Every so often, a piece of news hits from the world of health that is so big it is picked up by every news outlet there is. And a couple of weeks ago, every print and electronic media outlet pick up on the following headline: “Healthy Obesity Is a Myth, Report Says.” Yes, one year after the doctors finally declared obesity as a disease—and many years after the American Heart Association moved overweight and obesity from a “contributing factor” to a full-fledged risk factor—now we hear that it is harmful to be obese, even if that is the only thing wrong.
One publication took things so far to publish a magazine article called “You Can’t Be Fit and Fat.” As usual, some of the headlines were misleading and the study didn’t even include exercise into its equation. Let’s have a look at what the outcome of this study was and then we will put it into perspective.
Researchers found in the study, which as published in Canada, that overweight and obese people (even without high blood pressure, diabetes or other metabolic issues) were found to have higher rates of death, heart attack and stroke after 10 years compared with their thinner counterparts.
“This data suggests that increased body weight is not a benign condition, even in the absence of metabolic abnormalities, and argue against the concept of healthy obesity or benign obesity,” said researcher Dr. Ravi Retnakaran, an associate professor of medicine at the University of Toronto.
The terms “healthy obesity” and “benign obesity” have been used to describe people who are obese but don’t have the abnormalities that typically accompany obesity, such as high blood pressure, high blood sugar and high cholesterol, Retnakaran explained. “We found that metabolically healthy obese individuals are indeed at increased risk for death and cardiovascular events over the long term as compared with metabolically healthy normal-weight individuals,” he added.
It’s possible that obese people who appear metabolically healthy have low levels of some risk factors that worsen over time, the researchers suggest in the report, originally published Dec. 3 in the Annals of Internal Medicine.
Dr. David Katz, director of the Yale University Prevention Research Center, welcomed the report. “Given the recent attention to the ‘obesity paradox’ in the professional literature and pop culture alike, this is a very timely and important paper,” Katz said. (The obesity paradox says that obese people with chronic diseases have a better chance of survival than normal-weight individuals do).
Some obese people appear healthy because not all weight gain is harmful, Katz said. “It depends partly on genes, partly on the source of calories, partly on activity levels, partly on hormone levels. Weight gain in the lower extremities among younger women tends to be metabolically harmless; weight gain as fat in the liver can be harmful at very low levels,” he explained.
I think most experts today would agree that being overweight in and of its self is harmful. Aside from it contributing to diabetes, high blood pressure and high cholesterol, being very overweight or obese can lead to fatty liver disease, sleep apnea, emotional problems like depression and osteoarthritis. Yes, at some point, your musculoskeletal system will try to tell you that it wasn’t created to schlep around all that extra weight. You will feel it in your knees, your back, and your hips and in your feet and ankles. You will experience it through aches and pains that can negatively impact your quality of life as you age. And just because you went to the doctor at age 50 and your blood test looked relatively good, when you carry around too much weight, those numbers can and usually will change rapidly.
The biggest fault in this study is that it doesn’t address the “Fit and Fat” phenomenon. 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. This study, conducted under the supervision of Dr. Steven Blair examined data on 43,265 participants enrolled between 1979 and 2003, who filled out questionnaires about their lifestyle and medical history and also underwent physical exams, blood tests and a treadmill test to gauge their cardiovascular fitness. The researchers categorized obese participants as “metabolically healthy” if, aside from their weight, they didn’t suffer from insulin resistance, diabetes, low levels of good cholesterol, high triglycerides and high blood pressure. Nearly half of the obese participants in the study qualified as metabolically fit.
Compared with obese people who had at least two of the above markers of poor health, those who were obese but metabolically healthy had a 38 percent lower risk of early death from any cause. In fact, those who were fat but fit had no higher death risk than metabolically healthy normal weight participants. The problem with the current study is that it didn’t differentiate between obese people who exercise and those who don’t.
In Blair’s study, those in the lowest fifth in terms of fitness had a death rate four times higher than participants ranked in the top fifth for fitness. Dr. Blair states, “Being fit provides protection against mortality in these men and women 60 and older, whether they’re normal weight, overweight, or obese.” In another study by Lee, Blair, and Jackson several years ago, 21,925 men of all shapes and sizes were assessed and monitored for eight years. The study concluded that men, who were fit and fat, actually had a lower mortality rate than men who were normal weight but unfit and sedentary. One of the authors of this study is clinically obese. However, he runs 35 miles per week. So the key here is “fit,” and not necessarily thin.
So this latest research, highly touted and publicized, has its place. That place is this: if you don’t exercise and you are obese, it is dangerous, even if your blood pressure, your cholesterol and your blood sugar is all great! But, if you can manage to exercise while being obese, you’re better off than a thin person, who doesn’t exercise.
One more thing to think about: if you are counting on being overweight or obese and being an exerciser, take it from this personal trainer who has trained many overweight people—it isn’t so easy to exercise and be fat. You might have to do it, but it is a lot more pleasant to lose the weight while you are exercising with proper eating, proper sleep, good hydration and making sure your exercise program is balanced and safe for you to do.
At the end of the day, working toward a normal weight together with exercise will “add hours to your day, days to your year, and years to your life.”
Does being frum put you at greater risk for obesity? Read more at Jewish Action. http://www.ou.org/jewish_action/03/2013/weighing-in-on-obesity-in-the-frum-community/.