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Wednesday, January 2, 2013

You Don't Have to Be Thin to Be Healthy

Posted by on Wed, Jan 2, 2013 at 6:00 AM

Study says:

The report on nearly three million people found that those whose B.M.I. ranked them as overweight had less risk of dying than people of normal weight. And while obese people had a greater mortality risk over all, those at the lowest obesity level (B.M.I. of 30 to 34.9) were not more likely to die than normal-weight people.

There does seem to be some question, at least among the experts quoted in this story, as to whether people ranked overweight by their Body Mass Index live longer because of their weight ("There’s something about extra body fat when you’re older that is providing some reserve," says one expert) or because their weight is just causing them to have increased contact with medical professionals ("You’re more likely to be in your doctor’s office and more likely to be treated," says another expert).

But, this seems clear: “Fat per se is not as bad as we thought."

 

Comments (40) RSS

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Fifty-Two-Eighty 1
I'm sure John Candy would agree wholeheartedly. If he was still alive, that is.
Posted by Fifty-Two-Eighty http://www.nra.org on January 2, 2013 at 6:52 AM · Report this
2
BMI is a bad way to evaluate weight, as it doesn't differientate between fat and muscle, so you cam't tell ifr it if someone is actually overweight. Body fat % would be much more telling.
Posted by Ebenezer on January 2, 2013 at 7:01 AM · Report this
3
Excuse typo please - too early in the morning
Posted by Ebenezer on January 2, 2013 at 7:02 AM · Report this
4
Somebody needs to go tell the Japanese they're doing it all wrong. Ours is the only country I know where we keep producing studies and keep discovering new truths about health and longevity, except we don't end up experiencing health and longevity!
Posted by ScruffyBallardMan on January 2, 2013 at 7:20 AM · Report this
Theodore Gorath 5
Body fat and BMI is like penis size: It only really matters at the extremes.

On another note, where is my Swashbuckling Hero tag? I have been waiting very patiently, and followed your directions to the letter.
Posted by Theodore Gorath on January 2, 2013 at 7:25 AM · Report this
Theodore Gorath 6
Haha, I should have known the Stranger would make that happen on my first post after the new year when I had no way of knowing before I made a post.

Thanks Strangers!
Posted by Theodore Gorath on January 2, 2013 at 7:26 AM · Report this
8
@2 is absolutely correct. BMI is like a pitcher's win-loss stat, it can be very deceptive. Just look at all those professional athletes who have bmi's that are technically off the charts, but body fat percentage in the low single digits. If you don't distinguish between muscle mass and fat, the study is sort of pointless.
Posted by dave1976 on January 2, 2013 at 7:42 AM · Report this
Zotz 9
If you're fat, you may live just as long as someone who is normal weight. QOL is another matter.

The fundamental insight about diabesity is that it doesn't kill you, but it makes your life suck (medication, insulin injections, gangrene of the extremities, hoverround chairs, etc.).
Posted by Zotz on January 2, 2013 at 7:51 AM · Report this
Matt the Engineer 10
@7 Are you claiming this study was put out by Hostess, or that the researchers themselves are fat? It's easy to say a study's total crap before you read it.
Posted by Matt the Engineer on January 2, 2013 at 8:12 AM · Report this
Matt the Engineer 11
@5 What were the steps? I sent in a donation, then forwarded my reciept. I assumed that entering the contest was the same as getting a tag.
Posted by Matt the Engineer on January 2, 2013 at 8:14 AM · Report this
Foghorn Leghorn 12
I wonder if accidents were taken into account. Maybe a bunch of the skinnies were crazy fitness buffs, who died tragically during high-five accidents while Cross-Country-Extreme-Heli-Jumping. Meanwhile Fatty McFaterson was safe on his comfy couch watching Biggest Loser and eating a bucket of Deep Fried Finely Textured Reclaimed Meat-Food Sticks. Or maybe generalizations are misleading.
Posted by Foghorn Leghorn on January 2, 2013 at 8:16 AM · Report this
Matt the Engineer 13
@7 Ok, I looked at the paper for you. It's a review of 100 studies of over 3 million people, published in the JAMA. Sounds pretty comprehensive to me. And that would rule out "but all the high BMI people are probably just body builders". Out of almost any group of 3 million Americans, the average high BMI person is just fat. (it was actually an international analysis, but most of the studies were US based)
Posted by Matt the Engineer on January 2, 2013 at 8:24 AM · Report this
fletc3her 14
Obesity is defined as the weight above which you start to see significant health risks. When we say a third of the country is obese it's the same as saying we expect that a third of the country weighs enough that they will see significant health risks down the road.

