Weight change & associated health problems

Physical benefits of losing weight and effect on chronic conditions

“To be able to do that (climbing a hill) is like, well, gold medal and it’s all down to weight loss. That’s all it is. My bones were aching. My knees used to hurt. My hips were hurting. All that’s gone. It’s completely gone.” Janet

For people who have a weight related chronic health condition losing weight will often have a beneficial effect on their health. Losing weight also reduces the risk of acquiring further health problems, such as:

  • high blood pressure
  • heart disease
  • stroke
  • type 2 diabetes
  • some types of cancer
  • osteoarthritis
  • back pain

For most obese or overweight people health benefits can be seen with a loss of 5% of body weight or more (NHS website 2019, accessed 27/2/19).

The people we spoke to described a range of health benefits after losing weight, which we explore below.

Feeling better

In general terms, people said they ‘felt better’ after losing weight. Specific changes that were mentioned included:

  • Having more energy
  • Sleeping better
  • Having fewer aches and pains
  • Improved ability to move and get around
  • Getting less out of breath
  • Improved digestion
  • Taking less medication

Julie describes the physical and emotional boost of losing weight.

Julie describes the physical and emotional boost of losing weight.

Age at interview: 73
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

And then see, you know, you weigh yourself or you feel better, or you don’t feel so full or, you know, your clothes fit a bit better or something. And the strange thing is although I’ve lost quite a bit of weight I’m still wearing the same dress, still wearing the same size clothes. They’re fitting me looser, but I’m still wearing the same size clothes. I can get into a smaller size now, but I’ve got used to enjoying having all that extra. I’m so pleased to put on a dress and find there’s all this extra space that I don’t want to go down to a smaller size. It sort of, it, it gives me a great boost to see my clothes loose, you know, [laughs] not fitting properly.

That’s very interesting.

Yes.

Okay.

Yes, rather than go down to a smaller size, I’m, which is maybe just fits right and maybe makes me feel a bit, you know, ‘Oh and perhaps I should lose a bit of weight,’ I’ve put on my big clothes that I’ve worn and they’re big and then I can see, oh gosh you look so much, you feel so much better and you feel better when you lose weight. You can move better. I walk faster. If feel, I don’t feel so, you know, it’s such an effort. You realise after you’ve lost weight, God it was such an effort with all that weight, walking from a to b. You don’t realise what an effort it is when you’ve got extra weight on you. It’s only when you lose it that you realise how you can walk more freely. You can feel your hips moving when you walk. Not just your knees wobbling along, you know. It, it’s the whole feeling of, and that feeling, I enjoy that feeling. I find that very rewarding, just that feeling of being upright and pulling, you know, having a stomach that doesn’t stick out and I always used to look, and my stomach always stuck out further than my bust and now when I stand up it doesn’t. My bust sticks out more and its little things like that that are rewarding for me I mean from the vanity point of view it’s rewarding but from the mere physical freedom point of view of being, of being able to move more easily. Feel my hips move as I walk, instead of just wobbling along on my knees. It’s just that freedom that I enjoy so much.

So there is a kind of emotional boost?

Yes.
 

Six months in to her weight loss Jane is already feeling the benefits with improved energy levels and easier movements. She is proud of herself.

Six months in to her weight loss Jane is already feeling the benefits with improved energy levels and easier movements. She is proud of herself.

Age at interview: 42
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

Less tired. Yeah, I don’t, I have more energy, you know what I mean, and losing the weight I can actually, you know sit down, like I can do my laces and I feel like I can run to get the train, you know, I feel, you know, much more energetic, you know, like that.

And this has been just within the last six months?

Yeah, yeah, yeah.

How were you feeling before?

Yes, yes definitely. I mean, you know, when you’re climbing the stairs, you know, I feel, ‘Oh I’m tired and, you know, my belly is all up here.’ You know I do have a belly here, the baby weight and I don’t know how I’m going to go back. Yeah I feel frustrated and, and heavy, [sighs] you know, like slow not able to walk, you know, fast. Maybe not being able to get my train on time, you know what I mean, I used to run and say, “Oh no.” But now I can probably leave my daughter and then maybe run, you know, probably not all the way to the train but I can run fast and manage to get my train.

