The reality is that "fat but fit" is a myth; it's a modern creation designed to make people feel better, but science does not support it. That isn't fat-shaming; no one should make fun of, criticize, or treat someone obese like they are less valuable. But the science is pretty clear, there is no such thing as fat but fit.
3
The book Health at Every Size goes into this question in detail. One of the points this book makes is that people who yoyo diet, repeatedly losing and gaining weight, are at greater risk compared to overweight individuals who never lost and regained. The author posits that it is possible that the process of repeatedly changing your weight is what is causing the problem. In addition, diabetes can contribute to weight gain, so, the causality of illness may be backwards from how we typically think about it (instead of fat -> diabetes and obesity, maybe diabetes -> weight gain, and already at higher risk for other illnesses).
2
Wow! this article focuses on fat and seems to be fostering fat phobia yet at the end of the article it states: "The new study found, for example, that underweight individuals with no metabolic problems were at higher risk for stroke than normal weight, overweight or obese people with no metabolic problems, and if underweight people had metabolic issues, their risk increased even further.
Interestingly, while the risks of being overweight and obese draw scrutiny, doctors are often at a loss to explain the risks of being too thin." Why is the title not "Thin but Fit?" And why does it not question whether we can be still be healthy and fit in bodies that are too thin or "under weight?"
3
BMI is a crude but efficient measure for large population to study. At individual levels, fitness should be equally if not MORE important. And the latter is easy to measure: flights of steps you can do without getting winded ( I do every day on my way back to my place fourth floors above, and often all eight floors after I have already walked briskly for 20 minutes because it's refreshing, no reminding of how much exercise I NEED to do; downward dog and cobra and a few more full stretches every day before I start my day; in-place running for ten minutes about twice a week for quick cardio; chase my cat if he is in mood too; flexibility at all joints such as shoulder -- bring arms back and pull the other one down; dips against the bath tub, bring foot close to abdomen, and scores more ways to innovate on your workouts. It has kept me fairly limber in body and alert in mind my mid seventies. And, yes, NO medications at all! I've barely found need to visit my doctor.
Newer research is discovering that timing is an important component of weight gain. Satchen Panda, a researcher at the Salk Institute, discovered that the same number of calories eaten over 10 hours will lead to weight gain if eaten over 18 hours instead. It has to do with the circadian cycle of the body. Think of the longer workdays and commutes of the last 30 years - it is hard to go from first coffee to finished supper within a 10 hour window. More info here: http://blog.mycircadianclock.org/science/
Would anyone get on a plane if aeronautical engineers were this "confused" about the science? This controversy appears to be driven mostly by aesthetics.
1
Before you get too riled up about this study, it's important to note a few things:
1. A case control study like this is missing lots of data, contains lots of data inaccuracies (how accurate are your medical records?), and makes conclusions based on those data. A case control study is only Level IV evidence, with a randomized clinical trial being Level 1 evidence.
2. The authors of this study have their own biases. The cohort is called The Health Improvement Network, or THIN.
3. The author of the article brings her own interpretations and bias. For example, of the three major conclusions, only two are reported. The other, that obese people with no metabolic abnormalities were at NO increased risk for cerebrovascular disease, was not mentioned at all. I wonder why?
There may be metabolically healthy obesity, but this is NOT the study to determine that.
'I do think that’s a better message than telling people, ‘You better not gain weight,’” Dr. Lavie said.'
This is just absurd. It's must much easier to keep weight off than it is to lose it. This is like saying people shouldn't be advised not to smoke, but to exercise instead.
That said, it's important to draw a distinction between being a bit overweight and being obese. Being a bit overweight appears to increase life expectancy, not diminish it, perhaps because heart disease isn't the only risk factor -- though there are so many confounding variables here that epidemiological studies have to be taken with a grain of salt.
What we must not do is pretend that the health effects of obesity can be ignored. Yes, fitness can reduce mortality in the obese, but the fit person of normal weight will be healthier than the fit person who is substantially overweight. Like smoking, obesity is a risk factor no matter what one does.
2
The one point that seems to be left out here is---what's the objective? Quality of life? Longevity? If it's quality of life---red the book "Intuitive Eating" and make food a joy-not an obsession.
1
Where I live, Portland, Oregon, school breakfasts contain up to the equivalent of 14 teaspoons of sugar. Seems like a lot.
1
Notwithstanding the few anecdotes, fat is not fit. And not withstanding the politically correct line, it's not beautiful either. And blaming the food industry is ridiculous. People make their own choices about food and exercise.
7
"And not withstanding the politically correct line, it's not beautiful either. "
That's your (unkind and not beautiful) opinion, not a fact.
7
Thank, Chris. That’s a fine example of the kind of commentary that keeps people that NEED to and WANT to exercise from being active. Too ugly to go to the gym, too ugly to go dancing, too ugly to be of value. To which I’m sure you’ll confidently say, “Well, it’s THEIR choice to worry about what people think of them.”
When you carry the blanket of judgement every single day, it weighs and wears you down.
But you know what? Just keep denying that genetics and socio-economics are a major influences as to whether or not a person is thin—excuse me, “pretty”. It’s all in their head, right?
3
health experts said about Fatness is food has taken from a restaurant, outside food and junk food it will effects health like Overweight and heart disease is linked specifically to intra-abdominal fat because that type of fat releases chemicals that irritate coronary arteries. Yet, thin people get heart disease, too. A lot of that susceptibility appears to be genetic.For more health-related topics go to this site https://www.zoylo.com/ and also directly interact with doctor
Fitness is the ability to perform a physical task. Accordingly there are numerous kinds of physical fitness, some of which have little or nothing to
do with physical health. A 225 lb baseball pitcher is fit enough to
throws baseball 90 mph but might not be able to run a single mile faster than 9:00. Conversely, a 130 lb. runner could be fit enough to run that same mile around 4 minutes and throw the ball only about 50 mph.
1
I know one thing is true, not everyone can be size 4!
4
The junk food industry and overweight people want to believe that exercise matters more than what you eat. It isn't true.
7
The restaurant and package food industry needs to work out how to cut out the sugar and move the diet conversation away from the debunked eating fat makes you fat to eating sugar makes you fat.
Sadly the US government does not want this to happen despite shouldering the costs for the under employed, those on disability and dialysis. The food labeling with 'added sugar' content was just abandoned and the food pyramid still has many simple carbs way to low down.
Listen to Michael Polan's eat food, mostly plants, not too much and even the fat but fit will become fit. It will also help the TOFI population. Thin-outside, fat-inside, lean individuals with a disproportionate amount of fat (adipose tissue) stored within their abdomen.
2
Sugar does not magically make people fat. Foods high in sugar are calorie-dense, which makes it easy to consume excess calories. Same with high-fat foods. It is interesting to note that the most palatable "carbs" that the self-described carb-addicted report problems with are high in fat:ice cream, cookies, donuts, french fries, fried rice, pasta-whatever, etc. Take the fat out of french fries, and all that is left is plain potatoes. Low in calories and not particularly appealing.
4
@childofsol:
It's not magic, it's the physiology of insulin, fat storage, and hunger/satiety. All of the foods that you've listed are highly processed foods containing both refined carbs and refined fats. Relatively unprocessed whole foods are satiating, including naturally fatty foods (meat, fish, eggs) and naturally carb-rich foods (potatoes, veggies, beans, actual whole grains).
4
Wow Pooch, you've changed! Good to know you're no longer demonizing whole carb-rich foods. And speaking of whole, it seems like you could have filled a whole book there with with your whole grain bashing. "Actual" whole grains.
But no, it's not insulin or any other magic. It's calories, same as it ever was.
Yes, the foods I mentioned are highly processed. So is sugar-water. Maybe you missed the point, which was that absent the fat content, the foods are not highly sought after. Most of the "carbs" and "sugar" that people moan incessantly about in these nutrition articles are foods which are high in fat. Which takes even more of the "magic" out of sugar when you think about it. We like sugar, fat and salt. Our brains, that is. Not our insulin.
The meat, fish, eggs, cheese and butter. That stuff is still out there. It didn't go away, and in fact we're still eating a lot of it, except for eggs. We just substituted chicken for beef, and cheese for milk. Problem is, the sugar, fat and salt-loaded processed food is out there competing with it.
It's senseless that there is a controversy at all.
Thin does not equal fit. And the opposite of thin does not equate to the opposite of fit. Is it possible to be fat and healthy? Yes. Would a fat person be healthier if they could lose excess fat? Most likely they would. But what would it bring?
My father was fat his entire life. He ate wholesome foods and was physically active. No soda or alcohol ever. No cream or sugar in his coffee. No sweets, desserts, bread or second helpings. Doctors gave him diets to try and he was faithful to them. And still fat. But he walked and biked miles each day and swam regularly. He even rode the three miles each direction to his doctors' office in his last decade of life. He lived well into his 80's. He would have preferred to be thinner having been criticized since childhood for the crime of fatness. But if there were a magic wand to make him thin, the benefits might only have been cosmetic.
14
What were his portions like?
BTW, and not being pedantic, but these analogies completely miss the point of the epidemiological studies, which, while exceptions exist, properly estimate the risks for, usually, 95% of the population. Whereas an anecdote has no power of estimation. Yes the NYT (and any other online paper/blog) commentary section is full of people who think that the anecdote of their father or mother trumps scientific inquiry. Is the problem the education system or what?
4
After 25+ years as an adult maintaining a healthy weight through exercise and careful eating, I recently went through a year of eating whatever I want, whenever I wanted. I gained about 25lbs and have crept up into the overweight category for the first time in my life. I tried to convince myself that "size acceptance" is the way to go and to just be content as a larger person. But the reality is that my body started to breakdown from the stress of the added weight. My knees hurt so much I would lie in bed unable to sleep. My acid reflux became a daily issue. Clothing became uncomfortable - I'd buy new and within weeks it would be uncomfortable again. I finally had to admit that size acceptance and fat but fit may be OK for others, but not for me. I am far happier and healthier when I'm watching my weight.
16
Working out regularly, eating moderately, and having an active lifestyle that includes social interactions are the keys to a good life. Regardless of what experts say, I know from personal experience of family members and friends that extra weight - and I don't mean obese - is a strain on knees and joints and compounded with eating junk food and a sedentary lifestyle is no life. Americans are lazy - they drive everywhere, look for the closest parking space, regard those of us who walk and use public transportation as somehow unAmerican.
18
The author is missing the point. When people say they are fat but fit they mean fit for themselves. It is possible to have a clinically obese person and for that person if they tried to lose more weight they would have to make unhealthy decisions to do so (extreme diets, extreme exercising etc.) So for them the realize that at a certain weight they are the healthiest they can be. Comparing that clinically obese person to a skinny and fit person and saying they still have higher risks of strokes etc. is missing the point.
8
@Jessica That doesn't make any sense.
The whole piece is doubletalk. What is there to discuss? The ability to move yourself effectively is preferable to being confined in fat. That it has statistically lower disease associations is true, too. Watch obese people - they actually lean on things to rest while standing. They waddle. They exhaust easily so they learn to move slowly. They live in a more limited physical universe, how can that be preferable and for what? To be able to have more seconds of sweet, sour, salty sensation inside one's mouth? Come on be real it's not even a point of realistic discussion.
12
CK, people are fat because it's very difficult to permanently change their eating habits in a culture where high-fat, high-sugar (and cheap!) foods are constantly offered to them, and where most people get around in their cars. Getting exercise takes a special effort for most people, and they may not have the time for it.
So, many fat people hope that they can have a long, healthy life anyway.
This study debunks that idea to some extent.
And even if somebody could be fat and fit by getting plenty of physical exercise, they're unlikely to actually do that, because it's less pleasant for a fat person to exercise. Very few fat people run for miles every day, or even swim and hour a day. So the caveats about exercise aren't relevant for many fat people.
3
Jane, all I got from your comment was one excuse after another. No one said it would be easy, but it's not as difficult as you paint the picture to be. You are misinformed.
4
Not all fat people struggle like you describe. I am fat, and I can move quite nimbly, swim with serious endurance (wanna race 2 miles? I bet I can beat you), excel in yoga, and have an excellent health profile, aside from my weight. What I read here is your judgement of fat people, not the reality of being fat.
3
I don't see how this is at all informative if they didn't look at exercise. I'm practically a workout worshipper--I'm convinced that regular strenuous exercise is what matters most. Being really overweight makes it harder to exercise strenuously on a regular basis, and thus makes it less likely that you will do just that. BUT: suppose that you DID--as some very overweight people obviously do. Then I would predict that you'd be fine, health-wise.
Of course, I may very well be wrong. But how can something call itself a study of fitness-while-fat without looking at exercise-while-fat? Isn't fitness largely a question of physical *capacity*--not just the absence of disease?
10
@Bess: Indeed. I know they use the term "metabolically healthy," but I would be interested to know how many people fitting the definition of overweight, obese, etc. are "fit" in the sense that they can sustain anything close to normal physical exertion. To be clear, I do not have the answer to that question, but it seems relevant.
