“Scientists discover fried dough filled with frosting and covered with chocolate glaze and sprinkles saves lives”…. Sorry, not a scientific breakthrough you’ll be reading about anytime soon, despite some recent articles suggesting overweight and obese individuals are healthier than normal or even underweight individuals.
To better understand the obesity paradox, you have to first realize the concepts of being overweight or obese are derived from the Body Mass Index (BMI), a statistical device that is nearly 200 years old and was really only meant for statistical evaluation of populations and not individuals. The BMI is a ratio of a person’s height and weight. The ranges of BMI are again, really just statistical ranges but unfortunately one of the common measures used to evaluate a person’s health. It is widely acknowledged that the BMI has considerable race, age, gender, and body morphology limitations so any scientific studies that are hinged on weight issues as a part of their conclusions should be taken with a grain of salt or packet of sweetener, as the case may be.
Going back to the obesity paradox, the gist of this theory stems from research showing a phenomenon where obese and overweight individuals in chronic disease or diabetic studies had fewer deaths then their normal or underweight counterparts. The worst outcomes (ie. death), were shown in thin elderly males.
So the limitations of the obesity paradox start with the BMI being a poor isolated measurement of a person’s health or fitness. Other shortcomings include conclusions that the reason the thinner people showed higher death rates is because their thinness was actually a consequence of a more severe disease state. Most of these studies did not use exercise tolerance, body morphology, or physical capabilities as health markers.
- The medical community will likely shift to accepting that it is probably reasonable to suggest a BMI of around 27 versus 25.
- The waist to hip ratio is a much better predictor of fitness and risk for chronic diseases and cardiovascular events than the BMI. It is much less healthy to have the central obesity (large trunk and skinny limbs) versus the curvy frame.
- Realize that most calculators of cardiovascular events or chronic disease risk include history of high blood pressure, smoking, cholesterol, and family history and not just a BMI.
- Your healthy weight in my practice is when the clothes you want to wear fit comfortably, you can maintain a moderately active lifestyle, and any medical illnesses are controlled or cured.
- Thin and normal weight SEDENTARY individuals are less healthy than moderately active individuals at any weight.
- Cardiovascular disease is the leading cause of death in women – so ladies, you have got to exercise. Focus on your energy, the way your clothes fit and not numbers.
You may now enjoy your donut . . . that’s your only one for the week, right?
Dr. Curvy, aka Dr. Stephen Camacho, is a family doctor practicing in the midwest. He’s a busy guy, married with 8 kids, no typo here, 8. He loves singing, dancing, reading, cooking, playing all sorts of sports, doing outdoorsy things, being artistic and creative. Every day he tries to learn or do something different to make himself a better person for others, and for himself. You can follow Dr. Curvy on twitter.