Science Proves That Thinness Is Deadlier Than Obesity

Illustration for article titled Science Proves That Thinness Is Deadlier Than Obesity

Evidence is mounting that being overweight isn't as detrimental to one's health as previously believed. In fact, numerous studies conducted on patients with certain chronic diseases found that those who were overweight to moderately obese had a lower mortality rate than those of normal-weight suffering from the same illness. It's being called "the obesity paradox."

For a piece about the phenomenon, the New York Times spoke with several experts that who have met with resistance over research suggesting that obese patients often fare better than thin ones. Dr. Carl Lavie — medical director of cardiac rehabilitation and prevention at the John Ochsner Heart and Vascular Institute in New Orleans — spent a year trying to get his findings about the obesity paradox with regards to heart failure published in a medical journal, saying:

"people thought there was something wrong with the data. They said, ‘If obesity is bad for heart disease, how could this possibly be true?'"

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While Dr. Lavie was one of the first to document the obesity paradox in 2002, study after study since then has supported his original findings. For instance, one study found that heavier dialysis patients had a lower mortality rate than normal-weight or underweight patients. Same with a study about coronary disease, diabetes, stroke, and high blood pressure. In 2007, a study conducted on over 11,000 Canadians over the course of a decade found that overweight people had the lowest chance of dying from any cause.

So far scientists are at a loss for the reasons behind the obesity paradox. One theory is that chronic diseases require higher energy and caloric reserves from a body. Another is something called "metabolically obese normal weight," meaning that a patient can have a normal body mass index, but also have metabolic abnormalities like high insulin levels.

Mostly, though, long-held assumptions about body fat and health have only taken B.M.I. into account (which is a ratio of height and weight) and not physical activity or fitness. A person who exercises and weighs more is often healthier than a person who doesn't and weighs less.

But it will apparently take a while for even general practitioners to catch on, as one nutritionist (ironically named) Linda Bacon says that our ideas about weight are "just too culturally embedded, and the risk of going against convention is too high."

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That's not to say that you should eat a bacon double cheeseburger and consider it preventative medicine. But the argument that overweight automatically means unhealthy is getting thinner.

In ‘Obesity Paradox,' Thinner May Mean Sicker [NYT]

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DISCUSSION

CommonVices
CommonVices

Ugh. I hate it that whenever a study like this comes out that can be vaguely construed in a way that's fat-affirming, a contingent of heavier readers rushes to the false conclusion that "fat is actually healthier than thin! Huzzah! Pass the donuts! Suck hard science, skinny b*tches!"

According to the article (disclaimer: I have not read the study), the study only seems to say something about the mortality rates of fat and/or thin people that are already sick. It doesn't say anything about the rates at which those people get sick in the first place, or draw distinctions with respect to the reasons the test group got sick and how being overweight (or not) may have affected that. The original article even raises that point that there may be a world of difference between thin people who are genetically susceptible to certain diseases and fat people who may have gotten the disease based on their lifestyle choices.

The study doesn't speak to whether plus-size people are actually healthier overall or less susceptible to contracting those diseases in the first place.

If you stop reading at "fat and fit is better, healthwise, than being thin and unfit" (well, no sh*t) then you're only getting half the message. Fit is always better than unfit, and thinness is an unreliable proxy for fitness. At best, it's a logical byproduct of being fit, and the fact that there are other ways, apart from attaining physical fitness, of becoming thin make it a less than perfect metric. But that doesn't mean that fat is actually fitter or that obesity isn't a pretty fair indicator that someone is unfit.