The New York Times has an article summing up the same study that I talked about yesterday (thanks to “Alas” reader Katie for the tip). The big finding: it’s better to be a little “overweight” than to be “normal” weight.
People who are overweight but not obese have a lower risk of death than those of normal weight, federal researchers are reporting today.
The researchers – statisticians and epidemiologists from the National Cancer Institute and the Centers for Disease Control and Prevention – also found that increased risk of death from obesity was seen for the most part in the extremely obese, a group constituting only 8 percent of Americans.
And being very thin, even though the thinness was longstanding and unlikely to stem from disease, caused a slight increase in the risk of death, the researchers said.
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.
Perhaps the Times just didn’t mention it, but it sounds like they didn’t control for the negative health effects of weight cycling (aka “yo-yo dieting”). Multiple studies have shown that weight cycling can take years of of people’s lives; a morbidity study of fat that doesn’t control for this factor will inevitably exaggerate the risks of fat.
The article’s conclusion:
“The take-home message from this study, it seems to me, is unambiguous,” Dr. Glassner said. “What is officially deemed overweight these days is actually the optimal weight.”
And hey, while I’m on the subject, let me recommend this terrific Paul Campos article from the New Republic, “The Weighting Game” (pdf link – the article begins on page 3). Thanks to “Alas” reader Richard Bellamy for the link. Here’s a sample, but the whole thing is good:
If fat is ultimately irrelevant to health, our fear of fat, unfortunately, is not. Americans’ obsession with thinness feeds an institution that actually is a danger to Americans’ health: the diet industry.
Tens of millions of Americans are trying more or less constantly to lose 20 or 30 pounds. (Recent estimates are that, on any particular day, close to half the adult population is on some sort of diet.) Most say they are doing so for their health, often on the advice of their doctors. Yet numerous studies–two dozen in the last 20 years alone–have shown that weight loss of this magnitude (and indeed even of as little as ten pounds) leads to an increased risk of premature death, sometimes by an order of several hundred percent. By contrast, over this same time frame, only a handful of studies have indicated that weight loss leads to lower mortality rates–and one of these found an eleven-hour increase in life expectancy per pound lost (i.e., less than an extra month of life in return for a 50-pound weight loss). This pattern holds true even when studies take into account “occult wasting,” the weight loss that sometimes accompanies a serious but unrelated illness.
For example, a major American Cancer Society study published in 1995 concluded in no uncertain terms that healthy “overweight” and “obese” women were better off if they didn’t lose weight. In this study, healthy women who intentionally lost weight over a period of a year or longer suffered an all-cause increased risk of premature mortality that was up to 70 percent higher than that of healthy women who didn’t intentionally lose weight. Meanwhile, unintentional weight gain had no effect on mortality rates. (A 1999 report based on the same data pool found similar results for men.)
Perhaps I’m insane, but it seems to me that “optimal” weight is the weight where lifespan is best and/or mortality is lowest. If people who weigh 200 pounds have better lifespans than people who weigh 180 pounds, then the people who weigh 180 pounds are underweight and the people who weigh 200 are at the biological optimum.
I find it interesting that the television news shows, while covering the story, are trying to minimize the implications. You might live longer being fat, they say, but you’ll be sicker, and who wants to live if you’re not going to be well. IMHO, what they’re really saying is, who wants to live if you’re going to be fat.
It only makes sense that fashionably thin people have no reserves to see them through illnesses that may affect their desire or ability to eat enough to sustain life. Thing is, I remember reading years ago that insurance statistics showed that slightly underweight people died earlier than people who were slightly overweigt.
I think that’s how the people who have bashed fat people for so long would take this information, Robert, but I see no reason to assume that this “optimum weight” is necessarily good for everyone. Weight manipulation has been shown to be very risky behavior on its own and I am loathe to support it in any circumstance.
What this does show is that the popular assumpsions about weight are simply not supportable. A group targeted aggressively by the anti-fat industry has now been shown to have the lowest morbidity of all groups. This doesn’t justify forcefeeding people to 200lbs anymore than it was justified before to starve people to 120lbs. What we should look at is whether “weight maintenance” measures encourage for “health” are actually profoundly unhealthy. We should question whether fatter people are discouraged from healthy activities because they have seen from experience that those behaviors won’t make them thin and they were told that was the real goal. We need to encourage a healthy and moderate lifestyle for everyone. Clearly the obsession with fat people is misplaced and it would make a great deal of sense to take weight completely out of the equation and concentrate on the changes that have been proven effective at improving people’s health even if it doesn’t make them thin.