So how do you feel again emotionally to, to have been able to achieve this?

Yeah, I mean yeah, I mean I feel very proud and, and, and happy. You know, I was like, ‘Okay, I’m on the right track, you know what I mean. I can, I can do more, and it will be great for me, you know, if I would be able to run faster having the, you know, the strength to do more things. I think like great about it.
 

Managing a Chronic Condition

Those who had lost weight noticed positive differences in their chronic health conditions, including:

  • Less back pain
  • Less joint pain
  • Better control of diabetes
  • Lower blood pressure
  • Lower cholesterol
  • Better mental health
  • Improved asthma symptoms
  • Reversal of non-alcoholic fatty liver disease

Stuart lost weight before having a heart bypass operation.  He found that when he weighed less, he didn’t have as much back pain or pain in his legs from sciatica. Tommy described how a combination of losing weight and regular swimming had greatly improved his arthritis.

When David reduced his weight, it improved control of his diabetes and his blood pressure, which he monitors himself.

When David reduced his weight, it improved control of his diabetes and his blood pressure, which he monitors himself.

SHOW TEXT VERSION
PRINT TRANSCRIPT
Fortunately, my diabetes and my blood pressure both came under control with drugs and I also started monitoring, personally, my own blood pressure and blood sugar levels regularly and it didn’t take very long for me to work out myself that some foods were bad for me and also both the diabetes and the blood pressure were related to my weight so I started to try to reduce my own weight with some success but not an overwhelming amount of success but I did certainly notice for myself that, when I was able to reduce weight, it improved my control of both my blood sugar and my blood pressure and that’s largely been the situation ever since. I continue to monitor my weight. I continue to monitor my blood pressure and my blood sugar and, over time, I found out what things are worse for me. I find diet, I, my weight hovers between overweight and obese. I mean, as far as my body mass index is concerned I’m hovering between overweight and obese. And certainly, certainly it is clear that, if I am able to reduce my weight, it improves my general feeling of well-being, if you see what I mean.

Two years after having a gastric band fitted, Janet’s liver was back to normal.

Two years after having a gastric band fitted, Janet’s liver was back to normal.

Age at interview: 62
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

I decided that at the age of forty-nine that I had to something about this, not to make me look any different just to, you know, as a health precaution, I knew that I needed to do something. I’d got to that stage where this is just ridiculous. So, we decided that I would go and have this gastric band fitted which I did. I hadn’t even heard of this operation at that stage. A friend of mine visited from Australia and apparently it quite common over there so we did that.

When I came to from the operation, the doctor came to me and he said to me, “It’s a good job you’ve had this operation done today,” and I said, “Why’s that?” He said, “because you’ve got cirrhosis of the liver,” which really shocked me to the core and I first reaction was, “Well, I don’t drink.” Because I thought you just got that with drinking and he said, “No,” he said, “the cause of this, the biggest cause of this is the weight.”

So, I asked him, I said, “Will that ever repair itself?” Well luckily the liver is the only organ in the body that does repair itself. So after two years I went back for a liver test and it’s absolutely perfect. So that were that. But he also said to me, “Had I not had it done that day I would be dead before I were fifty-five.”

Everyday movements like climbing the stairs and getting in and out of the bath were easier for Hilary after losing weight. She wishes she had lost weight earlier.

Everyday movements like climbing the stairs and getting in and out of the bath were easier for Hilary after losing weight. She wishes she had lost weight earlier.

Age at interview: 62
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

And how does it make you feel to have lost all this weight?

I’m pleased with myself. I’m pleased with myself in the fact I said I was going to do it and I did it. I’m disappointed in myself because I should have done it earlier and I shouldn’t have let it get that far really. I should have been more concerned as the weight was going on but I feel much better for it. I feel much better physically. I know that I was wheezing when I was walking because of the extra weight. That doesn’t happen anymore.

It’s, I mean, we moved to this house because it’s, it’s easier to manage but also the stairs when you’ve lost a lot of weight, you realise how difficult the stairs were. But now that doesn’t bother me. It does with, with me knee, but that’s not something you can’t manage but when you look back at the way sort of I was and the things I couldn’t do. Getting in and out the bath was difficult because of coming up from so low and having knee damage anyway, it was difficult. But we had a walk-in shower put in, so okay, that’s great in the long term but it shouldn’t be the answer in the short term. Yeah.

