Why being fat may not be so bad for you after all

Why being fat may not be so bad for you after all

By JEROME BURNE, Daily Mail, 08:23am 1st August 2006
http://www.dailymail.co.uk/pages/liv...8&in_a_source=

With all the anxiety about obesity and its health risks, you'd expect
to find yourself at serious risk of heart disease and diabetes. But in
fact, you could be healthier than many slimmer people reading this.

Last month, the first new weight-loss pill to come on the market for
years - Acomplia - was launched, with a licence to treat anyone with a
body mass index (BMI) of over 30: the definition of obesity.

Conventional weight-watching wisdom says that if you are that bulky,
you need to start slimming down fast. But what if being overweight or
obese isn't the same thing as being unhealthy?

There's evidence to suggest that by focusing on achieving the 'right'
weight, we are missing the real causes of ill-health. For not only are
'overweight' people actually less likely to die early than those of
'normal' weight, but losing weight and putting it back on may well be
worse for you than staying at the same point on the scales.

Exactly what the connection is between weight and health has been the
focus of a furious debate over the past year.

Critics of the current view believe that when people exercise regularly
and have a healthy lifestyle, how much they weigh becomes a minor
issue. Walking a total of 20 miles a week and eating sensibly is a
better recipe for health than desperate attempts to drop the pounds.

"Concentrating on people's weight is a big mistake," says Dr Paul
Campos, author of The Obesity Myth and a professor at the University of
Colorado. "The culprit for health problems associated with weight is a
sedentary lifestyle and poor nutritional practices, not the weight
itself, except in extremely obese cases."

And Dr Campos goes further; not only is weight not the issue, he says,
but there is no evidence that trying to lose it does any good either.

At the heart of this debate is the body mass index, the standard way of
classifying whether you are the right weight or not.

According to the BMI, more than half of the UK population are
overweight and a further 20 per cent are obese, with all the associated
health risks.

BMI is calculated by dividing your weight in kilograms by your height
in metres squared, or your weight in pounds by your height in inches
multiplied by 703; 18 to 25 is normal and healthy, over 25 to 30 is
overweight, and over 30 is obese.

SO if you are 5ft 8in and weigh 158lb, then your BMI is normal at 24.
Go up to 171lb and you become overweight - top 197lb and you are obese.


But once you fall outside the officially approved category, is it
really necessary to try to bring your weight down instantly with diets
and weight-loss pills?

Research suggests it is not. Figures published in a top medical journal
last year showed people who were overweight were actually less likely
to die early than those classed as being a normal weight.

The figures were based on statistics from the prestigious Centers for
Disease Control (CDC) in Atlanta. The CDC had warned obesity was a new
plague, and estimated that 400,000 overweight and obese Americans die
every year as a result of their excess weight.

However, when the CDC data was reanalysed by the US National Center for
Health Statistics, it turned out that while obese people were at
greater risk of premature death compared to those of normal weight, the
overweight people were at lesser risk.

The centre's Dr Katherine Flegal says: "Although people think there is
all this evidence out there showing a high mortality risk associated
with being overweight, in fact the literature doesn't show it."

The results created an academic storm. Researchers who were convinced
of a link between increased weight and ill-health suggested that even
though overweight people might be living longer, they were only being
kept alive by modern medicine and were neither happy nor healthy.

The American research suggested the opposite; maybe they were fitter,
and because muscle is heavier than fat, they show up as overweight.

The issue is far from resolved, but it's widely recognised that the BMI
can be misleading in predicting who is at risk.

"There are certainly a lot of confounding factors," admits Dr David
Haslam, chair of the UK National Obesity Forum. "You can get athletes
packed with muscles who show up as overweight, and people can be slim
but unhealthy.

"But we are stuck with the BMI as a measurement - GPs are paid for
measuring patients' BMI as part of the drive to bring down heart
disease."

Another factor skewing the reliability of the BMI when it comes to
deciding if you should do anything about your weight is the matter of
location. Where on your body are the extra pounds? Because when it
comes to health and weight, location makes a big difference.

It's now clear that additional fat packed around the organs in your
abdomen - known as 'visceral' fat - is more 'metabolically active'; it
releases more of the acids that raise heart disease risk, along with
factors that increase blood pressure and blood sugar.

Meanwhile, the fat on the arms and legs might actually have a
protective effect. In one study, women with a very high BMI of 48 had
half the heart attack risk of women of normal weight, providing their
weight was around their hips and buttocks rather than their waists.

"We'd really like to see GPs measuring patients' waists," says Dr
Haslam. "It's much simpler and more useful; over 40 inches for a man
and 35 for a woman are the danger signs."