2
"BUT: suppose that you DID--as some very overweight people obviously do..."
But therein lies the dilemma... very overweight people would not be "very overweight" if they exercised strenuously on a regular basis. I would love to see a bonafide example of a "very overweight" person who exercises strenuously AND consistently (not counting bodybuilders who take supplements to intentionally gain weight). Show me such an individual and I'll show you a unicorn. Sure, there are overweight people who exercise regularly, but there is a large gap between walking on a treadmill for two hours versus lifting heavy weights and running for two hours.
1
There are lots of overweight people who exercise strenuously. Watch all the finishers of your local half marathon and you will see people who have just run 13 miles while carrying the equivalent of an extra half a person for 13 miles. Training for that race did not make them thin. It made them fit and doubtless improved their health, but exercise alone is not enough to cause significant weight loss in most obese people. Sure, you may take off 5 or 10 pounds, but to really lose weight you have to reduce your food intake drastically. Drastic diets can take the weight off, but they are bad for your health in other ways, and very, very few obese people who lose a lot of weight keep it off. If they buy into the idea that the most important thing in their life is to lose weight they will weight cycle --lose 50 pounds on a crash diet and then put it slowly back on again, because being on a crash diet and thus hungry all day every day is not sustainable.
If you have never had a serious weight problem you really don't understand what you are talking about. People on a diet toggle between two states -- hungry and guilty. If you eat enough to feel full you feel guilty, and if you don't you feel like you are starving. It's no way to live.
2
How is this a story about "fat but fit" people but the underlying study doesn't actually track fitness?
8
We're all doing the best we can here. We are all gonna die one way or the other. I refuse to live my life feeling oppressed by this issue. (This doesn't mean I'm gonna stop playing Game On, though, it's just fun and I DO feel healthier from better life choices.) And seriously, I'd rather die young than be one of the fat-shaming jerkss in the Comments section.
11
Dying young is your choice and isn't the problem. The issue is how much does obesity cost everyone else and the earth. Obesity results in a multitude of long term health problems (chief among them diabetes) which overloads the health care system -- into which we all pay. It's just like smokers and heavy drinkers saying their addictions don't harm anyone but themselves. We all know better.
6
"Expand" your horizons. Think about how your being fat impacts people around you. From taking up extra space on public transportation, even trespassing on another passenger's seat, to the costs you impose on healthcare which everyone else has to subsidize. Then, think about your family and friends and how they'd feel if you died suddenly from something that perhaps was preventable.
2
Ok, Kathleen—How about putting more money into health education? How about reducing the addiction-triggering chemicals in processed foods? How about paying people a living wage so they have enough time and money to feed themselves and their families real food instead of having to rely on what is affordable (ramen, chips, cereal, frozen dinners)? How about having sufficient mental health support so that the depression and addiction that locks people in their patterns can be addressed? How about having socialized health care so that people can have access to have their small health issues addressed before it escaltes and renders them unable to move actively and breathe freely?
Oh, but wait—It’s all about how much money a person is worth or costs, I forget.
1
What happened to the notion of weight maintenance? Some of us spend nearly the entirety of our lives on a diet. This can be a strain on the heart. 'Obesity' was relatively rare, or seen in the 70s but now it is becoming a common sight.
Here is a true anecdote: a woman in a wheel chair, surrounded by two friends, beside a long aisle of candy and sweets where they tell her 'Now you can eat everything you like because you have the stupid cancer that these sweets caused'.
Americans are a size larger. Some of us are also stronger than our parents' generation. Not all of us are compulsive over-eaters. A neighbor thinks her sibling is obese, but he can ride a bicycle.
'Tooth-picks' are also at risk? What if you were born with a small frame? Thanking Roni Caryn Rabin for this latest, and could we have a chart with some helpful indicators? In this technological era, we are becoming a more visual society and have less time to read.
Reading the News is enough to make one shrink :)
For the fat shamers out there looking for a handle on this: If fat is so bad, why do ALL longitudinal studies show that the greatest longevity and concurrent health status, statistically speaking, occurs in the BMI range of 25 - 30? Why are the highest mortality rates found in those under BMI 18.5 even when you control for diseases that cause weight loss? The research showing that fat, per se, is not a health problem has been available for literally decades, but since that doesn't match with the simplistic viewpoints of society it is ignored in the press.
Overweight and heart disease is linked specifically to intra-abdominal fat because that type of fat releases chemicals that irritate coronary arteries. Yet, thin people get heart disease, too. A lot of that susceptibility appears to be genetic. That is, a history of CAD in your family is a more important marker than your weight.
Want to know the real killer? Its not fat. It is a sedentary lifestyle. Sitting around all day at your job, sitting all evening on the couch watching TV, these are the things that really increase your risk factors. Bad diet (not necessarily the weight that comes from that) is another. The American lifestyle and diet, not the resultant fat, is the true killer. Good luck finding in depth articles that make that particular distinction in the press.
BTW, I am Professor Emeritus of Psychology who covered this material in my neuropsych class.
12
While I think treating the obese with shame and disgust is inexcusable, the fact remains that death is lowest for the 25-30 BMI range because the people are most likely to die after a long illness when they have lost weight from chemo, etc. Their lives are ultimately shortened by the longer time spent overweight. The overweight don't need science to justify their being treated with decency: that's basic humanity (which an alarming number of NYT posters lack). However, overweight is unhealthy. The end.
1
I love it. "overweight is unhealthly. The end."
Not only did you fail to grasp what this article said, but you pull conclusions out of air. There is a reason rational people now demand scientific evidence instead of arm chair theorizing.
Implicit in your conclusion is the very thing you claim to be against, the basic human dignity that overweight people deserve, not to be prejudged.
And you sir, are prejudging their health with no basis.
Simplying citing one possible explaination for the data, as if it is some kind of silver bullet that only you were clever enough to consider, is ridiculous.
I'm a woman.
1
This must be satire. Any cardiologist will tell that extra weight strains the heart. So play Russian Roulette because you can't control your eating, and by the way, you'll look gross too.
7
God forbid anyone should "look gross."
2
So sorry we don't all fit into your notion of attractiveness. My deepest apologies.
1
Thanks, David—that really makes me want to get out and exercise, knowing how “gross” I would look doing it. Great.
1
Compulsive overeating is the primary cause of obesity. Swap the hour you spend in the gym with one spent at an Overeaters Anonymous meeting and you'll be on your way. Better yet, find an extra hour in your busy day (skip that episode of Breaking Bad on Netflix) and do both, and nothing can stop you.
6
Many people in Overeaters Anonymous either stay obese or gain and lose weight, no matter how dedicated they are to attending meetings. A few are successful, attending meetings, even working the 12 steps, is no guarantee you will ever stop eating compulsively and/or lose weight (never mind maintain a weight loss).
4
Weight loss is a simple math problem. Count all calories you intake in a day and subtract the calories you burn in the day. If the difference is positive, you gain weight. If the difference is negative, you lose weight.
QED.
7
You're missing the point of the article, and instead offering simplistic and unhelpful (and actually rather smug) "advice" on losing weight.
Simple math doesn't make for a simple solution. Ask anyone who has tried to lose weight and keep it off. It's virtually impossible
11
It's usually impossible because the underlying psychological causes of the over-eating are not addressed.
6
Great. End of matter. I don't know why anyone researches anything these days.
2
Only in the post-modern world of the NYT does the fat, but fit “controversy” continue.
As a clever physicist once observed in response to concerns that the Large Hadron Collider would create a black hole on earth, that outcome is theoretically possible in the same way that it is theoretically possible, given the probabilistic outcomes of quantum physics, that a quarter dropped on a table will fall through the table, though both outcomes are highly unlikely.
Similarly, while it is theoretically possible that a fat person is fit, that outcome is highly unlikely.
6
I'm a physically fit 65 year old female. In addition to the health benefits, one added advantage for me is that I can do the physically challenging work in my yard. My strength and endurance (to shovel rock, dig holes, stack bricks, etc.) save me money and frustration in having to hire someone to do the work for me. Also, it just satisfying.
10
Amen, sister. I'm 63 and I work with kids and I HAVE to keep myself in shape which means keeping my weight proportionate to my height. My dear mother was 5'2" was over 300 pounds most of her life, she lived to be 82 but cost the health care system in Ohio a bundle and couldn't walk, bathe herself or sleep well for the last 15 years of her life. While I weep thinking of all she missed out on, it was a real motivation for me to stay as fit I can. No whining, no excuses just get busy.
11
How seductive is the word "study"!
I read this article for third time. No one I've seen has commented on this:
"...critics say the analysis...leaves a lot out. Doctors’ records don’t typically capture lifestyle habits, so the study fails to account for the wide-ranging effects of diet. They classify weight status by using body mass index, a formula based on height and weight that doesn’t distinguish muscle from fat. Most important, critics say, such analyses don’t take fitness level or physical activity into account."
How much does this study tell us about the relationship between fat and fitness when much was not controlled for, particularly fitness levels?
Next, check out this conclusion at end of article:
"The new study found...that underweight individuals with no metabolic problems were at higher risk for stroke than normal weight, overweight or obese people with no metabolic problems, and if underweight people had metabolic issues, their risk increased even further."
This is a remarkable statement, that, if true, surely should receive more attention! The authors are stating that the underweight and healthy are at higher risk of stroke than any other weight group, an assertion that contradicts assumptions we make daily (that one cannot be too thin).
Surely the only reason there is not more interest in the health effects of underweight is because there is little if no market to exploit among the underweight in our times!
9
@Cam Well there are far less underweight people than overweight people, so it makes sense that it's covered far less.
You can not be fat but fit. I say that as a fat person with a fairly active life. While we might be able to keep up on a hike or walk from one end of Manhattan to the other, the extra weight we carry is over taxing almost every body system. Our feet flatten prematurely. Our joints wear more quickly. Our hearts, liver and kidneys all have to do more than those same organs in a slim person. Dealing with weight problems is hard but we shouldn’t kid ourselves that we get off easy if we are able to be active. The price may not come immediately but I speak from experience, there is a price. Try and remember the last time you saw a morbidly obese 90 year. I couldn’t either.
13
Well my grandmother is only 87, so ask again in 3 years. She’s also not bed ridden and doesn’t live in a nursing facility.
2
This is a subject where science and "common sense" blend. I had one obese acquaintance who lived to 96; I had another who didn't wake up one morning at age 43. Over the last four years I've gone from 242 lbs. to 194. Just had my yearly physical two days ago: blood pressure 116 over 71, blood sugar 88. Of course I feel better plus I'm off meds for blood pressure and cholesterol. Does it not make sense that my heart has an easier time pumping blood to 194 lbs. as opposed to 242 lbs.? Think of it this way: if the same size furnace heats two similarly insulated homes, one of 1600 square feet, the other of 2800, wouldn't you not be surprise that the former lasted longer? I'm not shocked that obese people who exercise more last longer, especially if they don't have a heart attack while exercising. Don't forget genetic differences. One example: my "significant other" exercises more than I, eats far fewer sweets, harps at me for eating as many sweets as I do, etc. Her blood sugar count ranges between 118 and 126. Mine, even at my heaviest, has never gone over 100 and as noted above, dropped to 88 with this last 20 pounds of weight loss. I have one trim friend who at 64 has three stents. Should I generalize from this. Of course not. We are talking of general patterns; let not an exception here or an exception there cloud what most of us know from experience and that old friend, common sense. P.S. I turn 80 in February: my goal, 180 by 80. Any bets?
5
Come on. Fat but fit is a way of allowing people who are overweight to avoid feeling bad about their weight. It's an outgrowth of the self esteem movement.
Obviously people don't try to be obese, but now they can find a message that says its OK to be that way.
By the way - being thin is no guarantee of heart health. I'm 6'2", 166 lbs. and pretty active yet I just got the shocking news that I have moderate coronary heart disease. Very high levels of plaque buildup in my arteries. Probably my diet. Always consumed large quantities of cheese, and still was doing milk and cookies/cake every night before bed at 60 years of age.
I always thought I was immune from such concerns. Don't make the same mistake I did. Eat right. Choices catch up with us.
11
The tendency of processed foods to be of increasingly higher calorific value while being increasingly easier to absorb as opposed to digest (which could take hours in case of normal diets ) is changing our hormonal secretion patterns fundamentally in the long term. 50g of potato chips has as many calories as it takes an adult person to burn in running a mile, but feels like literally nothing in our stomach. The younger one is, the more easily the shift occurs. If continually reinforced, it ends up changing fundamentally the foods that we crave when we're hungry. Ads step up the pressure with images of food and TV/media viewing times are at unprecedented levels. Once the alpha-amylase starts flowing, its an uphill battle.
Mass production and better-than-industry standard logistics ensures almost continual availability. The hygiene levels of corporate-style fast food outlets are, for most part, impeccable. Compare these times, standards and practices with say, changing the school lunch menu to introduce green veg or legumes instead of a packaged snack. The hurdles, the wrangling, the petitioning, the backlash, the heartbreak. For food that's actually tastier, more wholesome..
