The Effects of Obesity on Cholesterol Levels

Medically Reviewed By William C. Lloyd III, MD, FACS

Being obese means you’re at least 20% over your ideal body weight. If this is you, you aren’t alone. More than 78 million American adults are obese. That’s slightly more than one out of every three adults.

For people who are obese, the issue is more than cosmetic. Obesity has dire effects on your health. It raises your risk of diabetes, stroke, arthritis, heart disease, and high cholesterol, to name a few. High cholesterol can be especially hazardous to your health because it’s a silent condition. It has no symptoms, so you aren’t aware of it unless your doctor tests for it.

Obesity is a risk factor for high cholesterol.

Being obese puts you at risk of high cholesterol levels. But it’s not just high cholesterol that’s the problem. It’s the specific changes in your cholesterol panel, a test that breaks down the different types of cholesterol and other blood fats. In obesity, triglycerides and LDL—or “bad”—cholesterol tends to be high. HDL—or “good”—cholesterol is too low. This increases your risk of heart disease, heart attack, and stroke.

In fact, body weight has a direct association with cardiovascular risk factors, including high cholesterol. This means that as weight increases, so does LDL cholesterol and triglycerides.

Lifestyle choices contribute to both obesity and high cholesterol.

Sometimes, high cholesterol is an inherited condition. Other diseases, such as diabetes, can also contribute. But most cases of high cholesterol are due to two main lifestyle choices:

  • Eating foods high in saturated fats and cholesterol

  • Getting little to no exercise or physical activity

It’s no surprise that these two factors also often lead to obesity.

Obesity changes the way your body handles cholesterol.

If food choices play a big role in high cholesterol, it seems logical to decrease the saturated fats and cholesterol in your diet. It’s a smart move, but there’s a catch. Research shows that these dietary changes are less effective at improving cholesterol levels in obese people.

Obesity blunts your response to changes in the type of fats you eat. Obesity increases the amount of LDL cholesterol your liver makes. It also decreases clearance of LDL cholesterol from your blood. Research suggests a few ways this happens:

  • Your body’s normal process that adjusts LDL production and clearance based on the fats you consume doesn’t work. That’s why changing your diet has little effect on its own.

  • Inflammation throughout the body is a common complication of obesity. This constant inflammation decreases your body’s response to changes in dietary fat intake.

  • Insulin resistance is also common in obesity. It causes changes in the enzymes your body needs to handle cholesterol normally.

Weight loss is the key to reducing cholesterol levels.

Losing weight is often easier said than done. But it’s well worth the effort. Losing 5 to 10% of your body weight can improve your LDL cholesterol, triglycerides, and other risk factors for heart disease. Weight loss can help your body re-sensitize to insulin and reduce inflammation. As your weight decreases, your body starts to respond normally to changes in dietary fats.

If you’re obese, a slow weight loss is the way to go. That 5 to 10% weight loss should take about six months. This gives you time to make lifestyle changes step by step and adjust to a new normal. Talk with your doctor about your weight-loss goals and make a plan.

Energy balance is the key to weight loss.

To lose weight, the amount of energy you use to be physically active must be greater than the amount of energy you take in as food. This means cutting back on calories and increasing your activity level. Take one step at a time so you aren’t overwhelmed:

  • Choose low-fat or fat-free dairy products

  • Eat lean cuts of red meat, fish, and lean proteins (like chicken) without the skin

  • Include lots of fresh vegetables and fruits, and whole grains

  • Reduce saturated fats and substitute healthy fats such as olive oil and nuts

  • Start moving with a simple activity such as walking for 10 minutes at a time. Gradually build up your endurance and move on to other activities.

If you’ve lost the weight and kept it off for six months but you’re still obese, talk with your doctor about other options. Medical treatments may also be the answer if you’re not able to achieve your weight-loss goals on your own.

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  1. Fernandez ML, West KL. Mechanisms by which dietary fatty acids modulate plasma lipids. J Nutr. 2005 Sep;135(9):2075-8.
  2. Flock MR, Green MH, Kris-Etherton PM. Effects of adiposity on plasma lipid response to reductions in dietary saturated fatty acids and cholesterol. Adv Nutr. 2011 May;2(3):261-74.
  3. Obesity Information. American Heart Association.
  4. Obesity Consequences: Health Risks. Harvard School of Public Health.
  5. High Cholesterol. Mayo Foundation for Medical Education and Research.
  6. Overweight and Obesity. National Heart, Lung, and Blood Institute.
  7. Hypercholesterolemia. University of Maryland Medical Center.
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Dec 6
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