Multiple studies have shown that weight cycling can take years of of people’s lives; a morbidity study of fat that doesn’t control for this factor will inevitably exaggerate the risks of fat.
.. and that exaggeration will lead to people trying to lose weight, likely in a cyclical fashion, thus leading to premature death as well as confirming the results in the next poorly-done study.
It only makes sense that fashionably thin people have no reserves to see them through illnesses that may affect their desire or ability to eat enough to sustain life.
A friend of mine had to gain weight before the Peace Corps would send her to her post, since they figure you’ll lose a lot of weight through illness or lack of food. Yet they also don’t seem to take folks who are overweight but otherwise healthy.
Quite true, zuzu. The Peace Corps consider weight a disqualifying factor irregardless of weight. I know one person who pushed the issue and got the attention of someone who was impressed with her committment and had the power to make an exception.
One of the many reasons to bitterly hate Shallow Hal, I always though.
Since yesterday I’ve taken quite a bit of time to read through the various viewpoints on this study in the science press and I’m not convinced that these studies are really measuring much of anything at all. In my opinion, all they say is that BMI is lowsy for any type of epidemiologically study unless you are at one of the extremes, extremely obese or underweight (which is skewed on the distribution). I completely agree with what Brian wrote in post 4 (I think I now understand the basis for our previous dispute btw, if your interested note it and I’ll write, otherwise I won’t take up space) except the acknowledgement of such rubbish as Shallow Hal.
I am curious what this will mean for the caloric restriction people (and there was some comment on that in the NYT article)…
We should question whether fatter people are discouraged from healthy activities because they have seen from experience that those behaviors won’t make them thin and they were told that was the real goal.
We have a winnah!
A Tech Central column on this subject.
Might i humbly suggest that people read the original article that is online. Much of what is being reported is inaccurate.
The study confirmed what previous studies had found that being overweight (i.e. BMI 25 – 30) slightly reduces the risk of dying and that being obese(i.e. BMI > 30) rapidly increases the risk of dying.
These relative risks have decreased over the last 30 years because the major cause of death associated with obesity, heart disease, has seen marked improvements in survival rates. Fat people still have more heart attacks but they get bypasses and live on. The authors repeatedly make the point that varying the means of measurement and varying the number of people in weight categories will have significant affects on the statistical results produced. These are known problems of broadscale studies of this nature.
Also we should bear in mind that according to the CDC
the number of children who are overwieght in the U.S. has doubled in the last 30 years. The affect of this is not measured in this study because the youngest particpants would have been 18 in 1990(roughly).
Lastly, arguing that obesity should be sexy without considering it’s health consequence is just as wrong as arguing that thinness is sexy without considering the health consequences (e.g. anorexia).
The authors repeatedly make the point that varying the means of measurement and varying the number of people in weight categories will have significant affects on the statistical results produced.
Then you really can’t pick one conclusion to be wrong, can you? If ‘slightly fat is better’ could be wrong depending on how you vary the number, so can ‘slightly thin is better.’
As I recall the CDC also links obesity to poor diet and lack of exercise. A fat person who eats healthy food and exercises moderately isn’t cheating the statistics with a bypass operation.
Lastly, arguing that obesity should be sexy without considering it’s [sic] health consequence is just as wrong as arguing that thinness is sexy without considering the health consequences (e.g. anorexia).
What in the world do physical attraction and personal preferences have to do with anything anyone has said here? Kyan, I’m also wondering why you would even mention the CDC’s study on fat kids.
Couple of points – in the original study the authors point out that the increase in deaths in people with a low BMI occurs in the oldest age group and the increase in death in people who are overweight decreases as the age groups get older. This is contrary to the anecdotal evidence which is being bandied around. Again I would suggest that people read the original study.
mythago I don’t understand what your saying about bypass operations. The point that was being made is that the secular reduction in the amount of deaths(since 1970) that can be attributed to obesity is due to the success in treating heart disease (eg with bypasses). Also the point about the statistics varying is that the authors examined this and used this to establish error bars about their conclusons. The errors being talked about are matters of degree not questions of proving or disproving the hypothesis. The reason they looked at the possiblity of these things was to ensure the robustness of their conclusions.
