Leg Swelling and Obesity – a Common Problem

Obese people often have leg swelling. This arises from two main mechanisms. The first is high blood pressure in the veins, which causes a build up of fluid in the legs. The second is reduced mobility because of difficulty with everyday activities, such as walking and exercise.

Why is weight so difficult to control?

The answer to this question is complex. Strong evidence suggests a person’s natural weight is pre-set by the brain from an early age, making weight loss over time difficult.

In obese people, weight loss results in a decreased metabolic rate, that does not appear to return to normal rates. If anything, it continues to decrease over time. In other words, a person becomes more likely to convert calories to fat. It is as if the body is always trying to return that person to their pre-set obese weight.

Are hunger hormones to blame?

Also, a hormone called leptin, one of many similar hunger hormones, plays a big part. When leptin falls, appetite increases and vice versa. After weight loss, leptin levels fall but appear never to return to normal, making people feel hungry most of the time. Again, it’s the brain trying to return people to their pre-set obese weights.

What we do know is dieting and cutting calories are not the only answer for the majority of overweight people. This is because always being hungry, with a lower metabolic rate, win out in the end. It’s biology and not a lack of willpower.

Weight loss surgery is effective in controlling calorie intake and appetite but actual treatments for the underlying problem are still in their infancy.

What can I do about my leg swelling?

Obviously, calorie control, exercise and being a healthy weight are still important.

Increasing exercise helps with wellbeing, burns calories and helps the flow of fluid out of the legs.

Varicose veins treatment can help if the veins are causing symptoms. These may be aching or skin problems, such as discolouration, eczema, cellulitis, bleeding or ulcers. Although, as weight increases, the effectiveness of vein treatment decreases.

Wearing compression socks or stockings is the mainstay of treatment for most people. These reduce fluid building up over the day and encourage blood flow back to the heart.