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The idea that being overweight isn’t unhealthy got a turbo-charge in 2013. That’s when a study in The Journal of the American Medical Association reported that people who were up to 30 pounds overweight were less likely to die early than people at a normal weight.

A close investigation revealed major flaws in the study’s methods, though. Turns out, our happy weight isn’t so healthy after all.

What’s more, decades of research show that obesity leads to many serious health problems. These extra pounds make you more likely to get a wide range of diseases, from diabetes and high blood pressure to dementia and some kinds of cancer. Going up just a single skirt size over any decade between your mid 20s and mid 50s, for example, makes you a third more likely to have breast cancer after menopause.

The health problems tied to obesity, especially chronic diseases like diabetes, can have a long-term impact.

“These are diseases you have to manage not just for a few months, but for a lifetime,” says dietitian Rachel Brandeis. “They impact your health, your wallet, and your day-to-day activities. You spend more time at the doctor’s office and more money on medication. You’re always trying to manage your disease and feel better.” What’s at stake, she says, is your quality of life.

Still, many of us have a hard time facing our weight. Brandeis says most people are “shocked” when they step on the scales.

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