Many people have gone on managed weight loss plans and found that their goal weight based on BMI for their height was simply unattainable. Different body types may find a seemingly healthy sustainable weight that is still technically "obese" on the chart. Finding a healthy weight should be the key, not simply attaining a BMI goal.
Posted by fletc3her on January 2, 2013 at 8:26 AM · Report this
Asparagus! 15
Being inactive and thin is much less healthy being 'overweight' and walking regularly.
Posted by Asparagus! on January 2, 2013 at 8:33 AM · Report this
Free Lunch 16
Note that it says nothing about the quality of that life. I'd take fewer years of a healthy life over decades of type 2 diabetes, or rolling around in a motorized scooter amid palpable scorn.
Posted by Free Lunch on January 2, 2013 at 8:37 AM · Report this
Free Lunch 17
(Thus the title of this post is misleading, as the study does not even consider health.)
Posted by Free Lunch on January 2, 2013 at 8:39 AM · Report this
Matt the Engineer 18
@16 Keep in mind the study actually says the truely obese have a much greater risk of death. I think that includes the motorized scooter level of obese. It's just those at, say, 6' tall and 230lbs that aren't as bad off as everyone thought.
Posted by Matt the Engineer on January 2, 2013 at 8:46 AM · Report this
Ph'nglui mglw'nafh Cthulhu R'lyeh wgah'nagl fhtagn 19
Go back and read the article again, Eli.
Posted by Ph'nglui mglw'nafh Cthulhu R'lyeh wgah'nagl fhtagn http://youtu.be/zu-akdyxpUc on January 2, 2013 at 9:00 AM · Report this
34x42 20
fat country seeks to convince people that fat is healthy. maybe lindy west could write a story about this?
Posted by 34x42 on January 2, 2013 at 9:04 AM · Report this
vavavarooooom 21
So, just for the record, this comment thread is what science is for. You have these ideas that 'everybody knows,' and you test them. Sometimes you find out that what you 'knew' isn't entirely true. That is hard for most people. At one point everybody knew that gay people were just confused. Everybody knew that beating a child was good for him. Everybody knew that eggs were terrible for your cholesterol. Everybody knew that a Catholic priest is one of the safest, kindest people there are.

Anyway, all the comments about how fat fucks are always unhealthy is kind of ridiculous, when clearly that isn't true. Thin people get heart disease. Thin people get cancer.

To the point on BMI - it is useless for an individual person, and maybe someday we can get doctors to stop using it, but it is useful for studying large populations. Most people are not bodybuilders.

Posted by vavavarooooom on January 2, 2013 at 9:06 AM · Report this
22
I think the study just says BMI is too simplistic to gauge health with. Move along!
Posted by CbytheSea on January 2, 2013 at 9:10 AM · Report this
Free Lunch 23
@21 - Isn't "most people are not body builders" just another thing that "everyone knows" - i.e., exactly what you are arguing against?
Posted by Free Lunch on January 2, 2013 at 9:19 AM · Report this
24
Please also note that the study was saying that those at the low end of the "obese" range of the BMI scale seemed to not have adverse health affects. Maybe we are so thin obsessed that we start labeling people "obese" when that is just not the case. I think that we just dislike fat so much that we have gone overboard on our fat hate obsession. If being in the BMI range of 30 to 34.9 does not have adverse health effects in general, maybe those in that range are simply not "obese".

Maybe we should pay more attention to eating right and exercising, and pay less attention to people's "love handles". Christ sakes people. Quit finding reasons to hate on other people.
Posted by SeattleKim on January 2, 2013 at 9:21 AM · Report this
vavavarooooom 25
Here is another article which studied nearly 12000 Americans, and looked at mortality correlated with BMI and number of 'healthy habits.' They focused on smoking, alcohol, exercise, and intake of fruits and vegetables. >2000 people in the group died in the 6 years they followed them.

The high (>30) BMI people with zero healthy habits died at 7X the rate of people with high BMI and all 4 habits, and 3X the rate of people with low BMI and no habits. People with only one 'healthy habit' all died at roughly the same rate, regardless of BMI, and at 2X the rate of people with 4 habits.

http://www.jabfm.org/content/25/1/9.full

This is a link to the text but you can get the pdf for free, which I find easier to read.
Posted by vavavarooooom on January 2, 2013 at 9:21 AM · Report this
vavavarooooom 26
@23 - Ha! I see your point. Yes, I suppose I must allow for the possibility that every single high-BMI person in all studies have been body-builders.
Posted by vavavarooooom on January 2, 2013 at 9:29 AM · Report this
emor 27
I'm six feet and 220 lbs. So, fat. But my quality of life is okay. I ride my bike over mountain passes and stuff. Ride to work every day, walk all over the place, including 4-7 miles at work. Also, not a body builder. Just a big guy who loves eating.

