Is YOUR fat killing you? The subtle armpit change and 11 other signs chub has turned deadly

TURNS out all fat isn't created equal - there are two types of obesity and one is a whole lot more dangerous than the other.

But how are you meant to know if you're at risk of the deadly kind? The good news, there are some subtle, but telling signs - and here we reveal the symptoms that put you in the obesity danger zone.

Startling studies suggest that obesity is responsible for around 31,000 deaths every year in Britain.

Plus, it costs the NHS a staggering £6.5billion annually, and that figure is set to rise to £10billion by 2050.

We used to think of obesity as simply being fat or overweight (and crucially, having a body mass index above 30).

But new research says there are in fact two types.

“Pre-clinical obesity” is where someone’s excess weight is not yet impacting their health, while “clinical obesity” is when someone’s weight is a health problem.

The new definitions are set to move away from the traditional BMI measurement, where anything over 25 is considered overweight and 30-plus is obese and overall health and body fat percentage aren’t taken into account.

It could mean many of us are off the hook - at least for now.

Dr Thuva Amuthan, GP and dermatologist, tells Sun Health: “The new guidelines offer a more practical way to define obesity by shifting the focus from BMI alone to how weight is affecting day-to-day life and long-term health.

“BMI can still be a useful tool to screen for risk, but it doesn’t distinguish between muscle and fat or account for where that fat is distributed.

“Two people can have the same BMI but very different risks.

“A person with excess weight and no health complications may be considered ‘pre-clinically obese’, whereas someone whose weight is directly causing joint pain or breathlessness or many other symptoms we associate with obesity may fall into the ‘clinical’ obesity group.”

It provides further evidence that you really can be “fat and fit”.

If the NHS were to adopt these guidelines, it could only diagnose someone as clinically obese with a full measurement from a doctor.

However, Dr Amuthan says there are some clear obesity danger zone warning signs which shouldn’t be ignored…

ONE of the biggest definers of being clinically obese is when your weight impacts your day-to-day activities.

Persistent joint pain - such as sore knees or bad hips - that stops you from walking, working or doing housework would make you clinically obese.

Dr Amuthan says: “Knee pain that limits walking or daily activity is a clear sign your weight may be affecting your mobility.

“Every extra stone of body weight can add around four times that pressure across the knee joint.

“Over time, this can wear down cartilage and contribute to osteoarthritis, which often tips someone into a clinical obesity diagnosis based on functional impact.”

IF you’re short of breath after even mild activity, be warned.

This is one of the factors doctors look at when defining pre-clinical and clinical obesity as it’s a sign your weight is placing strain on your cardiovascular system.

Dr Amuthan says: “If you're getting out of breath doing simple things like walking up the stairs or carrying shopping, it might be a sign your weight is affecting your lung and heart function.

“The heart has to work harder to supply more oxygen to carry the excess weight.

“It’s a common early symptom as people move from pre-clinical to clinical obesity.”

THE body mass index is a formula used to decipher whether patients are of a healthy weight.

Measurements may also reveal that you are clinically classed as underweight, overweight or obese.

How do I calculate it?

If you're good with numbers then you can divide how heavy you are by your height in metres squared.

But who wants to do that when the NHS has created a handy tool for you to use.

It evaluates your age, gender, height and weight, before estimating your BMI.

When do I need to worry?

After you have calculated your BMI you will be given a number, usually between 18.5 and 30.

Those who have a BMI of 18.5 to 25 are considered to be a healthy weight.

If your number is between 25 and 30, you are considered overweight and if it goes above 30 you're considered obese.

The NHS recommends people stay within the healthy weight for their age and height.

If you are not within a healthy weight range, you are at a much greater risk of obesity-related illnesses like heart disease, stroke and diabetes.

But on the other end of the scale, you can also be underweight.

Anyone with a BMI under 18.5 is considered underweight and is more at risk of immune system problems, fragile bones and infertility

EXTRA weight, especially around the abdomen, strains the spine and affects posture.

People often compensate for that by changing the way they stand or move.

But over time this can cause mechanical issues which result in lower back pain.

So if you have this, it could be caused – in part if not entirely – by excess weight.

Dr Amuthan says: “Excess weight, especially carried around the midsection, shifts your centre of gravity and puts strain on the spine.

“Over time this can lead to persistent lower back pain or even sciatica.

“This can increase the wear and tear of your back over time and contribute to a clinical obesity diagnosis.”