We are losing the war on food, food that's making our kids more lethargic, unhappy and irritable, and eventually pushing many of them on to the brink of the war on drugs, or some other habit forming activity/substance (pc gaming, binge drinking, binge watching). What exercise are we even talking about ?
5
I'm 63. I was very fit and healthy as a young man....5'9" 165 lbs. Working behind a desk, not exercising, and lack of portion control put 70 more pounds on my frame over the last 20 years. I'd diet and start exercising, lose 15 lbs. and then stop and gradually put the weight back on again. But my parents are both still alive at 90 and my grandparents all lived into their late 80's and early 90's, so I must have good genes. I hadn't missed a day of work because of illness in 20 years. My blood pressure was OK and my cholesterol was within range. I didn't really have anything to worry about. Or so I thought, until I had a massive heart attack 18 months ago and almost died. And It did so much damage that I have heart failure and needed an implanted defibrillator. It was no longer a joke that I was "merely obese, but not morbidly obese." If I did not finally lose weight and change my diet, I was going to die. And lo and behold, I radically changed my diet (Dean Ornish's) and lost 55 lbs. I now feel great, my cholesterol has plunged, and I am experiencing no symptoms of heart failure. I am so lucky and fortunate to have a second chance. The question I keep asking myself is why did it take a brush with death to wake me up? Why did I not pay attention? I was a fool. I was kidding myself. You need to eat healthy and exercise.
17
What is the causation? What about the diet is causing inflammation? What signals disease? All this going to studies that show correlation without a mechanism. Because there is massive bias against obesity. Isolation of a b y population can create correlation in a study. Which is why we use science to find a mechanism. Strong bias against obesity has been shown to cause results from thin air.
2
"massive bias against obesity." Social attitudes don't cause disease; overeating does.
5
Recently there was a feature on the front cover of the New York Times on growing obesity in an African country caused by the appeal of fast-food supplied by American Companies. If you look at the portions on the plates that might be one indicator.
Moving along, on another nutritional note, there is obesity to be seen among pets. There may be a connection.
A younger friend recently mentioned that her five-year old was having some famous tinned soup for lunch (which apparently is no longer healthy, according to what she has heard) and then sent a photo of a birthday celebration where her son is having a slab of cake that Henry VIII might have trouble tackling.
What is too fat, or too thin in these times we live? Let us us have some reminders and guide-lines. Many thanks.
1
Eat more veggies. Drink more water. Do more YOGA! Eat more fat and Protein. Small meals 5 times a day. You can thank me later.
9
Yoga increases flexibility obviously, but other forms of movement fortify muscles, which is also essential. You can thank me later.
1
Yoga is not an aerobic exercise, nothing wrong with yoga, but it's not some kind of panacea, people still need to do "real" exercise. Swimming, jogging, playing basketball, bike riding, walking.
2
David and Eddie, yoga helps with appetite control, which may even "outweigh" [sorry, was looking for another word that wasn't "trump"] exercise in importance. At the very least, it makes aerobic exercise more doable.
5
- You might be obese, but are you gulping down sweets, white bread, rice or does your diet mostly consist of 1) whole grain cereals 2) whole grain lentils 3) kidney beans, chick peas 4) nuts 5) fruits and vegetables.
- You might be obese, but you walk frequently, or do you just sit whole day. One might be obese, but one should walk in the morning, in the afternoon, evening, and many times in between.
- Whether you are obese or not, do you sleep on time? Do you binge on videos or news or websites? Do you give your mind rest.
- Do you eat meat or are you a vegan?
- Are you kind? Do you take time in your life to practice compassion? Do you ever watch your breath?
- Are you working hard just like 99.99% people? Or your life is just spend enjoying pleasures because you happened to be lucky by your birth or past luck?
Summary: You can be slim but you might be living a much more unhealthy lifestyle. Or you might be obese, but living an unhealthy lifestyle. Or you might be obese but living an extremely healthy lifestyle.
Devil is in the details.
4
"Or you might be obese but living an extremely healthy lifestyle."
Or you would not be obese in the first place you were actually living an "extremely healthy lifestyle." In other words, obesity is not the byproduct of a healthy lifestyle.
1
I recently climbed a 12000 ft. mountain in Wyoming. I can mountain bike on slickrock quite well for a 54-year old man. I climb stairs rather than take the elevator, drink my red wine, eat my tomato sauce, and exercise every day.
I also weigh 210 lbs. at 5'7". That qualifies as obese. Well, too bad. The harrumphing tone and unscientific pronouncements of some of the commenters here, if you believe them, would be worse for my health than obesity. Before saying anything, people should know something about the science.
12
Before saying anything, maybe some people should wait a decade or two before offering themselves as shining examples to others.
9
Clearly there must be a difference between someone 10 or 20 pounds overweight and a person who is obese and 100 or 200 pounds too heavy. Why don't these studies describe the difference?
13
There are plenty of studies/information about DEGREES of fat, but all say any extra weight is problematic. Unless you think you are on the way to heaven, this should matter to any sane person. And yes, you look bad too when you're overweight.
5
A "new paper" should not be considered to deliver a "message", much less a number of them. A single study is a small component in the construction of a scientific edifice. It is a brick in a wall, not a school of architecture.
8
I wonder if the underweight people experienced a greater amount of trauma (as people who are traumatized are at risk for mental health disorders that can reduce appetite or cause other metabolic changes, see the ACE study). So, was childhood trauma controlled for in this study?
2
From the article, it sounds like this was a data dredge from doctor's records - they didn't control for exercise, so it's unlikely they controlled for trauma, as most records wouldn't have that information.
Also, if the underweight people's results might be partially due to trauma, wouldn't the overweight people's be as well?
1
Another article discussing fat, and too many comments expressing our perennial American disgust with fat.
Could we all agree to become more precise in our language? Even in this article, the terms "fat", "overweight", and "obese" are thrown about as if they mean the same thing.
They don't.
Next, can the author of this piece clarify what the researchers meant by "fit"? Fitness to a general reader is not freedom from "metabolic markers" (indicia of disease or precursors to disease).
Fitness is, well, fitness: can one walk? Run? Climb stairs? Work outside in 90 degree heat for a couple hours? Work outside in 35 degree cold for a couple hours? Hike a couple miles over easy terrain? Over rough terrain? Swim for twenty minutes? Carry bags of heavy groceries into the house? Lift a toddler with ease? Get up off the floor? Sit on the floor?
My sense from observing people for decades is that with overweight or moderate obesity, fitness can, and often does, coexist with moderate fatness. I agree with the comments of the doctor who states here that "it is not doomsday" to be overweight.
I also know more than a few who are lean, if not underweight, and not fit, and not free from disease.
Health, vitality, and longevity are complex and arise from many factors, perhaps the most important of which we do not even know yet.
As I myself age, I am wondering if the biggest missing element to our American notion of health is calm, relaxation, and joy.
26
The actual caveat is that those people carrying the extra 20-40 pounds around strain their hearts much more vigorously than most normal-weight people do, except maybe for the extreme fitness junkies. And that's who they must be compared with with the question of whether too much excercise is what really harms the heart.
4
I would say, whether you are fat or not, it is far better to be fit than unfit. And given how hard it is for people to lose weight and especially to maintain weight loss, I would encourage everyone to be as fit as possible, whatever weight they are. Of course it would be optimal to be thin and fit, but at least be fit.
10
Before someone can lose weight, they have to stop gaining it. It seems to me that if someone has repeatedly gone on a diet, lost weight, and then not just gained the weight back but put on more - then they should stop dieting. Better to be "fat but fit" and a constant 30 pound overweight, then lose 30 pounds, then gain 40, lose those 40 pounds, and then gain fifty.
To me, "fat but fit" and "fat acceptance" are about not making a bad situation worse. Maintaining a constant weight is not perfect, but it's better than to be slowly cycling upward. Being obese and exercising regularly is not perfect, but it's better than being obese and sedentary.
15
When I went to Weight Watchers twenty years ago, a leader (let's hear it for Michael, gay borscht belt comedian manque) would suggest we decide each week whether we wanted to lose weight or maintain our weight loss. I found having that choice very helpful, especially since I had decided it didn't matter to me how long it took me to lose, so long as I didn't regain (and I haven't).
14
You will die of something. Preferably later rather than sooner, but you're gonna die. When all is said and done, I suspect having a high-stress job and working in front of a computer all day is deadlier than being 50 pounds overweight. Balance. We need more balance. More time to exercise and prepare and eat healthy food, less stressful work. More time with family and friends. And we'll still die, but I think we'll be happier.
10
Awww, you're trying to make yourself feel better? That's cute.
50 pounds overweight ? Nothing to brag about.
1
...all the while being a drain on the health system with lifestyle-related illnesses that could have been prevented with a little bit of willpower and discipline.
1
Sometimes you don't need studies when common sense gets you the answer. Exercise is good. Not being obese is good. If you can meet both criteria, great. If you can meet one criteria, better than meeting none. Case closed.
7
I am obese but very healthy with no high blood pressure and low cholesterol. I would love to be in a study, My dad lived until 107 and my maternal grandmother was 108. So yes I believe that genes do play a great part of it. Everyone else in my family is petite and thin. I wish I had some answers as to why me!
6
Dense muscle tissue is heavier than fat. But most obese individuals are made up of fat. Soft, light, malleable fat tissue. Not dense muscle.
6
I'm thin and fit looking but I actually am super unhealthy. I eat junk and I smoke and I don't exercise.
I'll be dead before I'm 70, but at least I enjoyed my life. Obese people who love food, who cares? You get to eat lobster and you die when you are 65. That's better to me than eating kale and dying when you are 75 in my opinion.
10
It’s been nice knowing you.
6
Let us know how you feel about things when you're 68
8
Perfect weather to be outside, walking, running, riding whatever turns you on. But something has to turn you on to take advantage of being outdoors, you know, more than walking from your front door to the car, or trying so hard to find that perfect parking place close to the entrance of a shopping center, really!
Hard to explain what it feels like, riding the Me-Mover, wind in your face, seeing the incline ahead, using more force on the pedals, reaching the apex, heart rate increased, no such thing as anxiety, can't be, feels too good.
Only way to experience the endorphin treat is to find that which makes you feel good by using your body, so many different ways, indoors too. Yes I stopped at the Y to do some stretching, but did a light weight training workout. Why not? The more you use your body, the more you want to.
2
So tired of this conversation. Of course they don’t account for difference between muscle weight or fat weight. Of course they don’t take into account food quality or activity. The BMI was long ago proven to be an ineffective measure and still it’s used as a base measure in studies that essentially support a diet industry more than a healthy society.
13
It's simply an oxymoron. The controversy only exists in the minds of the corpulent who are totally in denial. Thế studies always focus on the threat òf heart disease but thẻre are a whole hóst of other problems generally listed under the heading òf metabolic syndrome that spell out disease in many diferent párts the body. Eat smart ỏr die young!
13
Eat "smart," die anyway!
4
Losing weight is not simple:
https://academic.oup.com/fampra/article/16/2/196/480196/Effects-of-dieti...
https://www.ncbi.nlm.nih.gov/pubmed/2204100
2
Readers of the Times unite! Read first! Start with the packaged and processed food you already have in your pantry and refrigerator. If you feel like you you are in a chemistry class, you are. Maybe it’s time to re-educate our eyes, brains and tastebuds. So you know your doctors’ and pharmacist’s names, but do you know your farmer’s name? Time to recognize that the best four letter word starting with f is farm.
5
Having read this whole article twice, I am tempted to quote or misquote a hobbit who said, "Go not to the wizards for advice for they will say both yea and nay."
7
Couch potatoes are at risk no matter how thin they are.
7
Fat, but fit? Great!... For now. Remember Jim Fixx?
http://www.nytimes.com/1984/07/22/obituaries/james-f-fixx-dies-jogging-a...
By the way, Jim Fixx was NOT fat.
Genetics? Diet? Stress? You are better off with lifestyle changes early on. And, nowadays, there are genetic tests, as well as regular blood cholesterol testing that, at least, might possibly forebode your fate. Why worry? Stay fit, and eat so you stay happy (remember: a poor diet, in general, decreases feelings of well-being and may increase anxiety levels).
1
Such middle class obesity should be a minor concern. However, it is the focus of the "fat" debate.
Lower class obesity, on the other hand, is a deadly national plague. Visit West Virginia. When I go to Walmart, I have frequently to change aisles because mine is blocked by the shelf-to-shelf width of only two people. Not their carts. Their flesh. This isn't an irritation. It's a tragedy.
In Appalachia, diabetes is called "sugar". Give me a moment, and I'll think of a friend who doesn't have it. Or heart disease.
Our response to negative statistics is "Thank God for Mississippi."
The government worsens the epidemic. America sanctifies food: staff of life, touchy-feely granola, wholesome, nutritious, etc. We demonize the inclinations of the poor, who thus need moral guidance.
The obvious cure for their poverty is to give them money.
But OMG! they'll spend it on booze, and cigarettes, and dope. Immorality we cannot condone or allow. So, we require that their income supplement go only for nice expenditures. And what is nicer than food? So, they get food stamps.
