Living with obesity increases your risk of developing hyperlipidemia (high cholesterol). Treating obesity can help lower your risk of hyperlipidemia and its complications.

Doctor talking to a patient.Share on Pinterest
Hero Images/Offset/Shutterstock

Hyperlipidemia and obesity share many of the same risk factors and complications, but they don’t always occur together.

Hyperlipidemia, which is also known as high cholesterol, happens when you have too much cholesterol in your bloodstream. Cholesterol is a type of fat found in many different foods.

Having obesity increases your risk of hyperlipidemia.

Here’s what to know about these conditions and how to reduce your risk.

Obesity is closely associated with many of the risk factors of having high cholesterol, including a diet high in saturated fats and salty foods.

Obesity itself, which involves higher levels of adipose tissue (body fat), can increase your risk of hyperlipidemia. Excess weight creates inflammation, interferes with metabolism, and contributes to insulin resistance.

Researchers believe that as many as 60–70% of people with obesity also have hyperlipidemia. Up to 2 in 5 U.S. adults have hyperlipidemia — total blood cholesterol at or above 200 mg/dl.

Obesity is associated with insulin resistance, which is a component of metabolic syndrome and increases your risk of diabetes. Hyperlipidemia may also play a role in insulin resistance. And insulin resistance can lead your body to produce more triglycerides and LDL (“bad” cholesterol) and less HDL (“good” cholesterol).

The role of diet and lifestyle

Diet and lifestyle choices play important roles in your weight and cholesterol levels. A sedentary lifestyle, which means you don’t get much movement, is a risk factor for both obesity and high cholesterol.

Exercise can help lower your cholesterol levels.

A heart-healthy diet can help you reach a healthy weight for your body and lower your risk of developing both obesity and high cholesterol.

Some lifestyle risk factors for both conditions include:

  • stress
  • smoking
  • drinking too much alcohol (more than a drink a day for women or two for men)
  • exercising too little
  • eating a lot of saturated fats, found in fatty cuts of meat, full-fat dairy, and many packaged and prepared foods
  • not getting enough good quality sleep

Other contributing factors

Other factors can increase your hyperlipidemia risk, including age, sex, and family history.

As you age, your body becomes less efficient at clearing cholesterol from your body. This increases everyone’s risk. But males are more likely than females to have higher LDL levels. After menopause, females’ levels get closer to males.

Some inherited conditions can also raise your risks, including familial hypercholesterolemia.

Healthcare professionals use blood tests to determine whether you have hyperlipidemia.

Cholesterol tests measure two types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is sometimes called “bad” cholesterol, and HDL is often called the “good” kind.

There’s also a third kind called very low-density lipoprotein (VLDL).

LDL is the cholesterol most likely to build up in your arteries. An optimal level is less than 100 mg/dl.

HDL actually helps clear cholesterol from your arteries. It travels through your bloodstream and carries LDL back to your liver, where it’s removed from your body.

Optimal HDL levels
Women over 2050 mg/dl or above
Men over 20above 40 mg/dl
Everyone 19 and youngerabove 45 mg/dl

VLDL is important because it carries another type of fat called triglycerides. High triglyceride levels increase heart attack risk in women or those with high LDL and low HDL.

Losing weight if you’re overweight or have obesity can help lower your cholesterol levels.

Losing just 5–10% of your body weight is enough to help lower your total cholesterol, LDL levels, and triglyceride levels, according to a 2016 study of 401 people with overweight or obesity. The study found even greater improvement in people with obesity who lost more.

But, you may experience a temporary increase in LDL if you go on a very low calorie diet, according to research in 2019. It tends to resolve over time.

If you have both obesity and hyperlipidemia, a healthcare professional will often treat both conditions at the same time. They will recommend changes to your eating and exercise habits, and they may also prescribe some medication to help.

Does hyperlipidemia qualify you for weight loss medications?

If you have obesity and can’t sustain an ideal weight, your healthcare professional may recommend long-term anti-obesity medication.

Hyperlipidemia alone isn’t usually enough to get a prescription for these medications. If you have obesity and hyperlipidemia, you may be a candidate for some newer medications like Wegovy.

Medications for weight loss

The Food and Drug Administration (FDA) lists seven approved long-term weight loss medications. They are prescribed alongside a nutritious, lower calorie diet and regular exercise.

These medications include:

  • orlistat (Alli, Xenical)
  • phentermine/topiramate (Qsymia)
  • bupropion/naltrexone (Contrave)
  • liraglutide (Saxenda)
  • Gelesis100 (Plenity)
  • setmelanotide (Imciveree)
  • semaglutide (Wegovy)

Cholesterol-lowering medications

Cholesterol medications manage cholesterol by:

  • decreasing its production
  • reducing its absorption
  • helping with its elimination

There are several types, including:

Dietary changes

If you have hyperlipidemia, tweaks to how you eat may greatly help your cholesterol levels.

Some changes to consider include:

Physical activity

Healthcare organizations recommend at least 150 minutes a week of moderate-intensity exercise to help prevent weight gain. You’ll likely need closer to 300 minutes weekly to lose weight.

Breaking it up into smaller sessions can help you stick with your plan.

Over time, excess cholesterol can collect in your arteries. These deposits, called plaques, can narrow and block your arteries. When blood stops moving through your arteries, it can cause a heart attack or stroke.

There are many risks associated with having both conditions.

Some include:

Do weight loss medications lower cholesterol?

As of yet, no research has proven that the newer weight loss medications (GLP-1 agonists) lower cholesterol directly. But they have been shown to produce significant weight loss.

Weight loss and a nutritious diet should help reduce your cholesterol levels.

What’s the difference between hyperlipidemia and dyslipidemia?

Hyperlipidemia is the term for elevated cholesterol and triglyceride levels.

Dyslipidemia is an imbalance between the levels of “bad” (LDL) and “good” (HDL) cholesterol.

What is mixed hyperlipidemia?

Mixed hyperlipidemia is another name for an inherited disorder called familial combined hyperlipidemia. It causes high blood cholesterol levels and high triglycerides and can lead to heart attack.

  • Hyperlipidemia is the medical name for high cholesterol. Too much cholesterol in your blood can lead to heart attack, heart disease, and stroke.
  • Obesity can cause or worsen hyperlipidemia. The same lifestyle factors can contribute to both.
  • Eating a balanced and nutritious diet low in saturated fats, exercising regularly, and taking medications can help. If lifestyle changes don’t help, a healthcare professional may also prescribe medication.