UNDER the new Lancet guidelines, having sleep apnoea – a condition that causes snoring and stops you breathing in the night – and being overweight are both symptoms of being clinically obese.

Dr Amuthan says: “Snoring most nights, especially if it's loud and persistent, could be a sign of obstructive sleep apnoea – a condition linked to excess weight around the neck and upper airway.

“This often starts in the pre-clinical phase, where the airway is partially blocked during sleep.

“If left untreated though, it can progress to sleep apnoea and potentially clinical obesity.

“Even a modest weight loss of 10 to 15 per cent can make a big difference in reducing symptoms and taking you out of the danger zone of clinical obesity.”

HYPERTENSION, the medical term for high blood pressure, is a symptom of preclinical and clinical obesity in both the new and older obesity guidelines.

Almost all GP surgeries and lots of pharmacies have blood pressure measuring devices for members of the public to use for free.

Dr Amuthan says: “Obesity contributes to high blood pressure by making the heart work harder to pump blood.

“You may not feel unwell, but high blood pressure is a silent risk factor that increases your chances of heart attack or stroke.

“It’s also one of the markers that can signal a transition from pre-clinical to clinical obesity.”

EVERY blood pressure reading consists of two numbers, shown as one number on top of the other, according to Blood Pressure UK.

The first (top) number is your systolic blood pressure - the force at which your heart pumps blood around your body.

The second (or bottom) number is your diastolic blood pressure - the resistance to the blood flow in the blood vessels between heartbeats when blood is pumped around your heart.

An ideal blood pressure reading is between 90/60mmHg (millimetres of mercury) and 120/80mmHg.

You have high blood pressure if your readings are consistently above 140/90mmHg.

If you're over the age of 80, high blood pressure is considered to be from 150/90mmHg.

If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes, the NHS says.

Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening health conditions, such as:

• Heart disease
• Heart attacks
• Strokes
• Heart failure
• Peripheral arterial disease
• Aortic aneurysms
• Kidney disease
• Vascular dementia

If you have high blood pressure, reducing it even a small amount can help lower your risk of these health conditions.

Doctors can help you keep yours at safe levels with lifestyle changes and medication.

You might be more at risk if you:

• Are overweight
• Eat too much salt and do not eat enough fruit and vegetables
• Do not do enough exercise
• Drink too much alcohol or coffee (or other caffeine-based drinks)
• Smoke
• Have a lot of stress
• Are over 65 years old
• Have a relative with high blood pressure
• Are of black African or Black Caribbean descent
• Live in a deprived area

BOTH heartburn and acid reflux contribute to a pre-clinical or clinical obesity diagnosis.

Extra weight, especially abdominal fat, puts pressure on the stomach, causing acid to rise.

Dr Amuthan says: “Carrying extra weight increases pressure inside the abdomen, especially when lying down or after meals.

“This pressure can cause stomach acid to leak into the oesophagus, triggering reflux and heartburn.

“These symptoms are common in people with obesity and tend to improve significantly with weight loss.

“If they get worse though, they could indicate part of the diagnosis for clinical obesity.”

DARK, velvety patches – medically called acanthosis nigricans – are skin folds or areas which darken over time.

They frequently occur in obese patients and are often seen alongside other symptoms on the list.

Dr Amuthan says: “Dark, velvety skin patches – especially on the neck or underarms – are a skin sign doctors and clinicians associate with insulin resistance, which is common in people with obesity.

“It can be an early clue that the body is struggling to manage blood sugar and left untreated, could lead to clinical obesity.”

THE NHS website has sweating as an obesity related health problem and anyone who’s been pre-clinical or clinically obese knows how difficult excess sweating – known as hyperhidrosis – is for patients with weight issues.

Dr Amuthan says: “People with obesity often report feeling too hot or sweating more than others, even with mild activity.

“This happens because the body has to work harder to regulate temperature and move around.

“Sweating tends to reduce significantly when weight is lost so it can be used as a diagnostic tool for clinical and pre-clinical obesity diagnosis.”

OBESE women are urged by the British Fertility Society to lower their BMI before embarking on assisted reproductive technologies like IVF.

But fertility issues connected to obesity affect both genders.

Studies show obese men have reduced sperm concentration and less motility – which means they don’t swim as well.

In women, obesity affects egg development, fertilisation and embryo development, which is why obese women are often monitored more during their pregnancies.