Paul – the point about the CDC study on fat kids is that these kids are not included in the original study (because they were too young). As many people here have pointed out – cure(i.e. weight loss) is problematic. So preventing unecessary obesity seems like an important issue to raise.
Also much of the previous threads on this subject here have been taken up with discussion about the construction of beauty as thinness. The point I’m making is that whether beauty is contructed(construed) as thinness or as fatness, beauty should not override health issues.
Wow. That’s an amazingly dishonest slight of hand. Honestly, I don’t know how to call that quote anything but a flat out lie.
Being “overweight” reduces deaths by over 86,000 and you see this as a “slight” reduction. Meanwhile, being “extremely obese” increases morbidity by 82,000 and you see this as cause for declaring it a “rapid increase”? Oh, right. You lumped the merely “obese” into your declaration even though the increased risk there was a very modest 30,000. So that modest difference (nearly 1/3 of the decrease in risk for the “overweight” that you declared slight) is enough to push the risk from a slight increase to a “rapid” increase. Stunningly inconsistant logic, but not at all unexpected. I knew it wouldn’t take long for someone to declare the nearly equal ammounts in the decrease for the “overweight” and the increase in the “obese” and act as if its massive difference.
Oh, another thing. So the risk of being “obese” is now in the neighborhood of 100,000 once you forget about the benefits of being “overweight” which is still being aggressively targeted by folks like the CDC who’ve promised to ignore their data. That’s still a quarter of what they said it was last year. And it still doesn’t control for the risks associated with the failing “treatments” fat people are subjected to.
And as bean points out, the standards for “overweight” have changed dramatically and that never gets recalled when making scary statements like you just did. Now that all people classified as “overweight” have actually been shown to be significantly healthier than “normal” weight people, the folly of depending on these manipulated numbers is all the more clear.
Was that even brought up in this thread? Or, is this really what gets you? The idea that fat people might be seen as beautiful really just gets on your nerves. How dare they! How dare they get the rights you’ve fought so hard for yourself. Gotta be something wrong with that, right? Gotta make sure you can attack them if it ever comes up. Heck, even when it doesn’t come up. Well, just so you know, the point made is not that fat is sexy and unhealthy. Its that fat can be seen as sexy and can be just as normally healthy as anything else. Your view that no one gets to disagree with your “fat is deadly” pronoucements isn’t recognized, so the problem you see for people who want to think fat is beautiful doesn’t apply.
Here is a possibility for you to consider: obesity (how about we just call it fat?) is something that is not “preventable.” Fat is what it is, and health is the thing that needs to be focused on, if anything. The myriad programs talking about “improving kids’ health” are blanketed in the anti-fat fervor, and it’s really frustrating – in addition to pointless.
I also take issue with your use of the term “cure” for fat. Fat is not a disease and does not require a cure. I’m curious what your “cure” would be for excessive height, darkened skin color, or the female gender. I exaggerate slightly but my point should be pretty clear: fat is an attribute. It is a part of one’s body. It is not an illness, not a disease, and not the root of all evil.
Previous threads, perhaps. But your words suggest that you find fat so very unhealthy that the idea of people finding fat attractive is appalling – as Brian notes above. That’s a personal problem (one exhibited by many anonymous fatphobes littered across the web) that needs to be tackled, but it’s a deeply-rooted stigma as well – and it smacks of an incredible, incredible amount of ignorance and immaturity.
Brian
I find you comments perplexing – the study does make it clear that being overweight (BMI
Oh dear, I’ll try again.
Brian
I find you comments perplexing – the study does make it clear that being overweight (BMInot say that fat people are not attractive. Your vituperative language is both hurtful and unneccessary.
arrgh -my comments keep getting chomped… To repeat myself. I did not suggest that fat people are unattractive. There is nothing inconsistent with saying that being a little overwieght is healthy and being a lot overwieght is unhealthy. Obesity is a risk factor not a disease. It is not wholly due to genetic factors.
kyan,
No one can say with certainty why people are fat because the question has never been addressed in those terms. The assumption in studies done on “obesity” is that being fat is a condition of the body that is not normal.