Kate’s healthier, sugar free diet has had a positive effect on her blood pressure and her gut.

Kate’s healthier, sugar free diet has had a positive effect on her blood pressure and her gut.

SHOW TEXT VERSION
PRINT TRANSCRIPT
So I have many times between February and now found myself hovering in the confectionary aisle and just saying, “Do I really want to spoil what I’ve achieved because I feel so good about being a good weight. And it’s changed my, my gut in that, you know, instead of being. It’s changed my health. You know, I, You know I. My stools are different. my wind, you know, I’m, flatulence is non-existent and just lots, and lots of things have changed because of this sugar, leaving out the sugar.
 
So, you know, so once I did start working on my blood sugar level and my portion size and things it started going pretty quickly. People started saying, “Oh you look well.” And that happened pretty quickly as well. And you know that was, the positive feedback was very positive. And I went to the [Health Centre]. I should say about every two weeks I’ve been in there measuring my blood pressure. So…
 
Ok so
 
Really to prove Dr [Name] is wrong.
 
Ok. So when I was eating a lot and I was overweight I was farting a lot and my stomach rumbled a lot. I had this outrageous appetite and very loose stools. So now eating in a much more perceived to be healthy way but particularly without the sugar that’s all under control. I seem to be very, very, sensitive to sugar and digestion.
Even those with severe symptoms of co-morbidities, like Joan, Maxine Mary and Janet, saw an increase in their energy levels, a reduction in medication, less pain and/or better mobility (depending on the severity of the condition). However modest, the impact of losing weight on their co-morbidities improved their quality of life and wellbeing.

Although she could not see an effect on her arthritis, losing weight had been positive for Maxine Mary: “I feel so much lighter and fitter and there’s not so much pressure on my joints”. Joan was able to reduce her blood pressure medication and to walk a bit more but was well aware what would happen if she was to put on weight: “I’m sure my blood pressure would go up, my mobility would definitely decrease and it’s bad enough just now [laughs] I don’t do a great deal of exercise but I think it would have an adverse effect on what I’m doing just now”. Janet was able to reverse her liver disease, decrease her insulin dosage, and her asthma symptoms no longer affected her like they used to.

Joan talks about the physical benefits weight loss has had on her mobility.

Joan talks about the physical benefits weight loss has had on her mobility.

Age at interview: 57
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

First, first and foremost, I can move better now that I’ve lost. Don’t get me wrong, my walking is really limited. In the house, I’m not bad, it’s all on the flat. Going outside any gradient, you’re up hill or down hill causes me huge problems. Before I could really struggle to get into my car. Now I can probably walk to my car but when I get to my car I’m glad of a seat. What happens when I walk is my two legs feel as if they weigh tons and I find it hard to lift them up and move them and I get pain running mid back down the buttocks down my legs. On the left side it goes right down to the knee. On the right side, it just goes to the thigh. When I sit down the pain goes away. So I what I tend, how I started increasing the amount I walk is [street name] is a great place to walk because there’s lots of benches [laughs]. So I would start from where the disabled parking is to Costa. Have a seat and then I would walk to one bench, have a seat and then I walk to the other bench. Now it took me about three months, but I can, still stopping and starting but I can make it to [shopping centre] which was do you know, I thought, ‘Right, do you know what you’re going to do is one day get down to the front door there,’ which was great.

I started with the weight management doing chair exercises and I then go to a vitality class at the local gym which started on chair exercises but I’m now up to tone, it’s, you do maybe like a twenty minute warm up and it’s very gentle, it’s not and then it’s like there’s seven or eight stations that you do three minutes at and then I slow down, so I’m going to that once a week and that I think’s helping keeping me active. I’m also going to be moving flats, so I’ve had a lot of running about to do. But again, I’m really fortunate because my family and close friends have been really, really good, you know, but that’s probably the journey of the weight loss.
 