Dr Amuthan says: “Excess body fat can disrupt the balance of hormones that control the menstrual cycle and ovulation. In women, this may cause irregular periods.

“These effects can improve with modest weight loss.”

THE use of BMI is highly debated amongst clinicians, nutritionists and the public.

Experts like Dr Amuthan agree it’s possible to be overweight and healthy in the same way it’s possible to be underweight and unhealthy.

Personal trainer Tej Patel says common sense and reducing the reliance on BMI to diagnose obesity can only be a good thing.

“Having worked with so many obese women over the last eight years, one thing that people are the most scared of is their weight and their BMI,” she says.

“Measurements build a picture of people’s health and expectations around the number on a scale, rather than what they are set to gain from changing the way that they look after themselves.

“The new way of measuring things is a real step forward.

“Some of the healthiest people I know have had big BMIs.

“They train every single day, they eat really well. They have more fitness and mobility in their little finger than someone who's lighter and smaller than them, but because they've got heavier, more dense muscles, their BMI shows them as being unhealthy and overweight or even at some point, obese.”

EVERYBODY is different, and some of us find it easier to lose weight than others.

But if you’ve been dieting for years and you can’t seem to slim down, you could be in the obesity danger zone.

Dr Amuthan says: “When someone has carried excess weight for more than a decade, we start to see it show up as metabolic complications — like insulin resistance, raised cholesterol or joint degeneration.

“At that point, even if a person feels they’ve ‘gotten used’ to their weight, their body often hasn’t.”

CALCULATING your waist-to-height ratio can help you understand if you're carrying too much fat around your tummy.

According to the NHS, your waistline should be no bigger than half your height.

Research shows that carrying excess weight around the middle of the body, or being apple shaped, can more than double your risk of cardiovascular disease, regardless of your actual weight or BMI.

Experts say it leads to fatty materials building up in your arteries which, if left untreated, can result in heart attacks and strokes.

In fact, being obese can increase the risk of heart disease by around 12 per cent and stroke by as much as 24 per cent.

People with obesity are up to seven times more likely to develop type 2 diabetes. Losing even a small amount of weight can dramatically reduce your risk

Dr Thuva Amuthan

Dr Amuthan says: “Obesity increases your risk of developing high blood pressure, abnormal cholesterol, and insulin resistance – all of which raise the risk of heart attack or stroke.

“The longer these factors go untreated, the more damage they can do to blood vessels.

“But the good news is that weight loss, even just five to 10 per cent, reduces those risks almost immediately and could move you out of a clinical obesity diagnosis.”

BEING obese means you’re seven times more likely to get diabetes than someone who is a healthy weight.

But the link can work the other way, with diabetic patients at risk of clinical obesity.

Patients often struggle with weight gain due to medications, plus a sedentary lifestyle.

Dr Amuthan says: “Obesity is the biggest risk factor for type 2 diabetes.

“It causes insulin resistance – meaning the body can’t process sugar properly.

“People with obesity are up to seven times more likely to develop type 2 diabetes.

“Losing even a small amount of weight can dramatically reduce your risk.”

DOLI Hiralal 38, from London, was 13st 1lb (83kg) and told she was obese by her GP.

She says: “It wasn’t just my doctor that told me I was obese, it was my family too who were worried about me weight.

“I knew it was an issue; I struggled climbing stairs, I felt tired all the time, I had painful periods, lower back pain, I didn’t want to go out anywhere and I found physical things difficult.

“I really disliked how I felt and looked.”

With the help of personal trainer Tej Patel, the fat started to drop off.

“I started losing weight in lockdown and it took me eight months to lose 66lbs (30kg). I’m now around 8st 5lbs (53kg),” Doli says.

“Since losing weight, I feel amazing. I strength train four or five times a week and I’m physically able to do everything.

“My sleep is fantastic, I’m not as ill as I used to be, I have way more energy and there’s not really anything I can’t do.”

She adds: “To anyone who is obese who thinks they can’t do it and thinks they’ll never be able to lose weight, I’d say to give it a go. The difference to your health is huge.

“When weight creeps on slowly like it did with me, you don’t feel the physical challenges obesity gives you but when you lose it and you feel like half the person you were, your energy levels go through the roof and you wonder why it took you so long.

“Yes it’s hard losing a lot of weight and the physical exercise is tough at the beginning but it’s so worth it.”