I do know some really skinny people who don't exercise and can't or won't ride their bikes over mountain passes. I'd take my quality of life over theirs. Also, don't endurance athletes regularly die of heart attacks in their 50s?
Posted by emor on January 2, 2013 at 10:13 AM · Report this
28
It's not just skinny people who don't exercise -- it is skinny people who binge eat and purge. Skinny people who starve themselves to look a certain way. Skinny people hopped up on drugs to stay skinny. Skinny people with interior lives that are highly stressful. @25 has the right idea -- BMI with HEALTHY HABITS is the way to look at it.

This obsession with how one looks is killing lots of skinny people.
Posted by bareboards on January 2, 2013 at 10:23 AM · Report this
29
Jesus Christ. Eli. I am sincerely disappointed.

BMI is only a slightly useful tool when trying to calculate the over-all body mass of an aggregate population for extremely generalized statistical tables used by health insurance companies. It is far too general of an index to draw any other conclusions from.

For the millionth time BMI has fuck all to do with body fat percentage.

On these BMI tables people like me rate as "obese" even though I have a body fat of less than 12%. This study is including people with high percentage of muscle mass as "obese."

I have yet to ever hear of any scientifically valid study that claims that people under 60 with high percentage body fat - over 25% percent body fat - have anything but increasingly higher rates of disease and mortality. If there is, this one isn't it.

Posted by tkc on January 2, 2013 at 10:36 AM · Report this
30
The Seattle Times this morning printed two completely contradictory stories about the same study, the one you cite here and another titled "Fructose may lead us to overeat, study suggests." The second half of the latter story deals with the BMI/mortality study. It is considerably more critical of both the study and its findings, and of the chief researcher involved. Here's a sample:
"The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly higher risk of death than those who were overweight. Many experts criticized that work, saying the researcher — Katherine Flegal of the Centers for Disease Control and Prevention — painted a misleading picture by including smokers and people with health problems ranging from cancer to heart disease. Those people tend to weigh less and therefore make pudgy people look healthy by comparison.

Flegal’s new analysis bolsters her original one by assessing nearly 100 other studies covering almost 2.9 million people around the world. She again concluded that very obese people had the highest risk of death but that overweight people had a 6 percent lower mortality rate than thinner people. She also concluded that mildly obese people had a death risk similar to that of normal-weight people.

Critics again have focused on her methods. This time, she included people too thin to fit what some consider to be normal weight. The study could have taken in people emaciated by cancer or other diseases, as well as smokers with elevated risks of heart disease and cancer.

“Some portion of those thin people are actually sick, and sick people tend to die sooner,” said Donald Berry, a biostatistician at the University of Texas MD Anderson Cancer Center in Houston.

The problems created by the study’s inclusion of smokers and people with pre-existing illness “cannot be ignored,” said Susan Gapstur, vice president of epidemiology for the American Cancer Society.

A third critic, Dr. Walter Willett of the Harvard School of Public Health, was blunter: “This is an even greater pile of rubbish” than the 2005 study, he said. Willett and others have done research since the 2005 study that found higher death risks from being overweight or obese."
More...
Posted by cheakamus on January 2, 2013 at 10:42 AM · Report this
31
@18

No. That is not at all what the study says.

Basically when people get older they loose mass. Both muscle and fat. And when your old and get, say, an infection like pneumonia if your body doesn't have the energy reserves in either fat or muscle you are more likely succumb to fatal complications.

What this study does not take into account in the general starting health of the population nor does it adjust competently for the age these people first became classified as obese.

All this study is saying is that if you make it to seventy in a fairly healthy state - pack on the weight.

We have seen over the last thirty years a dramatic and exponential increase in people under twenty classified as obese and with that a dramatic increase in chronic diseases inflicting younger and younger populations and medical interventions occurring with more frequency and intensity.

The CDC has projected that if these trends continue the US will be the first industrial nation to see a reduction in life expectancy.

http://www.cdc.gov/obesity/data/adult.ht…
Posted by tkc on January 2, 2013 at 10:51 AM · Report this
Will in Seattle 32
Look, three real medical takehome lessons:

1. Fructose will make you fat. Period. Eat a diet higher in UNPROCESSED grains, fruits, and vegetables and lower in red meat.

2. Having a few extra pounds keeps you from dying when you do get sick or injured. One reason why women think men like skinny women when, in fact, men prefer women who aren't too thin. Either that or thin women just tend to be more bitchy and neurotic. Ok, maybe the latter.