Those who ‘felt better’ after losing weight had often started to do more exercise, finding that exercise was easier or they had improved stamina. Sue X had so much more energy that she had started teaching Zumba four days a week! Losing weight and exercising in a safe environment under medical supervision made June X realise that she could exercise more without fear of injuring herself.

Since having a gastric band fitted, Janet can walk up hills without getting out of breath.

Since having a gastric band fitted, Janet can walk up hills without getting out of breath.

SHOW TEXT VERSION
PRINT TRANSCRIPT
Last week, I said to my husband, we’ve started, like I said, we’ve started walking only because kids bought me a Fitbit for Christmas [laughs] and I said, “Let’s walk up this hill which is, it’s an incline,” and we walked up to the top all the way round, nice walk, about five mile, yeah about five mile it is.

But walking up the hill was my nemesis and I walked all the way up that hill and I never struggled for breath. As I were nearly at the top and only because my husband were talking to me. If he hadn’t have been talking I wouldn’t have thought about it but I caught it a couple of times.

So for me to be able to do that at my age and I’ve had the chronic asthma like I’ve had when I were younger, to be able to do that is like, well, gold medal and it’s all down to weight loss. That’s all it is. My bones were aching. My knees used to hurt. My hips were hurting. All that’s gone. It’s completely gone.

I can safely say to you, I do 25 hours a week dancing, never bothers me that. I can dance, I can dance seven, eight hours. Never get out of breath. Never, my heart is not racing, there’s nothing. But walking up hills were always the one [laughs] and I can do it. Yay [laughs] Gold medal.

Since losing weight, June has been climbing hills in the Lake District and has walked the West Highland Way. A physiotherapist-led class taught her that she can do much more physical activity than she thought she could.

Since losing weight, June has been climbing hills in the Lake District and has walked the West Highland Way. A physiotherapist-led class taught her that she can do much more physical activity than she thought she could.

Age at interview: 69
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

Okay and in terms of your levels of physical activity, I mean have you seen a difference when you lose weight?

Well the difference is, the difference is, the difference is doing the West Highland Way, the distance is climbing hills in the Lake District. The distance is a couple of Monros (Scottish mountains), that’s the difference.

Okay and when you have…

We’re really talking all the difference in the world.

So from a physiotherapy point of view in an exercise class I can’t say that I learned so much about exercise per se, but what they were, what they were doing which I absolutely believe in and what I was reminded of which I have to remind myself or be reminded of, every time I put on a lot of weight and I begin to lose the weight, is the physical activity that you can do which is usually much more than people think that they can.

You can usually stretch further, they, one of the problems with obesity is you tend to let yourself off with a lot and believe that you are, you either can’t stretch so far or you’re going to hurt yourself if, through certain activities, and if you exercise consistently and stretch consistently in a properly safe environment, which is what the physiotherapists are doing on the programme and they are excellent and they’re what would you say, lovely girls [laughs] Yeah, they’re a bunch of really, really nice people, the whole lot of them actually, and they have a tremendous sense of humour and all the rest of it and again, it’s they have the expertise. They are, one assumes, in that capacity, it’s unusual to get more than one of them, but you do I’m sure in that environment because there are safety and health issues to do with extreme obesity therefore they want to be absolutely certain that any heart difficulties or any mobility difficulties they’re on top of instantly and they’re, they’re terrific and they’re very professional but I think that there is there are definite signs of people enjoying their time, exercising and, and beginning to get more out of it, and of course, that’s the whole, that’s the whole point because you can.
 

There was a history of high cholesterol in Shirley’s family. She describes how losing weight helped her bring hers down: “So, we all went in, got checked on our own sort of thing and I think I’d lost, I was down to my second stone when it started to check, he said, “It’s really dropped.” Because I was something like, I was something like seven point five and then I dropped straight down to six and then I went below the, with the next stone. So every time I was losing, the more I was losing, the obviously, the healthier I was eating, the better it was for my cholesterol.”

With the help of her GP, Shirley made changes to her diet that resulted in an improved cholesterol level. She is not on medication.

With the help of her GP, Shirley made changes to her diet that resulted in an improved cholesterol level. She is not on medication.

SHOW TEXT VERSION
PRINT TRANSCRIPT
Can you tell me a little bit more about it?

