Obesity is a huge problem in our country, pun intended. According to the Centers for Disease Control and Prevention, more than one third (37.9 percent) of adults aged 20 and over in the US are obese, which is defined as having a Body Mass Index of 30 or above. Obesity puts people at risk for a number of health problems, including high blood pressure, heart disease and stroke.

One of the most common health conditions associated with obesity is diabetes, specifically Type 2 diabetes. These conditions are so intricately entwined that experts have coined the term “diabesity” to describe their relationship. Type 2 diabetes accounts for 95 percent of all cases of diabetes in the US, and more than 90 percent of people with the disorder are overweight or obese.

Our bodies need energy to function, and they get that energy from the food we eat. During digestion, food is broken down into a sugar called glucose that travels through the bloodstream. Insulin, a hormone made by the pancreas, is like a key. It opens up your body’s cells to let the glucose enter to be used by the cells as fuel.

Some people’s bodies don’t make enough, or any, insulin, or they don’t use insulin appropriately, and glucose remains in the blood instead of getting into the cells. When the glucose level in your blood is too high, you’ve got diabetes. High glucose levels can damage many parts of the body, including the eyes, heart, kidneys, nerves and feet. With Type 2 diabetes, your body does not make or use insulin properly. Its onset can occur at any time, but it most often starts when people are middle-aged or older.

Many studies have demonstrated a link between obesity and diabetes, but just how diabesity occurs is complex and yet to be understood fully. What we do know is that people who are overweight or obese put added pressure on their bodies’ ability to use insulin properly to control glucose levels in their blood. This makes them more susceptible to developing diabetes.

One way obesity may lead to diabetes is by triggering changes in your metabolism, the processes that occur in your body in order to function. It’s believed that these changes cause fat tissue to release fat molecules into the blood. The increased fat in the blood affects the cells that are responsive to insulin and reduces insulin sensitivity. Calorie-dense foods leads to increased fat accumulation, and calorie-dense diets are common with overweight individuals.

When the body has to store excess fat and cannot properly control insulin levels in the blood, substances called free fatty acids are deposited in the liver, causing a condition known as fatty liver. Free fatty acids also move through the circulatory system causing reactions within other organs such as the pancreas, heart and muscles. This starts a vicious cycle of organ damage, inflammation, and deteriorating insulin resistance and insulin secretion from the pancreas.

Where the fat accumulates on your body is also a factor in diabesity. If your fat is primarily located around your belly, which is a predictor of visceral fat that lies around your internal organs, you are at an increased risk for developing Type 2 diabetes. Like diets high in fat and carbohydrates, visceral fat is associated with worsening insulin resistance.

It’s no surprise that major factors contributing to diabesity are chronic unhealthy behaviors, including eating a high-calorie diet and avoiding physical activity. We know weight loss has a beneficial effect on blood glucose control and fat metabolism, so lifestyle modification through changes in diet and exercise is generally the first diabesity management strategy. If you are also taking diabetes medications, your doses will have to be reviewed regularly, as they may need to be adjusted as you lose weight.

In certain cases, weight loss medications may be used to assist those with diabesity achieve and sustain substantial weight reduction. For some people, a surgical weight loss option, such as a gastric band or bypass, is a good choice, especially if they’ve not achieved positive results with lifestyle modification and medication therapies.

With 90 percent of people with Type 2 diabetes being overweight or obese, diabesity is expensive, too. More than one in five US health care dollars are spent on diabetes, about $245 billion. That doesn’t include the indirect costs of absenteeism, reduced work productivity, inability to work and lost workers due to premature death, accounting for another $68.6 billion.

Because it can damage many organs and tissues, diabesity lowers quality of life as well. If you are overweight, especially if you notice any symptoms of diabetes, have your blood glucose level checked by your doctor. Type 2 diabetes doesn’t always have symptoms, but some of the possible symptoms include increased thirst, frequent urination, hunger, fatigue and blurred vision.

Don’t wait until diabesity damages your body, get tested today, and get on the road to weight loss and glucose control. And a healthier, higher quality of life!

It’s easy to get obsessed with personal numbers these days. Put on a wearable like a Fitbit and see what I mean. The devices track your number of steps during the day, gauge your heartbeat, and record the amount of time you’ve slept at night. They can log your walking routes, with maps, and reveal how fast your feet were really moving.

You can sync to an app that records the calories you take in, for more fun with numbers. (Warning: if you’re trying to lose weight, the daily summary may be less encouraging on days you eat more. You might get something like this: “If every day were like today, you’ll reach your goal by April 18, 2022.” No consolation added if your big reunion is six months away.)

Of course, doctors will remind you that losing extra weight isn’t just about wearing a smaller dress size. The big payoff is better health.

In that regard, if you like tracking your progress in losing weight and getting fit, you might want to try using one of the simple health-screening tools that gauge risk for conditions like diabetes and heart disease.

The health-screening methods – that use BMI, waist circumference or waist-to-hip ratio – are based on research that shows body size and shape influences risk of certain diseases.

