You Can’t Be Fit and Fat

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It’s okay to be heavy, as long as you don’t have diabetes or hypertension–right? Not so fast, says the latest research.

There are always exceptions to the rule, and that’s true of health issues too. While the bulk of studies warn about the dangers — to the heart, liver, kidneys and other body systems — of gaining weight, a small number of trials suggested that some overweight or obese individuals may be as healthy as their normal weight counterparts, since they had normal blood pressure, no diabetes and relatively stable cholesterol levels. In fact, one study found that overweight individuals (but not obese people) tended to live longer than those of normal weight.

But in a comprehensive review of studies dating back to the 1950s, scientists contradict that idea, with evidence that it’s not possible to be both overweight and healthy.

(MORE: You Can Be Fat and Fit–and Thin and Unhealthy)

The researchers, from Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto, Canada, found that people who tipped the scales at above their recommended body mass index (BMI) but did not have abnormal cholesterol or blood pressure, for example, still had a higher risk of dying from heart disease over an average of about 10 years compared to metabolically healthy individuals within normal weight ranges. In their analysis, published in Annals of Internal Medicine, the researchers separated individuals in the previous studies into six groups: normal weight and healthy, normal weight and unhealthy, overweight and healthy, overweight and unhealthy, obese and healthy, and obese and unhealthy. Their results showed that regardless of the person’s BMI, an unhealthy metabolic state — such as having hypertension, diabetes or high cholesterol levels — was consistently linked to an increased risk of dying during the study period or having a heart event. And contrary to previous studies that suggested that heavier people with normal metabolic readings could have “benign obesity” or “metabolically healthy obesity,” the team also reported that metabolically healthy obese participants had a higher risk of dying earlier or having heart-related problems than those who were normal weight and also metabolically healthy.

Why did previous studies suggest that people could be fit and fat? According to the current study’s lead author, Dr. Caroline Kramer, the discrepancy likely has to do with how the various studies were set up. For instance, some large studies only compared weight and the risk of adverse events instead of looking closely at people’s metabolic health. So some of the apparently healthy but overweight or obese individuals might have had signs of diabetes or hypertension or high cholesterol that simply weren’t recorded in the study. Other trials compared healthy obese people to unhealthy obese people, instead of comparing them to people of normal or healthy weights, and other studies relied on small groups of participants who were only studied over short time periods.

“This concept of healthy obesity came in the last 10 years, and it compares people who are obese but metabolically healthy to only metabolically unhealthy overweight people,” says Dr. Kramer. “Some studies report that if you are obese but metabolically healthy, you are protected in a way. We don’t think that that is true. And I don’t think it will come as much of a surprise.”

But since obesity has different effects on the body for different people, researchers are still investigating how weight gain and its health effects may vary among people whose obesity is due primarily to things such as genetics and environmental exposures as opposed to unhealthy diets and lack of physical activity. Even the studies in the current meta-analysis, for example, did not all include follow-up with the participants, so the final mortality and heart disease rates may be slightly higher or lower than they should be. But for now, the advice about maintaining a healthy weight in order to avoid premature death and disease seems sound — there may not be a way to heavy and healthy at the same time.

23 comments
valentine.godoflove
valentine.godoflove

IN CAPS FOR THE ELDERLY......DEFEND THE WEAK......KNIGHT TEMPLARS....


"YOU CANNOT BE FAT ......AND FIT"......


DUH!!!!!!.....OBVIOUSLY......WHO IS THE IDIOT THAT THOUGHT ABOUT THIS ARTICLE.....


VALENTINE....COMEDIAN....LOL

PhilVarlese
PhilVarlese

So, let me ask the author.  About 14 months ago, you published an article titled "You Can Be Fat and Fit".  Here's the link for anyone who might want to read it.
http://healthland.time.com/2012/09/05/can-you-be-fat-and-fit-or-thin-and-unhealthy/


So, what's happened to change your mind since September of 2012?


So, assuming that these many of these fatties are unhealthy, why is it that more and more of them are making it into their senior years?  From a recent study by the University of Glasgow, published in the UK Telegraph, and while the Telegraph meant it to sound alarming, the fact remains that fat people are living to quite advances ages today, much to the dismay of some people.
http://www.telegraph.co.uk/health/elderhealth/10473122/Obesity-crisis-more-than-one-third-of-60-70-year-olds-now-dangerously-overweight.html

kris_12
kris_12

In no way are people who are overweight healthy, but my question is this, why is it that some thin people do not work out or eat healthy but are perceived as being "healthy" because theyare skinny?

KyleAlexander
KyleAlexander

The study mentioned in this article showed that people who are obese without metabolic problems die more often than people of normal weight. That doesn't prove that obesity can never be healthy. (Here's the study: http://annals.org/article.aspx?articleid=1784285). Nobody has ever proven that bodyfat directly causes type 2 diabetes or heart disease. Quality of health habits correlates much more accurately than bodyweight.

Furthermore, there is no advantage for us to focus on bodyweight in the context of health. Promoting health at every size has been PROVEN to give better weight loss results than focusing on bodyweight itself. In other words, increased disapproval of the fat does not help them lose weight. (Proven by this study: http://www.nutritionj.com/content/10/1/9)

Why do we have to say that obesity is 100%, flat out, and always bad? Why can't we just say that obesity OFTEN correlates with poor health? We have nothing to gain. Instead, we just make life harder for the overweight. And lead more and more young people into developing eating disorders by inflating their fear of fatness.