3. Seeing constant images of unattainable thin models causes you to GAIN WEIGHT. You actually lose more weight on a diet if you don't see such constant reminders of unattainable BMI women (actually, mostly girls).

Take from that what you will.
Posted by Will in Seattle http://www.facebook.com/WillSeattle on January 2, 2013 at 10:53 AM · Report this
Theodore Gorath 33
@11: That is all I did...I figured maybe the delay was holiday related. Donate, forward receipt to charity@thestranger.com with your user name, and you should be good.

Maybe you forgot to include your user name?
Posted by Theodore Gorath on January 2, 2013 at 11:01 AM · Report this
Aurora Erratic 34
In what way are they "overweight" then? Over the weight that makes you more likely to die?
Posted by Aurora Erratic http://www.finemesspottery.com on January 2, 2013 at 11:18 AM · Report this
keshmeshi 35
@29,

A recent study shows that BMI tends to *underestimate* people's body fat percentage. In other words, people have more fat and less muscle than even BMI presumes, so, if this study is accurate, it shows that even a relatively high body fat percentage is not necessarily unhealthy. Other studies have also indicated this, demonstrating that people in the "overweight" range have greater longevity than "normal" weight people and much more longevity than those who are medically deemed underweight. Meanwhile, people in the low range of "obese" have about the same mortality as those with "normal" weight. It's almost as if those in the medical establishment pulled their weight guidelines out of their asses, along with the high-carb, low-fat dogma they embraced in the '70s and '80s.
Posted by keshmeshi on January 2, 2013 at 11:36 AM · Report this
34x42 36
@32,

you think you know what men prefer? i am a man who prefers thin women over women with extra fat hanging about. please don't speak for men.
Posted by 34x42 on January 2, 2013 at 11:56 AM · Report this
37
@29 If you are going to mention "other studies" it would be awesome if you'd post cited links for them.

All I n=know for a fact is this - as far as medicine and science is concerned it is a settled matter that obesity is THE leading indicator for chronic disease and predictor of mortality. We now have nearly fifty years of data. It's tantamount to climate change denial to dispute this fact.

All this study says is that if you are already HEALTHY and on the lower end of what BMI classifies as obese (it say literally nothing about body fat percentage) then your mortality is average. But that is because "average" now is less healthy than ever and advanced medical intervention is happening with higher frequency than ever.

It says nothing about predicting increased obesity rates and it says nothing about quality of life and medical interventions.

In twenty years the sheer number of older adults with life-long chronic diseases caused by obesity will will overburden medical intervention.

Sure eating fat isn't as awful as we thought. But an entire society getting fat is far worse than we thought.

What studies like this betray is the wishful thinking bias in an ever more obese society. I would not be the least surprised if these results were cherry picked PR by food industry groups.

As noted by #30 here is already criticism of this so-called study and I'd wager it will be picked apart- but that won't make much news.
Posted by tkc on January 2, 2013 at 12:20 PM · Report this
vavavarooooom 38
@37 - since you 'know for a fact' and we have 50 years of data - why not cite your own sources as you have urged @29 to do? You have here a study saying fat /= death, but you are convinced that fat=death. Citation, please. Your opinion not a citation.

Please name your life-long chronic diseases 'caused' by obesity. I will need a citation showing that it was the fat that did it. Not diet, not environment, not smoking, not lack of exercise. If thin people also get the condition, you will have a hard time convincing me that it was the fat that did it.

The criticism of the study is that they included smokers and ill people -- which does not seem entirely wrong to me. The whole point of the study is looking at our reliance on body size to classify a person as healthy or not. They included sick fat and sick thin people, thin and fat smokers -- you can't just decide that smokers don't count because you don't want them to. I might not have included people already sick - but again, if your issue is that thin people do not get sick, you are skewing your numbers by not including sick thin people.
Posted by vavavarooooom on January 2, 2013 at 12:49 PM · Report this
blip 39
By far the most interesting finding of this study is that everyone thinks they are an epidemiologist.
Posted by blip on January 2, 2013 at 12:56 PM · Report this
Matt the Engineer 40
@33 That might have been it. I'll check.
Posted by Matt the Engineer on January 2, 2013 at 1:04 PM · Report this
Cascadian Bacon 41
@32
This may be the most sensible thing you have ever said.

@12
That is a good point, my "healthy habits" have almost gotten me killed on more than one occaision, and left me with fake teath. But I tend to gravitate towards high risk physical activity rather than being a scared obese couch dwelling pussy.
Posted by Cascadian Bacon on January 2, 2013 at 3:02 PM · Report this

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