – aside from fibre and healthy fats, plants contain plenty of protein, complex carbohydrates, vitamins and minerals, which are not only good for you, you need them for your body to work at its best. It’s not unusual for obese people to be malnourished – lacking vital vitamins and minerals for example. A balanced vegan diet is very nutritious and boosts your health while helping you lose weight.
Plants supply plenty of antioxidants – an increased intake of antioxidants improves your metabolism, reduces inflammation and supports beneficial gut bacteria that have multiple positive effects on your health.

Getting your vegan diet right

Just as joining a gym but never going will not help you get fit, going vegan but living on junk food will not help you lose weight. Don’t forget that chips, biscuits, sweets, deep-fried snacks and ice-cream are or can be vegan but building your menu from these items certainly won’t help you become any healthier.

A balanced vegan diet is based on pulses, wholegrains, fruits, veggies, nuts and seeds, and accompanied by vitamin B12 and D supplements. See the next sections for more information.

Viva!’s 5 steps to healthy weight

1) Eat plant-based, mostly wholefoods

– every day, you should eat a variety of plant wholefoods:

- pulses for protein, minerals and healthy carbohydrates (peas, beans, lentils, chickpeas, soya) and products made from them, eg hummus, falafel, tofu, tempeh
- wholegrains for healthy carbohydrates, B vitamins and protein (wholemeal bread, wholewheat pasta, oats, brown rice, quinoa)
- fruit and vegetables for vitamins. minerals and antioxidants (fresh, blended in a smoothie, steamed, boiled, baked)
- nuts and seeds for protein, healthy fats, vitamins and minerals

Add plant milks and yoghurts, healthy snack bars made of dried fruit and nuts and, if you want, some mock meats a couple of times a week. Top it up with vitamin B12 every day and D if you need in in the winter (or all year round if you cover up) and a good source of omega-3 fats and you have a healthy diet that will effortlessly help you become lighter and healthier!

2) Choose your treats wisely

– if you try to be super-healthy and become too strict with your diet, you’ll likely fail and feel discouraged. It’s best to come up with some half-healthy treats that will satisfy your cravings while not undermining your overall diet. These may be, for example, a couple of squares of dark chocolate with nuts and dried fruit, wholemeal digestives, chocolate-covered rice cakes, various chilled vegan desserts, lentil crisps, roasted salted nuts and olives, vegan pizza or ice cream. Once in a while you can even enjoy a slice of cake.

Remember that these are treats only – to be eaten in small portions and not three times a day!

3) Distribute your meals evenly

– skipping meals tends to lead to overeating later. If you plan your meals and snacks so you eat every two or three hours, you should have a steady supply of energy and not feel ravenous before your next meal.

4) Hydrate healthily

– proper hydration is very important, especially when you’re making healthy changes in your life. Not drinking enough water can make you feel tired, headachey and even peckish. It’s also bad for your kidneys that are already under stress in obese people.

Healthy drinks include water, herbal tea, water infused with fruit and ginger or mint, two to three (maximum) cups of tea or coffee and – not more than once a day –diluted fruit juice.

5) Move about

– many recommendations for general fitness may not apply to you because your body has different requirements and limitations than an average person. If you experience pain or shortness of breath, there’s no point in making yourself suffer through a gym session. Begin slowly, gradually building up how long and how much you exercise.

A good start would be a daily walk, choosing to take stairs (even just going up one floor), gentle yoga with modifications, a DIY project that would make you move about and perhaps joining the gym for access to some more gentle activities, eg exercise bikes.

Sample menus for healthy weight loss

Virtually every weight-loss programme suggests a low-calorie diet and eating less than 2,000 calories a day. It may work for some people but not everyone is suited to calorie counting and it may trigger unhealthy obsessive behaviours.

We promote a healthier approach. Eat plants, mostly wholefoods, don’t add too much fat/oil and don’t rely on ready-made meals. Here are two sample meal plans for healthy weight loss:

Meal plans for healthy weight loss

Meal plan 1

Breakfast: Muesli with plant milk, chia seeds and frozen berries

Snack: Banana and a small handful of nuts

Lunch: Wholemeal tortilla wrap with beans, veggies, smoked tofu and your choice of sauce

Snack: Rye crackers with hummus and veggie sticks OR fruit and nut snack bar

Dinner: Bean chilli with roasted potatoes or sweet potatoes, steamed broccoli or rocket/watercress salad

Dessert: A couple of squares of dark chocolate, fresh or dried fruit

Meal plan 2

Breakfast: Wholemeal toast with a savoury spread (paté, yeast extract, hummus), sliced tomatoes and/or cucumber and roasted seeds

Snack: Fresh fruit and a couple of oatcakes

Lunch: Tomato and lentil soup, wholewheat pasta salad

Snack: Plant-based yoghurt, dried fruit and a tablespoon of nuts

Dinner: Stir-fry or curry with tofu or mock meat, rice, veggies

Dessert: Two chocolate-covered rice cakes or plant-based yoghurt and fruit

We have hundreds of healthy vegan recipes for you to try or get inspired by, head over to our Vegan Recipe Club’s Healthy recipes.

How to exercise when you’re obese

Sadly, many doctors don’t realise that exercise recommendations certainly aren’t ‘one size fits all’ and may suggest some utterly unsuitable activities. You have to be careful about your joints and back to avoid not just pain but also injuries.

Ideally, you should engage in some physical activity daily – 30 minutes is enough and you can even break it down into two 15 minute sessions. If you do housework, such as hoovering or dusting, that counts too.

Take 30 minutes as your goal to work up to and if you start feeling like you want to do more, you can make your exercise longer once you are more used to your new lifestyle. Be mindful of your body’s needs and limitations and adapt what you’re doing accordingly. That doesn’t mean you should stop when you get slightly tired but neither should you push yourself to the point of fainting, falling or suffering through a lot of pain.

Here are some activities that might be right for you:

Walking – an ideal activity as you can do it anywhere, you’re in control of how fast and how far you go and you can gradually build it up.

Cycling – a great activity that spares your joints as there’s no hard impact. Exercise bikes are excellent as you can cycle in any weather and watch your favourite show or listen to a podcast.

Cross trainer – another exercise machine found in the gym – this one trains your upper and lower body and doesn’t put any significant stress on your joints because your limbs make an elliptical movement – you move your feet in an oval pattern while using handles to work your arms. It’s similar to a stepper but much better. You can go as gently and slowly as you need to and don’t worry, they are popular with people of all shapes, sizes and abilities.

Yoga – slow paced yoga classes are ideal for beginners, no matter what your body shape is. You work with your own weight and gradually increase your mobility, strength and stability. If you prefer, you can choose online yoga videos to follow. Just remember to take it slowly and listen to your body.

Swimming – water can be your best support as it literally takes weight off your joints. Many people are self-conscious and let that stop them from swimming – try to not let that stop you. Moving about in water can truly bring huge benefits to your health.

Gardening or DIY – these activities don’t necessarily train your body but they make you more active and give you a positive focus point.

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