OliMott1
OliMott1

Misguided, bad science, sending out the wrong message. Physical activity is far, far more important than weight, as the results from the Aerobics Longitudinal Study (the biggest and most rigorous study on the topic) state. Mary, you're right, sugar is terrible, but that's not the issue here. Despite less weight loss with a physical activity intervention than a diet intervention, the health gains from activity are dramatic, whilst the health gains from weight loss are very small (and they put the weight back on anyway).

RachelGilmore
RachelGilmore

there you go with the obesity and genetics concept...i wish that one would be laid to rest. Let's go with the truth- environmental exposure, AKA what we term 'normal' today like fast food/unhealthy diets, lack of exercise, and the list goes on; {with the EXCEPTION of some medical cases which make it harder for people to lose weight (i.e. not being lazy)}...Those "environmental" factors are the real reasons why our population is so unhealthy and 'obese', overweight, fat, whatever you want to call it. It mostly people's choices on a daily basis that could change this ultimate predicament we now find ourselves in.

mary.waterton
mary.waterton

At the heart of the obesity problem is SUGAR. The food processing companies put SUGAR IN EVERYTHING. It's difficult to find foods in boxes and cans that don't contain SUGAR. It adds up fast.

To eliminate sugar you have learn to decipher labels and identify sugar by its multitudinous cryptic names such as "high fructose corn syrup", "evaporated cane juice", etc. Then avoid it like the poison that it is. And don't be fooled when companies prefix those terms with words like "natural" or "pure" or "healthy" ... because it's none of those things.

commentonitall
commentonitall

BMI is crap.  It doesn't account for bone density or muscle mass.  I have 10% or less body fat, yet I am overweight by 28 pounds according to the BMI.

nlj
nlj

The data you presented is still a correlation, and not terribly conclusive. Perhaps there is a higher chance of heart disease associated with the depression that can come from being bullied and ostracized by society?

Additionally, this study will now need to be replicated several times over in order to be scientifically sound.

The only thing that can honestly be concluded here is that the overall evidence is still inconclusive.

olvit3
olvit3

thanx


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lose-weight090.blogspot.com

WalterPinkmanHyzenburrg
WalterPinkmanHyzenburrg

Does this mean we can finally put a moratorium on the whole "Big, Beautiful, and Healthy" bull**** that women use to rationalize being 70 lbs overweight and brand any man a jerk who dares to contradict that idea as utter nonsense?  

mprimak
mprimak

@PhilVarlese  And obese elderly are a HUGE problem for caregivers, nurses, and physical therapists!  Also, obesity leads to increased wear and tear on joints as well and when people have bad hip and knee disease, the pain is magnified by the stress put on their joints by their weight.

Aelfgifu
Aelfgifu

@PhilVarleseYou'd have found that the answer to your question in the one-sentence-long third paragraph of this article if you had actually bothered to read it before you decided to comment.

RobertJory
RobertJory

@kris_12  Why are skinny people seen as healthy? Same reason attractive people are seen as more moral people. It's the way our brain works. The thing that is harder to achieve is seen as the better thing. Before food was so abundant and easy to get being fat was harder to achieve and seen as the desired appearance. Now being skinny is harder to achieve so it's the more desired look and people just assume it means you're also healthier. Being skinny you can be healthy or unhealthy, but being obese means you're unhealthy.

willowbyrn
willowbyrn

@RachelGilmore While you are correct that genetics plays a role in only a very minor number of cases of obesity there are other biological factors such as epigenetics and microbial flora that can bias a person toward weight gain. This is not to imply that these factors should be used as excuses because while weight loss may be harder for certain individuals it is not impossible.

Rich1417
Rich1417

@mary.waterton I have never heard of anyone who was fat and stopped eating all foods with added sugars or other added sweeteners and did not lose weight. As Mary says, sugar is their poison. Once a person stops eating it, he will find it much easier to control his appetite in all respects. And then he should take the next best steps of cutting out other high glycemic foods (white rice, potatoes, etc) and engaging in some physical activity every day (building up to the point he can walk or ride a bike for an hour or he can run or swim or dance for half an hour).

Rich1417
Rich1417

@commentonitall A fairly good measure--better than BMI in my opinion--is your waist:height ratio (aka w/h). The circumference of your waist at your belly button (without sucking in) should not be greater than 50% of your measurement in height. For example, I am 6' 2" (or 74") tall and my waist at my belly button is 34". My w/h is therefore 0.46. That is in the healthy range. But, on the other hand, a man who is 5' 10" tall with a 40" waist has a w:h of 0.57, which is much too high. Using w/h is useful in a few respects: first, it accounts for those folks who are loaded with muscles, making their body mass appear too great for their size, when in reality they are fit; and second, because belly fat is much more dangerous for your health than other areas of body fat (say a fat butt or heavy thighs), w/h tells a fair tale of fit or fat. In fact, I have known men who are quite skinny in their legs, butt, arms, chest, head and so on, but have huge beer bellies. BMI might not completely capture just how unhealthy such people are, because their total body weight is not necessarily bad. But w/h will tell the story in those cases, too.