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June 2016 | Read this issue and more at www.healthandwellnessmagazine.net |
The Healthy Overweight
Paradox
Can you be fit and fat?
By Angela S. Hoover, Staff Writer
More than a decade ago, researchers noticed some patients who were
mildly overweight or obese fared
better than others who had chronic
conditions such as heart disease. In
fact, it seemed the protecting factor
was the fat.
Cardiologist Carl Lavie of
Jefferson, La., was one of the first
doctors to try to explain this “obesity
paradox.” But he couldn’t find a journal to publish his findings for more
than a year. People thought his data
couldn’t be true; something had to be
wrong with it, Lavie said.
But it was Katherine Flegal, an
epidemiologist at the U.S. Centers
for Disease Control and Prevention,
who really initiated the debate – and
also received the most backlash for
it. She and her colleagues looked at
hundreds of mortality studies that
included the person’s body mass
index (BMI). A BMI of more than 25
is considered overweight and a BMI
over 30 is considered obese. Flegal
found the lowest mortality rates
among those in the overweight and
mildly obese categories. The study
seemed to show that a little extra
weight is genuinely beneficial.
Although certain conditions are
more likely in this segment of the
population, it turns out a strong link
between weight and disease is only
seen among those who are severely
obese, not those who are overweight
and mildly obese.
Flegal’s most recent research
was comprised of data from nearly
100 studies and included close to 3
million people. The Journal of the
American Medical Association published her results and others immediately mocked her work. Outspoken
obesity opponent Walter Willett, a
researcher at the Harvard School of
Public Health, told NPR that Flegal’s
work was “really a pile of rubbish no
one should waste their time reading.” Editors of the journal Nature
later admonished Willett, but he still
maintains his stance, even though
his complaints keep losing their legs.
Over the past decade, dozens of other
studies have confirmed the existence
of the paradox. It is now generally
accepted that being overweight helps
protect patients with an increasingly
long list of medical problems, including pneumonia, burns, stroke, cancer,
hypertension and heart disease.
Unconvinced researchers have
not been able to show the paradox is
based on faulty data or reasoning thus
far. One of the most popular attempts
to try to explain it away is maintaining fat people get more aggressive
treatment than thin people since the
patient’s weight raises red flags at
the doctor’s office. However, studies
show overweight and obese people
tend to avoid doctors, get fewer
preventative screenings and receive
worse treatment because they’re often
misdiagnosed as “fat” rather than with
a specific medical condition. Overall,
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scientists – even those who do not
agree the paradox exists – accept the
evidence behind it, even if they do
not yet agree on what it means for
health.
This paradox and all the questions
it raises about health implications
for all people regardless of weight
has led to the “Health at Every Size”
movement. It is based on the idea
that healthy behaviors such as eating
nutritiously and partaking in physical activity matter more than weight.
Researchers have found the Health
at Every Size approach is more successful than merely a weight-loss
approach because it leads to lower
cholesterol and blood pressure and
other metabolic markers.
“We’re so stuck on the fact that
the way to mediate health is through
weight,” said Linda Bacon, a nutrition professor at the University of
California, San Francisco and author
of Health at Every Size: The Surprising
Truth About Your Weight. Bacon wants
to shift the focus from weight to
well-being, giving doctors, dietitians
and people of all shapes the tools for
achieving better fitness, health and
even happiness, – all without dieting.
For more information, visit Bacon’s
Web site at www.lindabacon.org.