What do you expect to happen? The poor can't afford bowling, spas, canoeing, camping equipment, campground expenses to spend time in our forests and gorges. Welfare doesn't pay for movies. Or bail. Or bullets to get a deer to live on for the winter.
Pleasure is a rare luxury for the poor. Eating is THE subsidized, affordable, pleasure.
Gee: the poor get obese. Tut tut.
27
This is all part of the "everyone gets a Gold star award." If I didn't care about my health and practice some discipline, I could be 50lbs.overweight too.
11
This view is part of the problem: it is an assumption that if a person is fat, she or he *must* also be lazy and undisciplined.
5
Exercise is the way to keep those "few extra pounds" off or at least fit. Discipline, a trait in short supply in our culture, is sorely needed; do the math, 3 lbs. a year will turn into 30 in 10 yrs. and 90 in 30 yrs.
2
I was shocked that underweight people are at greater risk of stroke than larger folks.
You would think doctors know this, and inform their patients.
I hope this is one of those "Looking at grass can cause boils type" soon to be refuted claims.
What do you do if you are underweight because you are healthy and fit??? Develop a taste for eating greasy trashy "food"...
What a concerning warning to healthy eating, fit and physically conscious folk!!
1
Plenty of underweight people have a taste for greasy trashy food. Underweight does not equal healthy and fit.
5
I know very skinny people who eat massive amounts of sugar, carbs, etc. No one comments that they should eat healthier (everyone should eat healthy, overweight or not). But people tongues really start wagging and the pitchforks come out when an overweight person eats the same way. It says a lot about society's view on heavier people.
2
Underweight people could be underweight due to medical conditions (rather than merely strict dieting) that may be risk factors for stroke.
1
No such thing. Never was, never will be.
Any tissue that is not physically acting to propel you or support you is deadweight. Fat is supposed to be fuel or insulation for the structure of the human body. It is NOT supposed to be one third of its mass.
A healthy human should be able to deftly handle its own bodyweight in any circumstance. That means you must be able to wield the equivalent of your actual weight to push, pull or run yourself out of danger at a moment's notice. Can you push and pull up your own bodyweight with your arms? With your legs? Can you run yourself quickly up several flight of stairs, and over at least 6 blocks? (... so that no one else needs to risk their life to carry or haul their own weight AND yours?)
If you can't do this, one of 2 things is true: You are either too weak, or too heavy.
If you want to remain that weight, OK: but you must become stronger.
If you want to remain that strength, OK: but you must become lighter.
Acting to achieve a bit of both works well.
The lengths we have gone to to tiptoe around hurting people's feelings have caused us to be hurting their very survival as viable humans. Enough already.
18
From your comments, I’m going to make three assuptions about you:
1) You have a well-paying job/ex-military
2) you work out every day because you belong to a gym and your schedule permits it
3) you’re a man
Correct me if I’m wrong here. I wouldn’t want to make improper ASSUMPTIONS about a person’s life factors.
I'm a member of an athletic club where all body types are accepted. The few obese members, while they can go through the motions, are not fit enough to race with us. These are the only fat people I know who regularly exercise, and their huffing and puffing during a workout is rather telltale. I lost 30 pounds, and I feel spring-loaded. I can't imagine what it's like to be carrying around an extra 150 likes these folks. Please put down the doughnuts, guys, and stop pretending you're fat and fit. You're not, and you won't live to see retirement.
14
It doesn't sound as though *you* are accepting of all sizes. If having lost 30 pounds makes you happy, then good for you. Now tell us: how are the fat people who work out with you ever supposed to lose weight when they're routinely faced with smug judgment by those not in their shoes? Given that so much criticism of fat people arises from the false notion they're "lazy," you ought to be holding a ticker tape parade every time one of them shows up to a workout, instead of scolding others about the doughnuts you assume they're eating.
11
He probably didn't say a word to them. Seeing malice and judgment where there is none is a hallmark of people who are highly insecure about themselves and their weight. Speaking from experience, losing a large amount of weight won't solve all of your problems. But it'll solve a lot of them.
1
Eat less move more and live longer. Obesity is the simplest thing in the world buy people hate being held accountable for self inflicted misery and low quality life styles.
4
Here is what I really like to know: What condition gives the highest probability of dying with dignity? It used to be that a heart attack or severe stroke finished you.
Now we must endure agonizing years of dementia and physical decline before we are afforded to leave this world.
9
Being thin and fit gives you the best chance of having a good, short death. Look up "compression of morbidity". That's what a healthy lifestyle does -- it compresses the long and painful decline of those facing amputations, kidney failure, dementia and all the rest. Thin, fit people tend to go full tilt until just before the end. That's the best way to do it.
Editor’s note: This comment has been anonymized in accordance with applicable law(s).
9
Stroking out during the middle of the night would be the best exit strategy for me.
Phrasing....
No, you cannot be obese and healthy. Period. I'm glad that people are more sensitive and accepting of different body types, but let's not give obese people the false impression that they are not unhealthy.
17
Unless you know every fat person on earth, and their detailed medical history, and are treating them, you can't possibly know this. If such declarations are what it takes for you to feel superior, my sympathies.
1
Yesterday I was at a crowded food court of a very popular mall in NJ at around 9 p.m. This mall has about 20 food vendors, 99.99% selling garbage food. Food court was packed with people eating these sugar, fat, sodium-laden offerings. Most notable, across my table where I was reading waiting for somebody, an about 300 pound man with one of those Chinese-food combo platters (fried rice, some kind of sauce smothered chicken and some broccoli), easily 700-1000 calories. He ate it all except the veggies. Loads of fat, sugar and sodium 500 calories at 9 o'clock p.m. , really, really, really bad for anybody let alone an obese person. So on what are we going to blame this certainly extremely poor meal choice: "Bad Metabolism", Inflammation", or just good old gluttony?
5
I can imagine the look on your face as you noted what was on his plate and what he left behind.
2
Do you know what else he ate that day? That week? That month? Of course you don't. The same is true for any slimmer diners you may have seen eating the same garbage.
5
Doctors don't spend a lot of time studying the risks of being underweight in the US because an ever-increasingly number of Americans aren't becoming morbidly underweight. Which is not to say that it is not extremely important to work to help underweight people manage their weight issues.
Obesity kills. Plain and simple data says that obesity reduces both quantity and quality of life. That's fact, full stop.
4
I wonder how many people read the last three paragraphs of this article. In fact, I wonder why the last three paragraphs are the LAST three and not given more prominence earlier. Granted, we don't have an epidemic of underweight people, but nevertheless we might want to temper our obsessive belief that weight loss is critical to health.
4
Tell it to the MD's that prescribe steroids for a variety of conditions. Talk about metabolic problems, you can never get back to normal metabolism.
We got the heroin epidemic and fat people. Who's to say it is not the same thing.
6
BMI is not too useful. My BMI is great, the hospital dietician told me so. Too bad I am barely maintaining weight on nutritional supplements. What about the unhealthy slim, the morbidly wasted? Or should we just argue and assign blame?
4
The World Health Organization does recommend half an hour of moderate to strenuous physical activity every day , for both "fat" and "fit" people. Just doing that, and not bothering about how experts nitpick about the definition of obesity, should work for a vast majority of the population. i mean, your body is your best friend. Do good by it. For half an hour a day. Definitions can wait.
2
Lots of great reading on the latest obesity (and fitness) research on Science Daily. Who knew that gut microbiome and even gut fungi (related to fat consumption) affect weight? https://www.sciencedaily.com/releases/2017/10/171011131654.htm
2
I'm responding to a psychologist below who said that he/she has patients with emotional/psychological pain who are not obese, so the 2 are not linked.
Logic 101: not all people with emotional pain are obese, but probably all obese people have psychological pain they are self-medicating with food. In obese people, the obesity is caused by overeating driven by emotional/psych pain.
Also, pretty much only affluent people can see psychologists (which is why psychologists tend to be very affluent). Affluent people are not likely to tolerate obesity; their pain manifests in different ways (maybe over-shopping).
Culturally, Americans respect affluence, education, and higher social class. Medical "fitness" does not elicit admiration or respect.
Obesity is simply judged to be an indicator of less education, less affluence, and a lower social class.
3
"In obese people, the obesity is caused by overeating driven by emotional/psych pain."
Right. And in no way is obesity related to people simply unwilling to stop eating the junk food and desserts that their younger selves were able to consume with impunity. Or people who are simply too lazy to take the stairs, walk or go to the gym. I guess this is all due to mental illness. Got it.
The first thing the medical community needs to do is scrap the Body Mass Index (BMI) entirely. It is not based on any medical methodology whatsoever, and its use by doctors and insurance companies is completely illegitimate and amounts to malpractice. When I was denied surgery because my doctor said my BMI was too high, I went to a different medical group where I got my body fat measured in a hydrostatic tank, and the difference between what my weight should be according to BMI, and what my weight should be based on my actual body fat was 70 pounds! That tank test cost just $60 and took just a few minutes. I went back to my doctor, filed an appeal with the medical group, and got my surgery.
2
check out "Fit or Fat"....by Covert Bailey......
To me the expression "fat by fit" means aerobically fit. In other words, how much do you move? This study doesn't address that at all. I'd like to see data on very physically active overweight people who are also metabolically healthy.
5
There's too much money to be made telling people (Americans mostly and women mostly) that everything's o.k. with being a "BBW". Books (like the one recently profiled in the Times by a French author), talk shows, magazines at the checkout, blogs, etc.
I take real issue with this segment/movement trying to turn the table when the same overweight people feel they shouldn't be judged "negatively" like it's baseless to think so.
As this study indicates there are very real, negative, causes and side effects of being overweight that have been studied extensively (education levels, impulse control/mental health issues/diabetes, heart problems, joint/thyroid problems.). All of these factors deserve attention and sympathy but a business of denial would rather tell us they don'y exist. That is the real evil.
What is so out of the ordinary of drawing conclusions (that are being proven right by science) on someones's appearance when we do it naturally with many other indicators too? We all know it's hard to live with something that one can't change overnight but retreating to a community of "enablers" that says nothing has to change is not the answer.
7
And not one obese person has ever been helped by the judgment and better than thou comments of people who do not have weight problems, including doctors. Judgment and negative attitudes only make the problem worse. It is ridiculous to believe that telling someone she is unhealthy, let alone bullying her with silent looks in public or outright rude statements on the internet will do anything more than want to make her curl up alone. Ostracizing obese people is not helpful. Stop worrying about whether they will break your chairs or sweat on you in an airplane. Stop staring if an obese person eats in public. God forbid that he go out for pizza or tacos like anyone else. The body positive movement helps people love themselves, which encourages them to live their lives. And that might mean more social activity, more movement, and more power to become healthier in whatever ways are appropriate.
9
Actually, there's "too much money" to be made convincing people, mostly women, that slimness is the same thing as morality.
11
The fat but fit "controversy" no doubt emanates from obese people who strive to make themselves feel psychologically more comfortable about being overweight.
Do we really need scientific studies to inform us that being obese is not healthy?
Of course it's not healthy, you don't need to be a scientist, a doctor or any other type of clinician to arrive at that conclusion.
I totally understand and completely empathize with overweight people who struggle with body issues, it's a very hard thing to live with day to day.
But this "fat but fit" thing is a dangerous red herring that really ought to be put out to pasture. It's a completely valueless idea.
9
Well maybe when you can solve the problem that most people who lose significant amounts of weight eventually gain it back (I heard it was 90%), and even those that are successful lower their metabolisms upwards of 30% more.
Maybe we can just quite our jobs and and go to the gym all day.
5
Or maybe people who lose weight can PERMANENTLY adjust their lifestyles to incorporate those elements that caused them to lose weight in the first place. Diets don't work. Permanent lifestyle modification works.
1
I'm curious about what happens when we age. If we are smaller boned and thin are there other risks? I know a nurse who says that a little fat helps prevent breaking hips and bad balance. Is the right weight and fitness the same throughout life? Why are thin people more at risk for stroke?
1
Read the study by Katherine Flegal that I mentioned above!
I wonder what percentage of people are overweight due to the medications they take? My friend (female, five feet eleven) zoomed up to 227 pounds from a normal weight when they put her on SSRIs for her OCD in college. Abilify too was a big appetite stimulant. She seemed like another person, gorging and never feeling satisfied. As soon as she went off those medications, she was able to lose weight and she's now back to 135 pounds. She was traumatized by the experience. It's too bad that so many of the meds for mental issues also make the person vulnerable to weight gain and the unhealthy consequences that come with it. Also doesn't do much to make them happier.
12
A lot of psychotropics cause massive problems with weight. They also cause kidney, liver, pancreatic problems (i.e. diabetes). It's too bad the medical community doesn't want to address this issue. They still hand out these pills like candy and then wonder why so many people have problems with their weight (and still remain depressed).