What all this suggests is that we may have more wriggle room than
current guidelines seem to allow.

If your BMI is up towards the mid-30s or over, then bringing it down
might well be a good idea; certainly checking your other risk factors -
cholesterol, blood sugar levels and so on - would make sense. But if
they are OK, you are obviously doing something right.

If you do want to shift visceral fat or lower your BMI, what are your
options? A diet is the standard recommendation and the new drug
Acomplia claims to be effective in reducing visceral fat as well as the
risk factors that go with it, such as a raised level of fats in the
blood.

But there is evidence that diets themselves can create problems in the
long term. A study involving 3,000 people, reported in New Scientist
last winter, found those who were successful at losing weight were at
higher risk of dying early.

One possible reason is that yo-yo dieting is not good for the immune
system. Researchers have found that women who had gained and lost 10lb
four times or more before the menopause were more likely to have
reduced blood flow to the heart, while women whose weight had been
stable had a more active immune system.

The most effective way of turning dangerous extra pounds into safe ones
is exercise. Steven Blair, director of the Cooper Institute of Aerobics
Research in Dallas, Texas, has found that obese men who do regular
exercise are at lower risk of cardiovascular disease than lean men who
are unfit.

None of this suggests that being 14 stone, slobbing in front of the TV
and living on a diet of takeaways is fine. It does mean that if you are
fit and eating well, you can give your scales the heave-ho.

I work in long term care and actually we do have quite a few obese people,
problem is they are not OLD people. At this point in time we have about 12
residents who are obese and they are all in their 60s. This is becoming a
big business one of our sister facilities has made an investment in
bariatric equipment and specializes in taking obese patients.


"Marengo" wrote in message
...
On 1 Aug 2006 07:46:03 -0700, "The Mongolian Death Worm"
wrote:


|'overweight' people actually less likely to die early than those of
|'normal' weight

Bull.

Have you ever been in a nursing home? How many fat old people do you
see there? Very few to none. Why do you suppose this is?

Marengo wrote:
:: On 1 Aug 2006 07:46:03 -0700, "The Mongolian Death Worm"
:: wrote:
::
::
::: 'overweight' people actually less likely to die early than those of
::: 'normal' weight
::
:: Bull.
::
:: Have you ever been in a nursing home? How many fat old people do you
:: see there? Very few to none. Why do you suppose this is?

It might be because they are not living in nursing homes!

Marengo wrote:
:: On 1 Aug 2006 07:46:03 -0700, "The Mongolian Death Worm"
:: wrote:
::
::
::: 'overweight' people actually less likely to die early than those of
::: 'normal' weight
::
:: Bull.

BTW, I think the article is using the medical definition of overweight.
That puts you on the BMI scale at a certain place. Beyond that, the issue
is fitness. Not being sedentary will have more to do with your well being
than if you're of perfect BMI.

::
:: Have you ever been in a nursing home? How many fat old people do you
:: see there? Very few to none. Why do you suppose this is?

Roger Zoul wrote:
Marengo wrote:
:: On 1 Aug 2006 07:46:03 -0700, "The Mongolian Death Worm"
:: wrote:
::
::
::: 'overweight' people actually less likely to die early than those of
::: 'normal' weight
::
:: Bull.

BTW, I think the article is using the medical definition of overweight.
That puts you on the BMI scale at a certain place. Beyond that, the issue
is fitness. Not being sedentary will have more to do with your well being
than if you're of perfect BMI.

The article is very biased and misleading. It isn't bull though that
overweight people are actually less likely to die early. The article
is correct that a CDC study about a year ago showed exactly that.
However, what they don't tell you is that the study showed people who
were only a little overweight were less likely to die. As I recall, it
was somewhere around 10-15 lbs overweight. And then there was a lot
of disagreement as to the validity of the study, how adjustments were
made for those that were under weight because of illness, etc.

I think a lot of the whole argument of the article is kind of circular.
They are saying being overweight is less of an issue than eating the
right foods and having the right eating habits. But if people do
that, then they are most likely not going to be overweight by much.

One thing I have to agree with the article on though, is the CDC study
did put into question the widely heard idea that being even a little
overweight is very bad and something to obsess about.





