Fat: Ask/Answer: High Blood Pressure Caused By Weight?

After I mostly closed comments on 21 Things To Stop Saying Unless You Hate Fat People, a comment came in that made me stop and think. Check it out:

I’m confused. I have high blood pressure caused by my weight. So my doctor should not mention my weight and how it’s causing me problems? I’m just confused about that one. I mean she gives me my meds, but I would assume her goal is to have me off meds in general, it’s more cost effective for me after all.

I didn’t publish this comment, because I had already decided to stop publishing any more that disagreed with the post, brought up similar points to other comments, or invited more explaining.

But, honestly, this is exactly the kind of comment I had hoped for and imagined when I wrote the post. This person isn’t rude, isn’t trying to explain anything to me, and is just seeking out more information.

Let me take a stab at it here.

The first claim is that the commenter’s high blood pressure is caused by ou* weight. I don’t know what leads the commenter or ou doctor to think that, but I don’t believe it at face value. For most people with high blood pressure, there is no identifiable cause. Other people have high blood pressure caused by kidney problems, adrenal gland tumors, congenital defects, and some OTC, presctiption, and illegal drugs. Let’s assume that all of those things have been ruled out.

The Mayo Clinic goes on to say that there are some risk factors of high blood pressure: age, race, family history, being fat, not being physically active, using tobacco, too much salt, not enough potassium, too little vitamin D, too much alcohol, stress, and some chronic conditions like diabetes and sleep apnea.

Some of these are behaviors. It makes sense for the doctor to mention that reducing salt, tobacco use, and alcohol use might have an effect on high blood pressure. Some of these are complex issues that may not be changeable. Getting enough sleep, for example, is dependent on many things – are you a parent? Are you juggling school and work? Does a chronic condition keep you awake? And some of these aren’t behaviors at all. It would be entirely absurd for a doctor to suggest that you try to change your age, your race, or your family history.

I would say that weight sits somewhere between “complex thing that you might not be able to change” and “isn’t a behavior at all”.

Let’s say that you have no other risk factors or possible causes whatsoever. This is highly unlikely, which makes the “caused by my weight” really suspect. But, just for argument’s sake, let’s say your doctor has ruled out everything under the sun and is 100% sure that your high blood pressure is caused by your weight. What now?

95% of people are unable to sustain significant, long-term weight-loss. Maybe you’re one of the statistical outliers who can. If you’ve ever dieted before and then regained weight, you probably aren’t. Maybe you have enough time to treat weight-loss like a part time job. Some people do. You probably don’t and even if you did, significant long-term weight-loss might still be out of your grasp. It is very, very likely that you are the size that you are and that like your age, race, and family history you can’t change it just because it affects a medical issue.

On top of that, intentional weight-loss attempts may have negative effects on your health. On top of that, acting like weight is a horrible thing you’re doing to yourself and a thing that you ought to change is extremely stressful, and that has negative effects on your health. Including blood pressure.

It’s GREAT that your doctor has prescribed medication for you. Too many doctors tell a patient to lose weight before they will offer effective treatments. What else? If you are interested in other options, your doctor may have useful advice about food, vitamins, and exercise that will help with your high blood pressure plus things to avoid, like certain OTC medications.

There’s nothing more to say about weight, though. Your doctor has said your high blood pressure is caused by weight. Okay, fine. But just like you can’t get younger, you can’t become a different race, and you can’t do anything about a family history of high blood pressure, you probably can’t do anything about your weight, either. You CAN still try to get off your medication by making lifestyle changes if you want to, but those lifestyle changes are good for you regardless of whether they lead to weight loss – which they probably won’t.


*Ou is a gender-neutral pronoun. I use it when I am talking about a hypothetical person or any person whose gender is unknown to me. You can read more about my decision to use it here.

Note: Comments on this post will be moderated. Questions are fine, and telling your own stories that relate to this post are fine. What’s not allowed is being mean, name-calling, and trying to explain how I’ve gotten it all wrong (even if you’re using your own story to do that). If you’re confused about whether your comment would be okay, check out some of my other posts on the topic of fat for more insight. Diets Don’t Work, These are the Fat FAQs, and 21 Things To Stop Saying Unless You Hate Fat People are some good places to start.

Starting with this post, I’m introducing a new feature called Fat: Ask/Answer. If you have a question about anything fat-related that you’d like to see me make a post about, here’s your chance. Not every question is a good fit for the comments section where replies are pretty short and the topic can easily drift. If you want me to pay closer attention to your question, just fill out this form and I will consider making a full post to address it.

[contact-form-7 id=”6173″ title=”Fat: Ask/Answer”]