I like these how to stay healthy pieces, I just wish they were consistent over the years. Fat is bad, fat is good, carbs are good, carbs are bad, take this pill take that pill. When does it end? When every last cent has been wrung out of a confused and scared populace. As in everything in our culture, follow the money. Quit buying "stuff" and the entire edifice collapses. After that being overweight might permit one to outlast the starving multitudes. Storing fat has an evolutionary advantage. Humans have left the evolutionary track, thankfully. It is time to plot a course that insures the survival of all individuals. Consumption and overconsumption clearly is not cutting it. Less is more.
4
When my doctor told me I was prediabetic two years ago, I started dieting. Now I have lost 75 pounds and my BMI is 25. I am no longer prediabetic. I have watched as my blood results, blood pressure and heart rate have returned to normal values.
People can rationalize all they want, but I have seen the truth. Being overweight will kill you. Lose the weight and get your results back to normal.
12
Obesity does not run in my family but hypertension and hear disease does. We are all active and normal or thin. These articles simplify everything.
3
The average BMI of women in this country is 29, which is very close to obese. The advice in this article applies to more than 2/3 of the people in this country. Simple advice is critical. You are an exception, and it does a disservice to most readers to complicate the advice.
1
You can be a skinny minnie and still get heart disease, diabetes, etc. Sure, it helps to eat healthy, be active, etc. That's the absolute ideal--for everyone on the planet. However, just because someone eats healthy and stays active, doesn't mean it's an automatic exemption from disease. Every healthy action helps, but there are no guarantees. Remember Jim Fixx--that super athletic runner who wrote all those famous running guides? He dropped dead young while running. He had genetic heart disease.
Ride a Me-Mover daily and lose weight, the longer you ride, the more calories you burn. Takes about 20% more energy to propel than a bicycle, low impact, stand and be seen, good for all ages, even my age, 80 in a few weeks.
Or choose something else that will burn more calories than you need, do nothing, and nothing good happens.
1
Italy has one of the lowest heart disease rates in the world, a food culture that is second-to-none (OK, the Japanese are right behind with the lowest rate of heart disease) and a population which is relatively "un-fat." I think most Italians spend more time walking, riding bikes and are generally more active than their American counterparts. If they would quit smoking they would live forever.
In the end, there are a lot of things that affect our overall health: diet, physical activity, genetics, etc., but just for the sake of feeling better and living a a more vibrant life, it's probably better to be more picky about what you eat and get off the couch/office chair and engage in some physical activities.
4
Most Italians don't move a lot. But they adhere to the habit of the evening walk, the famous passeggiata and are STILL concerned about the quality of their food. What helps is an ingrained body awareness, the idea of "La bella figura". And most middle aged people are slightly overweight! But times are changing. With every year the junk food isles in supermarkets are expending and diabetes and obesity are on the rise too.
The medical profession doesn't know how to help people lose weight. If you doubt me, just survey the weights of people working for your doctor. Would those overweight among them be happier at a normal weight? Surely they would, but their doctor -- your doctor -- can't help.
I have made it to 71. I am overweight but otherwise I'm in pretty good physical condition. I never signed up to live forever. If we can get people to my age in reasonably good physical condition, I say we declare victory and leave the weight issue till we know how to solve it. That would be a great thing.
5
Although there are some thin people who die of heart attacks, check out the local malls for obese individuals whom you estimate to be 40.....then 50, 60, 70 or 80.
Very few 70 or 80 year olds who are obese....they're either at home too large to get around or dead...
4
I measure my fitness by the time it takes me to run 5k.
Given the number of runners that take part in public events, it would not be difficult to assemble a set of subjects who (in many cases) would be willing to share relevant parts of their medical data with responsible researchers.
You could probably show that top fitness corresponds with top consumption of bananas and bagels, which would be fun, and maybe a good source of sponsorship, but there would also be serious and useful results.
Studies like the one described here seem very limited in imagination.
2
Running is good for fitness until it grinds your joints into sawdust and you become sedentary due to chronic joint pain. There are certainly other, more accurate, low-impact indicators of physical fitness that do not sacrifice your joint health.
All of these terms, fat, healthy, fit, unhealthy, skinny, are not well defined except in extreme circumstances. But one thing I've learned is that you can be fit but not healthy, healthy but not fit, you can be fit and healthy and you could have cancer and still be fit. There are so many different ailments and the way they affect you varies. A heavy person is usually very strong, they have to be to carry all that weight. You have them lose weight and they lose muscle mass and their endurance can go down. The real reason exercise is so important when dieting is that one must maintain functional fitness. I started to gain weight as I went past 55 and when I woke up one morning and had to kind of grab my belly to turn over in the bed I went to the doctor to find out why I was getting fatter. Turned out I was borderline diabetic. I quickly changed my diet and it went away. But back injuries and such have kept me from the physical activity that I used to like so I'm healthier now but not as fit. It just goes to show that it's hard to win on this. At this point I am very sympathetic to people who have trouble exercising. Beyond a certain point it is hard to get motivated because it hurts.
3
Try a gym that has an Ergometer....hand cranked bicycle. You can have a pretty good energy expenditure without using your legs or lower back.....They're generally pretty expensive so for most, having one at home is difficult. Over a longer period of time, you can compare the monthly cost of a gym to the cost price of this type of unit.
My life experience validates that people can be obese, even morbidly obese, but still be statistically healthy. I am 200 pounds overweight and have a 60 inch waist. I have high blood pressure and high blood sugar which are controlled with common prescribed medicines. I hardly exercise at all and can stay in my apartment for 5 days in a row without going out at all.
Between 2006 and 2010, I was a Gray Line tour guide atop the double decker buses here in New York City. Five days a week or more, I went up and down a flight of stairs ten times an hour for at least 5 hours a day. At that time, I was 160 pounds overweight with a size 54 waist. I did not need medicine for high blood pressure or for type 2 Diabetes. My resting blood sugar was 80. My resting blood pressure was 120 over 80.
3
I'm sorry, but I don't see your point. You were morbidly obese as a working person 10 years ago, but you were active and your medical parameters were within normal limits. Now you are even more obese and you have high blood pressure and diabetes. That is not "healthy." It seems to me that you have essentially proven the point that obesity is a risk factor for heart and metabolic disease.
1
I see pretty straight line correlations between blood pressure and drinking, and between blood pressure and weight. If i drink regularly, my blood pressure is higher than if i don't; and if my weight goes up substantially, so does my blood pressure.
1
Common sense and observation of those around us makes obesity look about as healthy as smoking cigarettes. However, good multivariate studies are very useful in convincing people to quit overeating, and to put the necessary effort into good conditioning. There is another thing that is rarely mentioned, the damage to relationships that occurs when one or both individuals 'lets go' and allows themselves to become substantially less attractive. We need to pay attention to all the implications of obesity if we want to improve the human condition.
3
I am overweight. I have been overweight much of my life. I do exercise. Exercise is good in many ways. I do burn more calories but I also am hungrier and eat more when I exercise more. This is not unusual as studies show that this is exactly what happens to people when they exercise unless they also restrict or reduce calorie intake. When people reduce the number of calories they eat for a period of a time, they do lose weight but if you look at the several studies including the Oxford study, this also depresses their metabolisms below what they would be for the lower weight.
According to the Oxford study, the lower metabolism was still operating even up to 2 to 3 years later which was the length of time this study followed people. This metabolism is lower than it should be based on their new weight.
So, people who make the effort to lose weight and do this multiple times often end up with much lower metabolisms. It seems to me that advising already obese people to lose weight is not helping them, it is making many of them gain even more weight in the long run.
My suggestion is that if you simply must meddle in the weight thing that you would be best to work on the issues that contribute to weight gain in the first place like eating fast foods or low fiber diets. Encourage children to be active. But feel free to criticize everyone who is overweight because a lot of you will even if it is counterproductive.
4
Interesting to read how many of the comments focus on the overweight results.
What surprised me about the article was the news that underweight people with no metabolic problems were at higher risk of stroke than normal weight people.
We know so much about the risks of being overweight, but not enough about the risks of being underweight.
22
Well, we have to prioritize. How do we define "underweight?"
If we go by percent body fat, a reasonable cutoff would be less than 10 percent in women and less than 5 percent in men.
I would estimate the ratio of underweight individuals to overweight individuals is 1:100 at least. Where should be put the research money?
I was wondering if that sentence about underweight ppl had a typo. Did they mean to say that underweight ppl with a metabolic disorder were more likely to have a stroke than overweight ppl with no metabolic disorders?
Hoping the author can clarify.
Anecdotally my tall very slim dad with all good “lab numbers” suffered a devastating stroke. No one had detected the plaque buildup in his carotid arteries. This despite having low cholesterol. Ppl really need to get carotid artery screenings. It’s something easy to miss on routine exam and the stethoscope doesn’t always pick it up.
2
Well...so very, very few of us are underweight that such condition is virtually irrelevant. I.e., "Are you too skinny...can't gain weight?....then...stop smoking."
Seems to me that the real test is what you can do and whether you honestly feel physically comfortable as you move your body.
Can you get down flat onto the ground and get back to your feet with no struggle? Can you happily sit on the floor and clip your toenails without your gut getting in the way? Can you run to catch a bus or up a flight of stairs without getting out of breath? Can you dance? Play tag with a kid? Toss a ball around? Jump up and down for joy?
A fit person can do all of the above without much effort--even when quite old. I went hiking with my 90-year-old dad a couple of weekends ago. He walked about a mile up a hill and sat down on the ground to eat a picnic lunch with the rest of the family and then got back up under his own power with only the aid of two hiking sticks.
When you get too fat, your body gets in your way--and you know it!!
73
My body gets in the way because I'm fat... and I'm fat because my body gets in the way. I live in a very rural community. I've been coping with very painful lumbar arthritis ever since a bad fall in my late 30s.
Swimming worsened shoulder arthritis. PT helped, but working 11-hour days (plus a 1-hour commute) in my 50s and 60s prevented other exercises. Poor medication for my movement disorder indirectly caused thoracic outlet syndrome, preventing most upper body exercises despite PT. Too much time on the treadmill wore away the meniscus on both knees; after a fall on vacation, I had to wait a year while exhausted from severe pain before insurance would OK surgery; I did use the treadmill. Yesterday my surgeon said: "No more treadmill!"
Now, in order to lose weight and strengthen my legs for knee replacement, I must commute 30 miles three times a week to the closest gym, to swim and use their machines, despite medication-induced exhaustion and the upcoming sleet, freezing rain, etc.
For many people, it's not as easy as saying, "Gee, I can't roll over easily--better exercise!" Please try to empathize.
65
Weight loss does not require exercise. Weight loss happens in the kitchen. Exercise can help but it is not necessary. People who are bedbound or in wheelchairs lose weight on a calorie restricted diet.
3
ML-it's very hard to lose weight through exercise--almost impossible.
If you cut back to about 1000 calories a day with few of the calories from carbs, you will lose the weight.
My own MD confirmed that for women to lose weight, they need to drop to 1000 calories a day and, once the weight is gone, stick to about 1200-1300 calories a day "most days."
My dr is over six feet, in his late 70s, and very thin. He eats about 1500 calories a day. It's the fork, not the jogging track, that makes the difference.
Good luck to you!
2
Who does the food shopping? Very important for health conscious people that are trying to control their weight. We all know what isles are the most rewarding for sugar cravings, all of those colorful packages beckoning, buy me, satisfy the sugar lust.
The weight battle is won or lost at the food markets and restaurants, but we all know that, don't we?
6
Actually, it seems to me lately that ALL isles are packed with brand names whose products are stuffed with sugar. Each aisle is a competitive battleground among the major brands, including salad dressings and sauces. Even the fruit and vegetable section is rife with sweet candied dips and garnishes for the fresh fruit, cakes for making shortcake, mixes for banana bread and trail mixes with lots of candy amid the nuts. The meat section features prepared "quick" dinners like pulled pork, for example, literally swimming in a sweet sauce.
If you want plainer food, you have to actually search for it. Like cereal without sugar added, or oatmeal that isn't flavored with sugary fruit. Sheesh!
5
The weight battle is instituted and perhaps lost at birth...so many factors involved besides colorful dessert packaging.
2
Stay away from the aisles filled with pre-packaged food..go around the periphery with fresh fruits, vegetables, meats, fish, cheeses, nuts
Avoid fruits with high sugar content....Drink water instead is my motto...often your brain or stomach isn't sure whether you are actually hungry or thirsty....Also stay out of the kitchen...
If you're not walking try parking at the far end of the parking lot, take the elevator up two floors short of where you're going....then walk the last two floors..same thing on the way down...
3
A persons fitness level is not a binary question. How much excess fat a person has is also not a binary question. As long as we think of fitness and fat as binary, this fat/fit debate will continue. There is an enormous range to fitness and to the amount of excess fat a person can carry. Can a person have a decent level of fitness and still carry excess fat, of course. How much excess fat can a person have and still maintain a reasonable level of health? Is a better question. A thin person that does not exercise may be more unhealthy than someone with excess fat that does exercise regularly.
34
Well...it is important that we do not try to dodge the obvious: "if you are overweight, lose weight." By discussing the degree of health benefits relative to other factors, we should not lose recognition that being overweight is bad for our health (it just might not be as bad in some cases as we had feared).