Yeah, he (GP) basically got me to, it was changing fats and things in my diet and I went from full cream milk to, it was just little things and he, he did tell me not to go onto, you know they do these yoghurts that are pro-bio or whatever…….

Probiotic.

Because he said that can give a false reading, which I found quite interesting because apparently it can lower your cholesterol, but if you come off of them your cholesterol can go back up. So just me changing,

Okay.

Just, just genuinely fats and things like that and I stopped drinking cider and things. I went onto wine and it was just lots of little things that helped with my weight that brought my cholesterol down.

So like for instance, you stopped eating butter…

Yeah.

….and you went to margarine?

Yeah, things like that.

And cream?

Yeah, but nothing like major, I was never on high fat stuff really. But it was just little changes, like cheeses and things, because I’m a big cheese fan and he said, “Little things like that you can change with your, change your cholesterol,” and I was quite interested in that.

So how long, how long you had to do these changes before your cholesterol became kind of more normal?

I think, I went and saw him, I’d lost a stone when I first went to see him because we all got checked, we all had, there was all, the whole family suddenly had this, we suffer with high cholesterol. So, we all went in, got checked on our own sort of thing and I think I’d lost, I was down to my second stone when it started to check, he said, “It’s really dropped.” Because I was something like, I was something like seven point five and then I dropped straight down to six and then I went below the, with the next stone. So every time I was losing, the more I was losing, the obviously, the healthier I was eating, the better it was for my cholesterol.
Losing even a small amount of weight can have noticeable positive effects on the health of people who are overweight or obese. Jane, who is on blood pressure medication, was recently diagnosed with type 2 diabetes, which motivated her to lose weight in order to manage her conditions. She started to do this by making small changes to her diet and so far, she has lost one stone and feels more energetic.

Feeling better’ was not always just a physical thing, but could include feeling happier or more optimistic [see ‘Mental and emotional benefits of losing weight’].
The physical and emotional benefits of losing weight could easily be reversed if people put the weight back on again. After her accident, Ellie found it difficult to continue with her weight loss programme and the weight crept back up again. As a result, the management of her type 2 diabetes is not as good as it used to be. In 2014, Ria lost weight and reversed her non-alcoholic fatty liver disease but her binge eating has led to an increase in weight since then. She is on blood pressure medication and worries about the prospect of needing to take insulin to control her type 2 diabetes.

After losing four stone Ellie was at the ‘cusp of coming off medication’ for high blood pressure and the HbA1c test results for type 2 diabetes went from 8.4 to 6.1. Her aim is to lose weight again and manage her health problems without medication.

After losing four stone Ellie was at the ‘cusp of coming off medication’ for high blood pressure and the HbA1c test results for type 2 diabetes went from 8.4 to 6.1. Her aim is to lose weight again and manage her health problems without medication.

Age at interview: 69
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

I was on medication by this time and the medication is horrendous and it gives you all sorts of bowel problems and sickness and nausea, so I thought, ‘I’m going to get off this. What can I do?’ So, I started going right through these forums and found that if you go on a low carb, high fat and start exercising, you can actually, maybe reverse or reverse the symptoms. You’ll never reverse it, but you would have to keep this up for the rest of your life, so I find that quite successfully. I lost four stone in maybe a year and I sort of tootling along at that and I was, I was on the cusp of coming off the medication when I had this accident.

So, hopefully I can get back onto that and try and get some of this weight off because I found it when the weight’s off, you can do more. You’ve got more energy and plus I can sleep better. If I can get, if I can get a full night’s sleep, test myself in the morning, my numbers are down drastically, and I think there’s a definite link between the, the amount of sleep you get, good sleep and what your blood sugars going to be.

So that was my aim was to get my blood sugars down and get off the medication and that way I felt like my life would be going somewhere rather than just waiting to die.[laughs]

Okay, so your diabetes control improved?

Oh hugely. I was never really that bad. You know how they do the numbers, I was always around about 8.4 and then they got it down to 6.1 and the one that they say when you’re, you’re not diabetic anymore is 5.9 and I couldn’t get there. I got stuck at 6.1 but it became an obsession to get down, so I was trying to walk more and more and more and then this happened and it just went.
 

Copyright © 2024 University of Oxford. All rights reserved.