Risk factors are quite difficult to put a handle on. They usually come in two flavors — behavioral and physical. Having unprotected sex with strangers is an example of the first. Being African-American is an example of the second. Having unprotected sex with strangers puts one at risk for STDs and unwanted pregnancies. Being African-American puts one at risk for sickle cell anemia. So stating that being fat is a risk factor is fraught with hidden meanings and potential misunderstandings.
See the problem is that many people believe that being fat is a risk factor in the first category. Fat people are fat because they overeat. Teach kids good eating habits and exercise habits and they won’t get fat is the basic premise of “obesity prevention” in youth.
But consider for a minute if indeed being fat is really the second category. Sure eating and exercise may account for some variation, but genetics seems to account for quite a bit in twin studies (and those are the only studies that really have considered the question at all). Sleeping a good night’s sleep makes you slightly taller in the morning. That doesn’t make sleep a cure for shortness, nor does it reduce the risk of several conditions that plague short people more often than tall people.
Eating well and exercising have many other benefits besides its effect on size. No one is saying — oh look now we can all eat twinkies and never have to worry again. See, that is the problem with this whole fat-phobia — we keep forgetting the health part.
So when you say “Obesity is a risk factor” or “being a lot overweight is unhealthy” I think you are unmarking a lot of assumptions. What if (and I’m just suggesting this because again no one really knows scientifically, though it has been my experience personally)…what if being fat is like being African American. Sure being fat is a risk factor, but does losing weight reduce that risk? I know you will quote me all sorts of studies regarding WLS patients who have less trouble with diabetes and sleep apnea, but those studies do not consider changes in diet or exercise which might have created those positive results on morbidity with cutting away someone’s perfectly good stomach. Those studies also suffer from “the rather be dead than fat” attitude as they do not include people who died after WLS.
Holding out weight loss as a means to reduce risk could be tantamount to prescribing skin lightening treatments to young African Americans to reduce their risk of sickle cell anemia.
So what can we do? I mean no one knows for sure why people are fat, so how can we resolve this without finding the funding and the experts to really study why people are fat (instead of assuming that fat is automatically bad and then studying how to get rid of it).
Well, I think we turn to the hippocratic oath: “First do no harm.” Don’t do a treatment until you are sure that it is will do good. By defining fat as inherently bad, a whole bunch of people making a whole bunch of money can now get the (supposed) protectors of our health to okay treatments that are quite harmful. We have known since the mid-1960s that dieting was harmful with 25% of the perfectly healthy young fat men who participated in a study in which they lost more than 75 pounds each were dead within five years of the study. I can’t remember how many times greater than the expected death rate that was for 20-something males, but I remember being very angry that no one saw fit to follow up on such findings.
We know that dieting and intentional weight loss harms health. We know that eating well and exercise improves health. We do not know why people are fat. We do not know if losing weight for a long period of time affords the same benefits to formally fat people as it does to people who were never fat. We do not know if fat could or should be prevented. And the CDC cannot make up its mind how big of a risk factor being fat is or what exactly being fat does or does not put one in risk of getting.
IMHO, all of this adds up to getting off fat people’s backs, leaving kids alone about their weight, and worrying about something else besides weight loss.
Excellent points, Pattie.
I wonder, if fat were actually the cause of illnesses like high blood pressure and diabetes, wouldn’t there be some study which shows that once the cause is removed (weight is lost) the disease is cured, too? I know of no such study. Instead, as you say, studies assume that fat is bad and interpret results from there.
I am grateful that my personal physician seems to get this. She has yet to look at my weight (235 lbs, 5’8″) and prescribe a treatment for me, or even suggest that I need to lose weight. She apparently understands that a moderate, varied diet, exercise, stress management, and plenty of rest are the things we KNOW affect health in a positive way long term, all of which are part of my daily life. If she didn’t understand these things, it’s safe to say I’d be finding another physician.
It’s a gross error for me to say fat people are unattractive. However, I feel completely comfortable saying fat people are unattractive to me. Attractivness to one another is like fitting a key to a lock. Either it fits or it doesn’t! I’m not concerned with the reasons why they are unattractive to me, I just know that they are!
Do y’all think something is wrong with me for feeling that way?
Why is it that so many women flirt with me when I’m an old guy and not particularly good looking? I believe it’s because I walk five miles per day, lift weights, and do aerobics three times a week. I have always been careful about my eating habits and tend to eat more protein than most. I have always taken vitamins and mineral supplements. My doctor has told me repetedly that I’m in excellent condition and I should live a long healthy life. Everything works and nothing hurts! I do not worry about being fat because I prevent the possibility!