2
You just fed the example of binary thinking. You didn’t say “being overweight is challenging,” or “being overweight has traditionally been associated with negative effects,” or “being overweight is an out-moded biological survival adaptation that is not ideal for our current society.” You just said “being over weight is bad,” as opposed to good. Implying that overweight people cannot be good, only bad.
I always shake my head whenever I see handwringing about BMI because the definition of "overweight" and "obese" has changed over the years. For my height, overweight used to start at about 165 pounds. That number was lowered to 155, and now it's about 145. I went from never being overweight, too occasionally being overweight, to always being overweight without gaining an ounce. Just like the threshold for diabetes was dropped, then prediabetes invented, then that threshold dropped, weight tables suffer from "disease creep". A doctor told me, "We want to alarm people earlier." Does that justify lying to us?
65
No one is lying to you. Standards have been changed because research has shown that excess weight causes more harm than researchers previously thought it did. Years ago, researchers thought your weight of 165 caused no harm. They now know that it may cause harm after all. Along the same lines, years ago some researchers thought that smoking caused little or no harm, but they later discovered that it causes disease.
If the doctors say you are overweight, you would be well advised to lose weight. They may be wrong, but losing weight has many benefits.
6
Perhaps the changes you mention were based on scientific research, not whim.
4
Do you have stats to back this up because I seriously doubt BMI tables have changed 20 lbs over your lifetime.
Stop, just stop with the "fat acceptance" narrative. Yes there are some genetic disorders and diseases that make being overweight unavoidable; and yes it is more difficult for some people to maintain a healthy weight than others. But being significantly overweight is largely avoidable and incredibly unhealthy. In addition to the heart disease risks mentioned in the article, obesity is the primary risk factor for type II diabetes, and also increases the risk of many types of cancers.
And the final sentence is shameful: "Interestingly, while the risks of being overweight draw scrutiny, doctors are often at a loss to explain the risks of being too thin." On what is this flippant statement, with no supporting evidence, based? First of all, because of the incredibly skewed tendency of Americans to be overweight, most Americans have no idea what "too thin" is from a medical standpoint. For a middle-age man, 6'2" 155 lbs is borderline and 145 lbs or less may be "too thin." Most Americans would consider 6'2" 155lbs "skeletal." Second, almost anyone in the U.S. who is "too thin" has an underlying disease (e.g. cancer) or psychiatric illness (i.e. an eating disorder) Otherwise healthy Americans aren't "too thin" because of their daily dietary choices. Finally, osteoporosis, poor cognitive function, heart failure, stroke, etc etc etc are well understood as risks of malnutrition by second year medical students malnutrition, much less experienced MDs.
--JHU MPH
84
From your lips to god's ears. We're going to look back in a century or two at "fat acceptance" and "HAES" and wonder what on earth possessed people back then to make such ridiculous claims. People like that are like Creationists and anti-vaxxers. They don't start believing these obviously false ideologies because of anything observable in reality. And they don't stop believing just because reality contradicts them at every turn. It doesn't matter how many studies get done that contradict their dogmatic beliefs or how much they themselves suffer and are limited by holding these beliefs. It takes a LOT to make a true believer start doubting. I follow some anti-HAES blogs and groups and a while ago noticed that when someone drops out of this belief, it's usually because they got old or fat enough for their health problems to really make life unbearable--or they got their first really serious health scare.
3
You sure do seem to know a lot. Credentials? Or?
1
Doctors are "at a loss" to explain the risks of being too thin because other than people with terminal diseases or anorexia, they occur in the U.S. about as often as bigfoot.
If that is supposed to be a convincing fact to support the "fat but fit" argument, it fails spectacularly.
It's sounds like more illogical rationalization and feeds into the false narrative of "well, it's not good to be too thin, either".
5
Skinny people die .... Birth, work , pay taxes die anyway
12
True, just not so soon.
3
I have a theory, if you find something that makes you feel good while increasing your heart rate for a period of time which in turn will burn calories that in turn will help to decrease weight, you will have more self confidence.
The problem is negative conditioning, change is non sequitur, lots of years of not even thinking of exercise.
Break the habit of the pandemic of sitting to moving with your legs as opposed to powered vehicles.
So many body powered vehicles to choose from, new ones being invented all of the time, check out the obvious, bicycles, then look at the niche market, lots to choose from. many could change your old sitting habits, the kind that is known to be a danger to life, the more you sit, the worse it is for your health.
Learn what endorphins can do, we all have the capability to find out, you don't have to get a prescription for it, just learn how to release that great feeling by using your body the way it was made to move.
5
Find a gym with a Crank-cycle/Ergometer....if your lower back or body weight doesn't easily allow you to walk or run.
"Weight, mortality, years of healthy life and active life expectancy in older adults"
this article says:
"Conclusions
Similar to middle-aged populations, older adults are likely to be or to become overweight or obese. However, higher weight is not associated with worse health in this age group. Thus, the number of older adults at a “healthy” weight may be much higher than currently believed."
There is also a large literature that says moderately over weight people have greater life expectancy than "normal" weight people. Perhaps, we need to rethink normal weight.
12
Exercise is good for you and something most people can do, while weight loss is not something most people can do (evidence being that most people who lose weight regain it), thus the question is not whether people who are obese and fit are as healthy as non-obese fit people, but whether they are better off fit than not. Which is a question that has been answered: Yes.
30
Where does it say that? I’m overweight ant metabolically healthy, and lloking for good news.
1
Seems like it would have been easy enough to also determine their fitness/exercise levels, and very basic diet questions. Oh well.
4
That is actually extremely difficult to do and that is why diet/weight loss studies are all over the map. All the data is usually self-reported in these studies without independent verification. Participants are notorious about what they eat, how much they eat, and how much they exercise.
No. There were no questions asked of anyone. They simply used the existing computer records, as stated in the article.
1
Skinny and sickly. I know skinny people who drink too much, use drugs, smoke cigarettes, eat poor diets; have heart disease, high blood pressure, knee problems, etc. I think that many fat phobic people, somehow think that they are more in control, have better emotional health, and will evade diseases and disability. Look around you, fat and skinny both go to hospitals and all of us die. I do not think that it is good to be too fat or too skinny, everything in balance. Most of the hate and bias about obesity is rooted in societal disdain for obese people that tries to masquerade as concern about the health of the obese.
40
If you have a loved one who is eating themselves into obesity it is a sad thing to see. They will face health issues (diabetes probably) AND workplace and societal stigma. I wouldn't wish this on anyone. If a friend or loved one drinks too much (or takes poisonous drugs) we would at least encourage them to seek counsel for their health and well being. Why would we not do the same for someone who eats too much (or is addicted to poisonous foods (processed anything)??? These concerns are based on love, not hate.
3
The question for me is whether given the immense social and practical incentive to be thinner, those who have not been able to respond by losing weight will become thinner if warned they will get sick and die or if this will only foster fear, hopelessness and resignation. I don't think the main issue here is the truth but rather what message is most helpful.
20
I can attest that these doctors thinking of ways to better alarm us and these threads of disdain and oversimplification sure interfere with obese people's creativty, caregiving of others, public service, and self image. If you have some effective way to lose weight and become quote-normal-end quote, please share--and I don't mean the anti-red meat, anti-fructose, pro-surgery, pro-ills, I did it so you can, etc riffs that we get on these threads. Don't have anything--let us get on with living then.
10
Weight loss is very simple once you understand a few key concepts in human physiology. Note I said "simple" and not "easy."
I would recommend the free kindle pages of Dr. Hagan's "Breakfast: The Least Important Part of the Day."
His basic thesis is that the perception of hunger, and, more importantly, our response to it (eating) is the result of learned behavior- encouraged by our culture. It is a habit that needs to be broken. One meal a day is all that is needed. Yes, he goes into the physiology of it, and covers a lot of interesting territory related to metabolism, exercise, fitness, and energy metabolism.
I know a sure-fire, 100% effective way to lose weight: eat less. If you find yourself in a war zone or third-world famine and you cannot get enough to eat, it is 100% certain you will lose weight, grow thin, and eventually die of starvation. When someone says "I cannot lose weight" they insult the millions of people in the world who die of starvation.
Any animal that does not get enough to eat will get thin. There is no such thing as super-metabolism that allows one person to get far more energy from food than another. There are no physical causes that prevent you or anyone else from getting thin. The causes are psychological.
The problem is that in modern society, some people find it very difficult to restrict their diet. Food is all around us. It costs practically nothing by the standards of the past. It is engineered to be tempting and even addictive. Some people find it psychologically very difficult to avoid eating too much. THAT is the problem. If you can overcome it, losing weight is simple.
To overcome this problem, I suggest you enlist the help of medical experts. The success rate for long term weight loss is much higher among people who get professional help and guidance. See:
http://www.nwcr.ws/
3
While were obsessed with obesity, as we probably should be, my take is two things require consideration. Fructose and your own metabolic make up. The gym rats business and fad diets, is a massive industry, so bring on the fructose consumption, it is in nearly everything we consume. For those of us aware of our weight and do have an exercise regime, the BMI guidelines never seem to be met, save starvation . If you do hit your BMI recommendation you will be skinny.
2
I've been weight training since I was 25, increased my weight substantially with the increase in musculature. Getting close to 80, I still weight train and still am considered overweight. Yes, i could drop some pounds and yes my appetite is still the same, I've always been a chow hound.
I also do aerobic training along with anaerobic, the more I workout the bigger my appetite, always been that way, even when I had cancer treatments, my appetite never decreased that much.
If I cut down the calories, i drop weight, I never let myself get to a point of no return, not too hard to maintain a comfortable weight because of vanity which has been a strong motivator for a long time.
6
Moverme:
Sounds like you've had a great life!
I just turned 64 and have been following your lifestyle----hardly ever sick, look great, feel great, can do just about anything-------hope I do as well as you.
This story suggests that the study disproves the idea that you can be fat and fit. However, it does no such thing. The study author himself acknowledges that fitness was not taken into account, only metabolic markers. Please read this critically. How can a study look at weight and fitness if it doesn't actually have any data about fitness? Would we accept a study looking at, say, the link between tuberculosis and birth order if we had no actual information on birth order?
This study does prove one thing incontrovertibly, though: Weight stigma is alive and well in the medical community as well as in the rest of the culture.
48
Thank you for your voice of reason! That a reputable medical journal even publishes this nonsense is shameful. As I wrote in another comment: Garbage in, garbage out! Without the right type of data no valid conclusions are possible.
1
This kind of makes perfect sense and is instantly obvious. I'm not a doctor, but I've picked up a lot of human biology over the years, and my main education was in physics.
Overweight people have hearts that are doing more work than people who are not overweight. If I'm moving 160 pounds of myself around every day, going up stairs and so on, and someone else is moving 320 pounds around, they're doing a lot more work with about the same size heart. Like every machine, the heart falls prey to entropy, and the more it works, the faster it gives out.
This is also why people who are extremely tall are more prone to heart malfunction, and have shorter lifespans overall. It's unfortunate and unfair, but their hearts are pumping blood over a greater distance than someone a foot shorter than them, and thus give out sooner. This is why we don't see a lot of people in their 90's who are over six feet tall (yes, people get shorter too, but not usually by over a foot).
However, it should be kept in mind that nobody lives forever anyway, and it's more important to have a high quality life than a really long life. And this too is why being extremely overweight is still a negative quality, because it does decrease the quality of life.
29
You're half right. A lot of people (actually, almost everyone) don't seem to consider the physics involved in energy. However, in regards to the heart, it is a muscle. And like all muscles, it can be made stronger through use and exercise.
Also, a lot of people who are extremely tall tend to have hearts that are not proportional to their body size. Andre the Giant had this problem.
2
You sound motivated. Instead of "picking up" you information on physiology helter skelter, I would recommend that you download a free copy of Guyton and Hall's Textbook of Medical Physiology- slightly out of date. Or order a new one. A very readable book, even though it is designed for medical students.
1
Nice theory. It might also explain why women tend to live longer than men (who are usually larger). But I’m curious how it might explain why exercise/being active tends to extend life vs being sedentary. Also, how would it account for the risks associated with being underweight? I suppose by weakening the heart.
1
I'm a tad overweight but I don't care. I could struggle to get my weight down, or not. Living to 75 or 80 makes no difference to me.
6
Sure Joe, but this isn't ten or twenty pounds over that we're discussing, really. If ten pounds means 5 years shorter lifespan, that's not that big a deal. But 40 lbs overweight meaning dying before retirement, that kind of changes things, right?
Thing is, it doesn't need to be a struggle.
1
It might when you're 75. :)
1
It's fat mass vs. muscle mass. BMI can't tell the difference. Regular, non-athletic people have variations in muscle mass and fat mass. Account for this instead of total weight, and the so-called "obesity paradox" disappears.
10
Yep. I run marathons, do cross-fit, distance biking, and yoga. My diet isn't perfect but primarily fruits and vegetables. My metabolic markers are great. I have no chronic illnesses and don't take any medications. I am muscular and do not particularly look overweight, but my BMI is around 30 -- "obese."