::
:: Have you ever been in a nursing home? How many fat old people do you
:: see there? Very few to none. Why do you suppose this is?

wrote:
:: Roger Zoul wrote:
::: Marengo wrote:
::::: On 1 Aug 2006 07:46:03 -0700, "The Mongolian Death Worm"
::::: wrote:
:::::
:::::
:::::: 'overweight' people actually less likely to die early than those
:::::: of 'normal' weight
:::::
::::: Bull.
:::
::: BTW, I think the article is using the medical definition of
::: overweight. That puts you on the BMI scale at a certain place.
::: Beyond that, the issue is fitness. Not being sedentary will have
::: more to do with your well being than if you're of perfect BMI.
::
:: The article is very biased and misleading. It isn't bull though that
:: overweight people are actually less likely to die early. The
:: article is correct that a CDC study about a year ago showed exactly
:: that. However, what they don't tell you is that the study showed
:: people who were only a little overweight were less likely to die.
:: As I recall, it was somewhere around 10-15 lbs overweight. And
:: then there was a lot of disagreement as to the validity of the
:: study, how adjustments were made for those that were under weight
:: because of illness, etc.
::
:: I think a lot of the whole argument of the article is kind of
:: circular. They are saying being overweight is less of an issue than
:: eating the right foods and having the right eating habits. But if
:: people do that, then they are most likely not going to be overweight
:: by much.
::
:: One thing I have to agree with the article on though, is the CDC
:: study did put into question the widely heard idea that being even a
:: little overweight is very bad and something to obsess about.

But don't forget the importance of exercise as it factors into a healthy
lifestyle. It's not just being perfect weight, not just about eating junk
food, and not just about being sedendary. Being too fat, too sedendary, and
too sloppy in diet will likely get us an early ticket out.

wrote:

It isn't bull though that
overweight people are actually less likely to die early. The article
is correct that a CDC study about a year ago showed exactly that.
However, what they don't tell you is that the study showed people who
were only a little overweight were less likely to die. As I recall, it
was somewhere around 10-15 lbs overweight.

The weight range of the overweight category is not that small for any
height. Even at 4'10", "overweight" BMI is over a 20 pound range. For a
6 foot tall person, it's approximately a 35 pound range.

And then there was a lot
of disagreement as to the validity of the study, how adjustments were
made for those that were under weight because of illness, etc.

I don't believe that's an accurate characterization of how the study
was received. Here are some quotes from the NY Times article that first
covered it:

"The new study, considered by many independent scientists to be the
most rigorous yet on the effects of weight, controlled for factors like
smoking, age, race and alcohol consumption in a sophisticated analysis
derived from a well-known method that has been used to predict cancer
risk."

"Some statisticians and epidemiologists said that the study's methods
and data were exemplary and that the authors - Dr. Williamson and Dr.
Katherine M. Flegal of the disease control centers, and Dr. Barry I.
Graubard and Dr. Mitchell H. Gail of the cancer institute - were
experienced and highly regarded scientists."

"The Mongolian Death Worm" wrote in message
ps.com...
Why being fat may not be so bad for you after all


This is total BS! The sickest people I've know and the first to pass away
from strokes, heart disease and complications of diabetes were the obese and
the heavy smokers. Not that thin people don't die prematurely, but they
died of things like Lupus, complications of smoking (cancer, chronic
bronchitis and emphysema) and other causes unrelated to obesity/inactivity.
Now add those things to the obese and........ need anyone say more?

LW
Start - 7/5/06 - 170lbs
Today - 160 lbs
Goal - 130lbs
Height 5'6"
~~~~~~~~~~~~~~~~~~

"pb" wrote in message
news:NA%zg.8165$ok5.4024@dukeread01...
I work in long term care and actually we do have quite a few obese people,
problem is they are not OLD people. At this point in time we have about 12
residents who are obese and they are all in their 60s. This is becoming a
big business one of our sister facilities has made an investment in
bariatric equipment and specializes in taking obese patients.


Why would someone in their 60s be in a long term care facility? Premature
senility? Accidents???

LW
Start - 7/5/06 - 170lbs
Today - 160 lbs
Goal - 130lbs
Height 5'6"
~~~~~~~~~~~~~~~~~~

Marengo wrote:
On 1 Aug 2006 07:46:03 -0700, "The Mongolian Death Worm"
wrote:


|'overweight' people actually less likely to die early than those of
|'normal' weight

Bull.

The study said simply that people who are overweight (BMI of 25-29.9)
have a lower risk of death than those at a normal weight (BMI of
20-24.9).

You can disagree, but then they probably put a little more effort into
their research.

The following quote is from the Times:

"The study, considered by many independent scientists to be the most
rigorous yet on the effects of weight, controlled for factors like
smoking, age, race and alcohol consumption in a sophisticated analysis
derived from a well-known method that has been used to predict cancer
risk."