And they’re pretty simple. All you’ll need to get started is a scale and cloth measuring tape. Once you know where you stand, working toward “low risk” is another goal to strive for.

1. BMI: You’ve probably heard of body mass index, or BMI. The index categorizes people in ranges from normal to super obese. BMI is a formula that includes a ratio of weight and height. The easiest way to crunch the numbers is to use an online BMI calculator, such as this one.

Risk of poorer health goes up for people with BMIs that indicate they are overweight. It climbs higher still for those in the obese category.

A warning, though: For people who are lean and muscular, there may be a hitch. Their BMI can indicate “overweight” or “obese” when they aren’t. This is because muscle weighs more than fat, so their total weight is higher. They aren’t fat, but the BMI formula doesn’t distinguish between toned muscles and flab.

2. Waist circumference: How big is your middle? Where you carry extra weight makes a difference, according to obesity researchers.

It’s a matter of being shaped like an apple or a pear.

The apple-shaped have bellies that are bigger than their hips. Any extra pounds tend to pile up on their waistlines. It’s the opposite for people who are pear-shaped. Extra weight likes to go to their hips and thighs.

Women are more likely to be pear-shaped – until they reach menopause when hormone levels change and weight gain heads for the abdomen.

People who are apples tend to be more at risk for certain health conditions. Their expanded bellies indicate visceral fat. This type of fat lies deeper within the abdominal cavity and has been linked to conditions like heart disease and diabetes.

Optimal numbers are based on gender, and individual height and weight doesn’t matter. Ideally, women need to keep their waists to 35 inches or less. The benchmark for men is 40 inches or less.

A screening chart from the National Institutes of Health combines BMI and waist circumference and shows how an apple shape raises health risks. Look at the chart and you’ll see how a BMI that indicates “overweight” puts you at increased risk. Combine “overweight” with a higher-than-optimal waist measurement and the level jumps to high risk.

3. Waist-to-hip ratio:

The size of your waist in relationship to your hips is another simple screening tool for future health risks.

For instance, a British medical study looked at waist-to-hip ratio and how it relates to heart disease. Have a big waistline and comparably big hips? That could be less of a risk factor than having a big stomach and small hips, according to the study.

Again, it’s about too much abdominal fat. In the study, researchers suggest that abdominal fat might alter hormones in a way that increases risk of heart disease. A large waistline in proportion to hips also has been shown to increase risk of uterine cancer, and has long been linked to Type 2 diabetes.

To determine your waist-to-hip ratio, measure your waistline and your hips. Divide the waistline measurement by the hip measurement – or go online for a waist-to-hip ratio calculator.

Ideally, results should be less than 0.85 for women and less than 0.9 for men, according to the World Health Organization.

Happy tracking!

There are a slew of health consequences that go along with carrying excess weight. It increases the risk of many problems, including heart disease, Type 2 diabetes, kidney disease and joint disorders. What’s more, research has linked weight and obesity to many types of cancers.

As part of one study, researchers analyzed 204 previously published studies to explore a possible link between weight gain, obesity, waist size and 38 different cancers. The results, which were released in March 2017, found “strong evidence” supporting a connection between these factors and 11 types of cancers, including breast, ovarian, kidney, pancreatic, colorectal and bone marrow.

A study released in 2016 had similar results, finding solid evidence of an increased risk for 13 types of cancer. Their list also included breast, kidney, ovarian and colorectal, as well as stomach, thyroid, uterine and multiple myeloma, a blood cancer. According to the chair of the group conducting this study, the 13 cancers they identified together account for 42 percent of all new cancer diagnoses.

When studying the link between weight and disease, researchers generally use a measurement known as Body Mass Index, or BMI, which is a ratio of weight to height. A BMI between 18.5 and 24.9 is considered a healthy weight. A BMI of 25 to 29.9 is overweight, 30 or above is obese and 40 or higher is morbidly obese. In general, the higher the BMI, the greater the risk for health problems, including the cancers studied.

There are several ways extra weight can affect the body and increase cancer risk. For one, it increases the levels of insulin and insulin growth factor-1. Higher levels of these substances may help some cancers develop. Also, obesity tends to affect immune system function, causing chronic, low-level inflammation, which is linked to an increase in cancer risk.

People who are overweight also release higher amounts of certain hormones like estrogen, which can feed the development of cancers such as breast and endometrial. Finally, fat cells themselves, might have an effect on the way the body regulates cancer cell growth.

If you need more convincing: The World Cancer Research Fund says excess weight contributes to as many as one out of three of all cancer-related deaths. Further, they estimate that about 20 percent of all cancers diagnosed in the US are related to body weight, physical inactivity, excess alcohol consumption and/or poor diet, and thus could be prevented.

Does this mean all I have to do is lose weight and I’ll be fine? Actually, there’s been more research done on the link between weight and cancer risk than on the effect on risk of losing weight. What is known is encouraging and suggests losing weight is beneficial.

Most researchers and health care professionals agree. Avoid gaining weight through your adult years. If you are already overweight, try not to gain any more, and it will certainly do you well to take off a few pounds. Losing weight will lower your risk for many cancers, and other health problems as well.