Fats Domino died yesterday at 89, which is a pretty long life for any man. Maybe it was because he was always walking to New Orleans or because he found his thrill on Blueberry Hill.
71
And cooked his own meals even when he was on the road.
1
When you see BMI as a measure of something in research, what follows is garbage. Its use is just laziness on the part of the investigators.
16
Not if they're measuring BMI properly. If they're doing the old water-dunk test to accurately measure BMI, it can be very useful.
When you see someone dismiss BMI you can safely assume they are out of shape and looking for a justification. Its an insignificant percentage of people who are overweight or obese according to BMI and not just in horrific condition.
1
This is important. Obesity is not a moral failing; no one should be ashamed of being fat any more than anybody should be ashamed of having any other serious health condition.
Obesity is simply the physical manifestation of a body that has lost its ability to properly process carbohydrates.
Think of it as a carbohydrate "allergy" -- and the intervention needs to be the same as it would be for any other allergy: Reduce consumption of the agent that causes the allergic reaction. If you're allergic to strawberries you avoid strawberries. If you're obese, the best response, the only thing that will work, is to cut the carbs.
The science is actually pretty clear right now, but unfortunately it will probably be another few decades before there is consensus in American society -- because the carbohydrate business is very profitable.
Big Food, very much like the cigarette industry, makes hundreds of billions of dollars selling obese people the thing that makes them sick. When health and profit are in conflict in 21st century America, we know what wins.
28
This is complete nonsense. The genetics of fat and thin people are exactly the same- evolved over tens of millions of years. The failing IS with the obese. Eating habits are the result of learned behavior. We only need to eat once a day if that. Our stomachs should be empty for the vast majority of the time. Sadly, our society glorifies food as the gateway to social and professional success.
2
Tell us about the science on this. Not believing there is any. Why would an allergy make a person's body MORE efficient in using calories?How is that allergic or even analogous to allergy? Gaining weight is a sign of health not of illness.( Even while it makes you less healthy at some point.) Can you imagine your car going twice as far on a gallon of gas because it is broken?
1
For the science, I'd recommend Gary Taubes' "Why we get fat" and Nina Teicholtz "The Big Fat Surprise."
The key scientific findings about obesity, sadly, have been with us for almost 100 years since German scientists figured out how insulin works. What's sad is that obesity is treated like this big mystery, when the cause -- and solution -- is as plain as day. Excessive carbohydrate consumption causes almost all obesity, and carbohydrate diets will alleviate all cases.
And it really can be done. People talk like it's impossible for obese people to overcome their condition but it's not. Better eating really can work -- and it doesn't have to be starvation. It is possible to construct low-carb diets that are delicious, hearty, filling, diverse and healthy. There are hundreds of thousands, maybe millions of Americans, who have successfully made the transition and lost weight. But it is a permanent lifestyle change.
The biggest obstacle is that there are so many scientists with financial ties to the food industry trying to obscure this. Soda manufacturers, sugar and corn syrup manufacturers, grain farmers -- this is a rich and powerful group and they have effectively lobbied the USDA for 50 years to recommend a terrible diet (the infamous food pyramid). The food pyramid made our country obese, but fortunately it can be reversed if people will just eat the right things and stop eating the wrong things.
14
Fat but fit?
All this does is go on about the metabolic and cardiology implications of fat.
The one thing that is the elephant in the room is the effect of fat on bones.
Carrying excess fat puts more strain and wear on the skeleton than it is designed to handle
People who are fat - even just the 'few' extra pounds - are damaging their
Hips
Knees
Ankles
Spine
Hips and knees can be replaced.
Spines can not be replaced
Fat is the leading cause of spinal spondylosis - severe arthritic bone changes in the spine which reduce the ability of the spine to flex, and, if the changes are in certain locations, pinch and damage nerves That is a condition that leaves people unable to bend, sit for long or walk; and they can end up in a wheelchair
Packing the extra fat, the extra pounds will ALWAYS damage the skeleton
When the fat damages the skeleton, it can NEVER be healthy - and it always causes damage sooner or later
92
Hips, knees and ankles are joints. You are mixing up bones and joints. When most people have knee pain (the most common pain), it is because they have worn out the cartilage inside the joint -- not because their points are weak.
Thin people often don't get enough calcium in their diets to put down good bone density by their 30s; after that, it is not possible to do so.
Ask any doctor who is more likely to have a hip fracture in old age -- the pleasantly plump old lady -- or the one who is frail and bird-thin, with no padding and osteoporosis from years of dieting.
I am not arguing FOR obesity -- nobody wants to be obese -- only that there is no point hectoring or nagging people. There is no known effective treatment for obesity. If you point out all kinds of bleak outcomes, you will get people to diet more -- you'll make them despair of any hope, so they will just sit on the couch and eat more Doritos.
18
Oh go away. You just can't resist - in any article - popping in your totally irrelevant and typically dead wrong two cents. Never saw someone who so loved the sound of their own voice or typing
Joints are where the bones meet
Arthritis is where the bone develops calcium deposits. Usually where the bone is being worn improperly (bad conformation) or is overstressed (fat)
Typically arthritis occurs in the joints. Spinal arthritis (spondylois) occurs because the vertebra become unstable because they (10 have an inherent structural defect or (b) are over-stressed (the fat)
Joints ARE part of the skeletal structure.
18
Almost all the people I know who are nearing or over 90 are frail and bird-thin, though, so there must be some correlation with longevity. And the few that are heavy at that age have huge mobility problems whereas the bird-like ones are trotting about and even taking long walks for pleasure.
2
If "metabolically healthy obesity doesn't exist' then every obese person should get heart disease, according to the flawed logic of the authors. These are just risk factors. It doesn't mean that every obese person is going to get heart failure or have a stroke. Some of them do, but in this case a lot of them don't. You might as well say that "metabolically healthy normal weight" doesn't exist because some normal weight people developed heart disease.
14
Doctors, researchers, epidemiologists and others are under HUGE pressure to condemn obesity and make obese individuals pariahs -- who must be fined, denied health care (!!!), have their foods taxed and otherwise be nagged, lectured, hectored, finger-wagged and otherwise socially shamed. It is part of our general cultural obsession with weight.
7
By the same logic then, smoking isn't unhealthy for the majority of smokers...
8
can we dispense with this focus on BMI? its absolutely discriminates against muscular people, confusing them with people who have high body fat levels.
I've told my Drs for 10 years that I'm far more concerned with maintaining a low level of INFLAMMATION than anything else. maybe one day medical science will catch up and realize almost ANY serious disorder is inflammation-based up to and including MS, Parkinsons, Lupus, MD, most cancers and about any other dirorder you can name.
Ive had a hsCRP done 2x/yr since 2006 and have managed to keep it so low its almost undetectable in about 5-6 of te tests over time. I dont smoke, drink almost at all, used to fight in my 20's, did triathlons in 30's and started power lifting in my 40's when I went from 150ish to 215 at my heaviest in less than 4 years. I do ross fit now, lost 25 of it but couldnt get under 170 now with a gun to my head. I'm never sick, have no lung phglem or runny nose problems (a real indicator of low-grade inflammation) and eat OK but Im not weird about it except I eat NO fried foods. ever.
and yes, the plural of anedcdotes is data, but somebody needs to investigate whether control of inflammation IS the key to better health. its coincidental only that excess body fat is a permanent low-grade case in inflammation but its not the fat.....its the inflammation. you heard it here first.
12
Do you take statins? that is the frontline in the fight against inflammation (which I agree is troubling) -- but most people cannot tolerate statins, which have terrible side effects.
2
Actually Turmeric Acid, Ginseng, et/ al...are on the "front-line" against inflammation...Statins are the WORST supplements you can take...especially if you are over 50...basically Statins suck, and are being "pushed" by MDs...even DOs...beyond the pale these fools are...
1
The reason people overeat to the point of being visibly overweight is psychological pain.
Anyone who tries to lose weight but can't should see a therapist--not about the weight, but about the pain/anxiety/fear driving the overeating.
"Fat but fit" misses the point. Fat is a symptom of emotional pain, no matter how calm or peaceful or happy the overweight person appears to be.
I don't see fat people; I see people in pain, as many of us are.
Almost all of us need healing, too.
56
I don't know about psychological pain leading to overeating. Hard to imagine a physically healthy person can overeat on a regular basis. Modern medicine focuses on acute conditions, and has a really broad definition of physical fitness. Mental process has its biological basis and is necessarily affected physical conditions.
1
As a psychiatrist I have observed that my patients are LESS overweight than the average person I see on the street. The degree of their psychic pain and pathology does NOT correlate with their level of obesity. They do not lose weight when they become healthier mentally. So where exactly do you get your theory from?
46
I remember the day I discovered the joy of overeating. I was a high school student at boarding school. The headmaster announced that three seniors had just died in a car crash.
Some students were shocked out of any appetite. My body's response to the horror was to wrap buttered toast around bacon and soothe my soul with every sweet-and-salty bite.
Similarly, after a stillbirth, with tears running down my face, I consumed half a roast chicken with all the trimmings.
Something about my physiology equates eating extra food with surviving adversity. Possibly this got inculcated before earliest memory, by caregivers who tried to banish tears with special food treats.
Anyhow, even today when I'm in distress I must use precious strength to deny myself the succor of food.
4
Doesn't matter what your size is the key is to move. Knowing that eating poor fatty food will make it painful to exercise is a great way to improve a person's diet.
3
Sugar and refined carbs create addiction and hence lead to overeating. Give a child a big plate of plain meat or fish and loads of vegetables and if they are really hungry they will eat until reasonably full. Offer them more veggies/meat and they will say No thanks, but offer them candy, pie cookies, ice cream etc. and they will get very excited and say yes please! Anyone with kids/ grandkids can put this to the test. BOTTOM LINE eat real, whole food and reject frankenfoods loaded with sugar and refined carbs.
105
There are plenty of fat people who don't especially like sweets or snack foods. You can get very fat eating nothing but meat and potatoes (*which are a vegetable!).
All vegetables are carbs. To your body....a carb is a carb. (What makes vegetables superior to chocolate cake is not the carb factor, but that the vegetable has vitamins, minerals, nutrients and fiber.)
9
yes veggies have vitamins, minerals etc. but there is another important difference. the sugar in vegetables is wrapped up inside the plant cell, where it takes longer for our bodies to digest it. this isn't true for chocolate cake, where the sugar is immediately available, causing sugar spikes and bursts of insulin.
1
I have type 2 diabetes and high blood pressure, both under control. I am also obese but I am losing weight, mostly just to feel better rather than to avoid heart problems. So far I've lost almost 20 lbs and my knees feel better. That's the kind of health improvement I want. Maybe if I can lose another 20, I'll be able to walk again. Wish me well.
211
Keep at it, George, well done!
16
Best wishes sent your way!
4
Keep up the good fight and good luck! You're giving yourself more sunsets, more days reading the NY Times, more time with your friends and family, more time to see the world unfold and you will have less pain while you do all those things.
5
The writer points out that in this study people who were metabolically healthy but considered merely overweight were at increased risk of coronary heart disease. However she fails to point out that people who were metabolically healthy and overweight were at either lower risk or no increased risk of cerebrovascular disease, heart failure, of peripheral vascular disease, compared to normal weight metabolically healthy people. This selective reporting and this blurring of the differences between overweight and obesity just serve to confuse the issues..
13
Making your legs (and their veins) carry a lot of weight is just asking for trouble. Yes, heredity as always plays a large role in varicosities and clots, but it doesn't do to make those extremities work harder than they have to.
6
Yes, skinny people have typically been presumed healthy so it is useful to finally disprove that automatic assumption. Especially since for many who are underweight it is NOT an conscious choice and they are not doing anything in particular to be "healthy" - so no particularly nutritionally dense diet, low in sugar, etc. They appear to be "blessed" and even doctors let them off easily, unless the rest of us.
8
What do we mean when we use the word "fit"? In this paper they focused on one aspect of fitness, 'metabolic fitness'. Fitness, however, is a term that is multi-dimensional. For example, A study based on data from approximately 43,000 adults, published in 2012 in the European Heart Journal found that about 38% the most fit individuals were (top 20%) were obese (BMI >30kg/m2). So in this study, many of the most aerobically fit individuals were obese. There are several other studies that confirm the finding. My point is that it really depends on how one defines 'fitness' as to our interpretation of the data. I would like to see a paper that attempts to quantify over-all fitness (aerobic, strength, metabolic, morphometric) and then compare normal, overweight, and obese individuals regarding fitness. I would not be surprised if a larger than expected number of obese individuals (though a small percentage of the total) were quite fit.
12
After 40 years of dieting (and failing to get thin again), I've accepted that this is it: I'm fat. But I try to eat as low carb a diet as possible, and it has paid off - I am no longer pre-diabetic, and my labs are great. All the dietary studies I read about are based on a diet that includes carbohydrates. For that reason, I feel the're flawed. Obese people should not be eating carbs. The results of all those studies might be radically different then!