Back to my question about why women constantly flirt with me. It’s simply that people who take care of themselves and do the best they can with what God gave them have a healthy glow about them which other people are naturally attracted to. If you allow yourself to get fat, you may be healthy, but you will not have as much energy for daily activities because you will get tired lugging around the extra weight. You will also be attractive to far fewer people regardless whether it’s justified or not! Another huge advantage of not being fat is that usually you and the people you associate with are always in a good mood and are fun to be around. They don’t wallow in self pity and constantly try to find reasons why being fat is ok.
As I reread my blog, I sound awfully self-rightious. I apologize to those of you who are thinking the same thing. I’m not a gifted writer but will try to do better in the future.
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This is my first time responding so hello all. Statement #23 both amused and offended me, so I have decided to stop lurking and finally post on this blog/board. Here goes.
It’s a gross error for me to say fat people are unattractive. However, I feel completely comfortable saying fat people are unattractive to me. Attractivness to one another is like fitting a key to a lock. Either it fits or it doesn’t! I’m not concerned with the reasons why they are unattractive to me, I just know that they are!
Do y’all think something is wrong with me for feeling that way?
No, you have every right to find something attractive and other things unattractive. I personally believe that is someone out there in this large universe who will find something attractive that I may or may not. Some are attracted to hair color, I find myself attracted to men and women who stimulate my mind. Go figure. I will admit that this is the only place where we are about to agree upon.
This is what I have the most problem with. Are you indicating that people who “allow” themselves to get fat can’t have a healthy glow? You state that the “may be healthy” but have no extra energy due to lugging around all the extra weight with them. You also seem to indicate because you are not fat and your friends (or social circle) are not fat that you have more fun because hey you guys are physically fit and don’t need to figure out if thin is okay to be, but fat people wallow in self-pity and try to find reasons (where there are none, seems to be indicated by this above statement). I imagine that if you are as physically fit you carry around your weight in muscle. Does that mean men and women who have quite a bit of muscle must be a drag to be around since they don’t have that healthy glow due to all the energy the put out carrying around the extra weight? Muscle has weight as much as fat does. By your theory they would be carrying around excess weight too. Do you mean to say that acceptance should only come to people who are fit? Do you know a lot of self-pitying fat people or fate people in general? I am confused there. You seem to indicate that you only hang around with people who-like you-are physically fit. It seeems that you buying into a lot of stereo-types about fat people.
I also don’t quite follow the whole beginning of the thread being related to fat in the first place. You equate being fit with women flirting with you. Are you saying that if you are unfit, no one will flirt with you?
I know I am being a little disjointed in my response so I am going to finish this by showing why I am a little offended by this comment. You see, I also get my fair share of compliments and flirtations by those of the fair sex both male and female. I am a huge flirt, and bisexual in case you wonder why I point out the flirtation on both sides.
I am constantly being approached by people I work with and those I went to school with about my constant energy, healthy glow and wonderful personality. I don’t mope, I don’t agonize over myself. I accept myself just fine.
In case, Don, you are wondering why I am offended when obviously I am fit, healthy and have no complaints about my energy level?
I am (big dramatic pause) morbidly obese. I am 5’11 and weigh 380 pounds. I walk anywhere from 4-8 miles a day, I chase two young children and have a wonderful life and a great social circle. Acceptance is a cause that shouldn’t be limited to those who are physically fit. When you live in a society that thumbs its nose at you, it can be a struggle to figure where you fit. Everyone goes through an emotional gambit trying to find themselves.
Maybe you didn’t mean it the way it sounded, but as a large and postive gal I wanted to show you that I felt some of your response just seemed wrong to me.
BMI is a silly way to conclude whether someone is overweight. I am very short,
and extremely active physically. I spend more time fencing, kickboxing,
kayaking, and playing tennis than anyone I know. I i’m five foot five, and weight 155lb. Before a kickboxing match I get down to 145, but whether I am under 150, I simply look undernourished (especially in the face)
But compute my BMI, and it puts me at ‘overweight’. BMI is useless for people who are active enough to have significant muscle. I would not be surpruised that the study is actually reflecting the health of people whose active lifestyle has pushed into the ‘overweight’ category.
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