53
Fruits and vegetables are carbs.
Are you saying obese people should not eat fruits or vegetables?
2
Fruits and root vegetables= relatively high levels of carbs; leafy vegetables = low in carbs. You can eat lots of vegetables and some berries now and then and stay quite low carb, and low carb eating is incredibly effective for treating obesity and diabetes.
mdytch means simple carbs. stay away from simple carbs like glucose, fructose, white flour etc. Personally, i can stay away from added sugars most of the time, but avoiding all carbs? i don't think i can do that.
1
My mom lived to be almost 100, eating fruits veggies with meat merely a condiment, swimming almost every day, keeping a calm peaceful spirit. She was overweight as was my father, who died in his mid sixties, after diabetes and heart attacks took their painful toll. He needed to be his regular weight, she didn't. How can I tell which fate awaits me? I can't. Better I stay healthy, at my normal weight, well exercised 30-40 minutes a day, dining half on vegetables and fruit, leading a calm and modest life, balanced with work I enjoy, quality time with loving family and friends, and regular rest and renewal time. Well, that's my goal, anyway.
37
Good plan, especially since eating well and keeping a normal weight likely means you will feel better for the years you have, whether you live to be 100 or 65.
7
I don't think you can overstate the "calm peaceful spirit" part.
Nearly all of the people I have known personally, who lived to a very ripe old age, had naturally very calm peaceful personalities -- the angry rage-filled types all died young. This was irrespective of their body weight.
5
except my mother! She is about the most UNcalm person I know, and going strong at 98.
If you go to the original article it actually says that in many cases the moderately obese individuals with no other risk factors are actually more healthy as far as cardiac fitness. Underweight people tend to stroke out more often.
9
This article ends by observing:"Interestingly, while the risks of being overweight and obese draw scrutiny, doctors are often at a loss to explain the risks of being too thin." Yes! We need an article on thinness but we need that it takes into account the crucial differences between: anorexia, too thin and, thin (discussing bone structure which ia generally left out of the analyses).
7
Ways to measure muscle weight should be widely available ! A short NFL running back is not considered to be obese even if he is 50 pounds overweight for his height. Similarly, active people who do physical jobs must have higher than average muscle weight. It would seem logical that people with more muscle weight would not be considered obese at the same weight levels as others. Without appropriate adjustments for muscle weight, too much corrective action could be taken.
5
The bottom line Imo from all data that I have read is that overweight people (not obese) live about the same number of yrs on average than average weight people.
However, they have all sorts of quality of life issues from diabetes, heart disease, bad knees, backs, feet etc. than normal weight people.
It goes with my equality of life theory, i.e. even though they live the same amount of yrs., they suffer from all sorts of ailments but enjoyed eating those hot fudge sundaes and greasy foods.
4
Good point Paul. That is why I like doing things that add life to my years over adding years to my life!
1
Yes, because of course -- ALL overweight people do nothing but scarf down hot fudge sundaes and greasy foods.
And as we know, no normal weight people have EVER eaten a hot fudge sundae or any greasy food.
<< rolls eyes >>
At 61, I know a heck of a lot of thin & normal weight people who have knee problems. My own orthopedic surgeon (yes, I had knee surgery -- but due to an accident) told me that the cartilage in your knees was only designed to last about 50 years under OPTIMAL conditions -- because people did not used to live much longer than that! Today, we are asking body parts to last 90 years when they were designed for only 50 -- knees, hips, backs, teeth, vision & hearing!
He also told me that most of his patients were there due to sports related injuries.
Paul: you seem to be under the impression that EVERY overweight person -- even those just slightly above ideal weight -- is diabetic. This is not even remotely true.
13
Also--"they" have changed thre requirements for joint surgery--they no longer demand you lose 50 lbs or something--bec people usually cannot do this. Joint problems are genetically involved--I am the fat one of the four sibs--the other three have had replacements...hips, basically. I refuse to do my painy knees because of horrible medical experiences in AZ. My mom was one of four kids--skinny, turned up her nose at meat, even did Adele Davis for yrs, died at 95. Her sister was "the fat one," ate Midwestern food--still going at 100. Good stock!
3
Telling people that obesity is "genetic" and that, accordingly, their weight and their health is beyond their control and that they are doomed to their fates is a lie, a disservice to them, not substantiated in the medical literature, and is a message happily brought to them by the processed food, soda, dairy, beef, pharmaceutical, weight-loss and health insurance industries, all of which profit OBSCENELY off of this cultured ignorance. Obesity is 95% controlled by your diet, simple as that. It's the food, it's the food, it's the food. Case In Point: I could come from a family line of 15 generations of fat, obese slobs, but if I choose in my life to eat a primarily plant based, whole foods diet rich in G-BOMBS (i.e., greens, beans, onions, mushrooms, berries and seeds), I'm going to be slim, trim and healthy. My "genetics"? Meaningless. My food choices? Everything. Pro Tip: It's not HOW MUCH you eat, it's WHAT you eat. A calorie is not a calorie. Spread the word. Ignorance kills.
51
Ignore genetics at your peril.
Cancer runs riot in my family. Of course, those who developed lung cancer were smokers, and a childless aunt developed ovarian cancer. Others had other cancers. But a first cousin who never smoked, never took drugs, ate vegetables and only some poultry and fish, and was straight and lean, developed cancer nevertheless.
There's a DNA basis for most things: blue eyes, musical talent, double-jointedness, intelligence. Some of our genes we can work around, some we can develop -- but don't discount them.
11
So, "just say no"? Did you ever consider that the ability to say no might be genetic?
9
I've read scientific articles published in peer reviewed journals that conclude that poor diet results in about 80% of the chronic diseases in this and other developed countries. The other 20% is obviously due to something else. But 80% is a huge number; if improving diet could eliminate 80% of chronic diseases, it would be more successful than most drugs and medical procedures available today. And btw, my husband's siblings -- with one exception -- are overweight to obese. He was overweight when I met him 10 years ago. He started eating my cooking (vegetarian, not vegan), and gradually lost 30 pounds initially and then 5-10 more. So, it's not genetics in most cases.
4
These data continue to support common sense. Fat storage has its evolutionary basis to survive famines, but you pay the price of poorer health and longevity. And I have never met anyone who believes that being obese feels like you're leading a better life, physically or emotionally.
19
Not true a Goldstein, i.e. you promote the healthy life, that is ok, nothing wrong with that and with obesity you are only are miserable but lead a short life on average.
However, the overweight person makes a life choice, i.e. he or she would rather eat those hot fudge sundaes and greasy foods all their life and pay for it, than not having the fun.
So from there point of view, they are leaving a better life than if they did not.
3
@a goldstein:
This is also known as the "thrifty gene" hypothesis. Problem is, it assumes that there would have been no evolutionary penalty for obesity or diabetes. No animal on its native diet overeats to the point of disability or disease, to do so would be just as maladaptive as undereating to the point of starvation.
1
It would be wonderful if you could be obese or seriously overweight and not have your health affected. But such people are a rare as unicorns. Even if your heart is not affected your musculo-skeletal will be ie knees, hips, etc.
The argument that one can be unaffected is cultish, faddish and fantasist, possibly the result of the fat acceptance movement, a kind of denialism. Let me be clear, I am absolutely opposed to discrimination and stigma and while we think it is an 'individual' issue because this problem appears at a population level it is a societally-formed condition.
But people should get real. The human body should be lean, any divergence from this stage has consequences.
188
Here in America, Mr. Rayner, we either make pathological what we don't like, and so excuse it, or turn it into a virtue. In that way, we can avoid dealing with societal issues or, heaven forbid, hurting people's feelings. Families leave their garbage behind when they're done picnicking in our public parks? Guys hang out on street corners and shoot one another? They really can't help it. None of them. They have so little, after all.
A good way to debase a society altogether.
9
Obesity has other ramifications, including over consumption of foods that require fossil fuels and other resources. Frankly, it's not discrimination any more than driving a Hummer or Prius should be free of judgement.
1
No doubt the human body should be lean, but let's be real. For some of us, that's a very difficult goal, especially as we grow older. I lost about 90 pounds a decade ago and was accused of looking anorexic at 116 pounds on my 5'4" frame, though I wasn't. Now I am back to the mid-1960's and would definitely prefer to be at least 25 pounds thinner.
The question is how to get there. Anyone can lose weight if they practice self-denial. The larger issue is how to stay lean after losing weight.
1
Well sure, people whose ancestors survived in the Pleistocene by storing fat for famine are not well-adapted to our obesogenic environment of Frankenfoods and dieting. But the implication of the article, that they should strive to be normal weight, is like telling short people it would be better to be tall. So it would, but it’s not going to happen because of biology. So, thanks for piling shame on those already disadvantaged by genetics. The Times has published a number of articles detailing how dieting leads to weight gain and makes people more vulnerable to hyper-palatable processed foods. The overweight and obese can profitably focus on being happy, eating healthy and getting exercise. It would help if they were not stigmatized for something beyond their control.
72
I agree with you about not shaming people. But some overweight people do lose weight and keep it off. Articles like this motivate me not to gain or even to take off a few pounds.
4
You contradict yourself. Yyour right when you say its about frankenfoods, specifically refined carbs/sugar. Then you say its genetics, well yes and no to that. IAC, THE FOOD INDUSTRY, NOT UNLIKE TOBACCO, IS POISIONING AND ADDICTING MILLIONS.
11
Clare: but articles like this DO shame people -- read the comments -- they are full of blame, finger-pointing, accusations, etc. One poster has already posted TWICE that "fat people eat nothing but hot fudge sundaes and greasy foods" (*because he personally knows every single thing eaten by tens of millions of fat people).
They also make for public policy that encourages useless nanny-stating like taxing soda pop -- "because you must stop those awful fat people from drinking their Big Gulp sodas!"
The percentage of fat people who PERMANENTLY lose large amounts of weight -- i.e., not a few pounds but who become slender -- is very, very low -- perhaps 2-3% of all fat people. Even gastric bypass surgery cannot guarantee a fat person will end up being thin.
This is not meant as discouragement, just realism. Encouraging people to be active and healthy has positive effects for them and for society. Shaming and hectoring makes people despair, and give up on fitness or activity, since it "won't guarantee to make them thin".
7
No benefit for being overweight has ever been found. Its just bad for the body. Aside from the obvious concerns with heart disease and diabetes, as you age the weight will affect your mobility and keep you from being active. I believe Michael Pollans quote (Eat real food. Not too much. Mostly plants) says it all. I would add KEEP MOVING!
136
Sure, but you can do all that and still have a BMI categorizing you as overweight or obese.
12
Actually the data for years has shown that people in the overweight category have the best longevity.
http://www.npr.org/sections/health-shots/2016/05/10/477376914/does-putti...
I recommend this Atlantic article on how obesity became a disease in 2013, contrary to the recommendation of the AMA's Committee on Science and Public Health.
https://www.google.com/amp/s/www.theatlantic.com/amp/article/388300/
1
I tell my patients that the most important thing they can do for their health is to get down to their ideal weight. Achieving ideal weight is more important than all the medications I can prescribe. They ask me how and I tell them 70% diet and 30% exercise.
20
"I tell them 70% diet and 30% exercise"
That's nice. Is there data that it works, or does it send patients down the destructive path of a life-time of weight cycling?
33
When I lost 120 pounds, I found it was about 100% diet, 0% exercise. In face, every time I tried to exercise, I gained weight. I'm not saying exercise is not useful, but it is in no way, shape, or form a weight loss tool. It's a health tool. I wish people weren't mislead in this regard.
108
That's such a lovely suggestion for your obese patients. Of course, they already know that and have fought a lifelong battle to get to their ideal weight and have been unable to do so, or have gotten there several times only to come back to the weight their body seems to prefer. I hope you have more help for them than that simple suggestion. I'm not saying there is a magic remedy for obesity, just that what we're doing now is clearly not working and we need more than a suggestion to do what is impossible for us.
25
My father was obese but fit. He ate a lot of fruits and vegetables and didn't drink. He exercised. He died of Type II complications at age 71. He ignored the doctors' instructions to lose weight.
13
Dear Abby,
I am sorry for your loss, and 71 is kind of young to pass away these days. But since he had diabetes, he did not fit the profile they're talking about here, which was overweight with no other serious health problems. Still, this does bring up the point that being overweight nearly invariably causes other health problems in later life anyway.
My sympathies to you. I have dear, close friends and family members who are obese but fit and year after year, decade after decade ignore their doctor's advice to lose weight. (And wind up with Type II eventually.) My husband and I, who fight the good fight as much as we can, both are dreading getting older. We know I will eventually get type II (It comes to me from both sides of my family and although my A1C is currently only a 5.1 - which happily, IS astounding, in a good way, some of my doctors, I know it will eventually edge its way up no matter how hard I work.) but that we have decent chances of being healthy and living long lives. We know these people so dear to us have much lower probabilities of being with us as long and we dread the day it catches up to them.
1
Good heavens--diabetes is not inevitable for you!
3