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“provocative” new study on fit and fat

Posted by on Aug 18, 2011 in Blog Posts | 13 comments

Here is an article about “new” findings that indeed shows that you can be “fat” and healthy.

“A provocative new study shows that obese people who are otherwise healthy live just as long as their slim counterparts. And that wasn’t the only surprising finding. The study also showed otherwise healthy obese people are even less likely than lean people to die of cardiovascular disease.”

Our findings challenge the idea that all obese individuals need to lose weight,” study author Dr. Jennifer L. Kuk, assistant professor at York University School of Kinesiology & Health Science, said in a written statement. “Moreover, it’s possible that trying – and failing – to lose weight may be more detrimental than simply staying at an elevated body weight and engaging in a healthy lifestyle that includes physical activity and a balanced diet with plenty of fruits and vegetables.”

several things came to mind

  • In light of the recent media attention on Jess Weiner and the media’s misunderstanding of health at every size, this is timely, and I hope getting some press. You can be fit and fat.
  • it is only “provocative” because it challenges conventional thinking, the simplistic and wrong belief that BMI and badness/death are linearly related
  • this is one of the few times I have seen any article on fatness/fitness that shows an “obese” person exercising and seeming to enjoy it- usually it’s the headless image of someone eating an ice-cream
  • this is not surprising or new information to those familiar with the research. I have been reading study after study in the last 5 years (since I learned these studies exist) that tell me similar, “provocative”  things like : the weight gain that women generally experience as they get older is protective, or that the lowest mortality was in the “overweight” category for elder Americans, that women of Hispanic descent in the US are heavier than their white counterparts but live longer,  that when you actually include and correct for fitness, many of the risks associated with “overweight” and “obesity”  in several studies disappear, or that lean and fat children drink the same amount of soda or the same fat-content in terms of milk….
  • That this is another study showing that  yo-yo dieting is dangerous. That repeated attempts and “success” with weight loss, followed by the typical weight gain is what is likely the most dangerous.

I’d love to see this type of study get as much press as the others. Please share this “news!” What do you think?

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13 Comments

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  1. Lisa

    I think it’s great to see this kind of research – which, as you said, has been available for years – is finally getting into the mainstream press. I am looking forward to seeing it taken to the next level – more articles about one of the reasons it’s possible for fat people to be healthy/thin people to be unhealthy: good nutrition well and moving your body is good for every body, and poor nutrition and being too sedentary isn’t good for any body.

    I’d also love to see some unpacking what being “healthy” actually means, versus wellness, versus healthism in the mainstream press. I was at the ASDAH conference this past weekend and we had some amazing discussions about all these interesting ideas.

    And yes – that picture with the article is AWESOME!!

    • katja

      Hi Lisa,
      I just joined ASDAH. Dorry I missed the conference! I think that while many of my posts/topics are not specifically about size, I always try to present the information in a HAES-consistent way. Everyone can use support with healthy feeding. I thought this article was interesting in how it categorized risk based on life-style. Odd that we don’t see the same categorizing for lean patients, and use it to exhort them to make healthy changes… I do think most MD are encouraged to, and use BMI as the #1, often only marker of health (OK, maybe smoking status too.) That needs to change…

      • Lisa

        Well, let me be the first to say “Welcome to ASDAH, Dr. Katja!” I am absolutely delighted to hear this. I have really appreciated your perspective on HAES and good feeding practices and now you will be bringing all that good stuff to ASDAH!

  2. Twistie

    The first time I saw an article about yo-yo dieting being unhealthier than simply being fat came out, IIRC, in the late seventies.

    It’s now 2011.

    How sad that it’s not only still news, but still shocking to many.

    @Meg: I’ve read every reply to your original comment multiple times now, and I honestly don’t see any disrespect. People respecting themselves are not automatically being disrespectful of you.

    As several others have already said, long-term significant weight loss is not possible for the vast majority of people. Study after study has shown that over 90% of all diets for significant weight loss are unsuccessful over any long period of time. Sure, most people can lose ten pounds. They may even manage to keep them off for some years. On the other hand, if you manage to lose fifty, maintaining that weight loss over a period of five years requires so much effort that it’s the equivalent of a full-time job. And even then, the weight often comes creeping back.

    Because of this, nearly every weight loss diet undertaken is a yo-yo diet.

    In fact, even if I lost fifty pounds, I would still be well into the obese category. I am ‘morbidly obese’ or as many of us in the FA movement call it ‘deathfatz.’ My body will never be in the ‘normal’ BMI range.

    I cannot expect to change my body. Genetics and history have made it what it is, and it’s not likely to change significantly in size or shape without something drastic happening to me.

    On the other hand, I can – and mostly do – pay attention to my behaviors. I can – and do – eat a varied diet including lots of lovely vegetables as well as the odd slice of cake when I feel like having one. I can – and do – move my body regularly because it feels good. I can – and do – get a good nights’ sleep nearly every night. I can – and do – take the time to do little things that make me feel good about myself, because emotional health is every bit as important as (and sometimes far more in one’s individual control than ) physical health.

    So, I’m forty-eight years old with textbook perfect blood pressure, balanced cholesterol, a normal blood sugar level, and a family history of people who looked just like me living well into their eighties and their early nineties. I’m liking my chances of living a long life with the vast majority of my faculties intact.

    Not everyone wins that much in the genetic crap shoot, no matter how fat or thin they are.

    There is no need for an ‘excuse’ to stay fat, anymore than there’s any need for an excuse to stay gay, left-handed, or tall. I didn’t choose to be fat (or left-handed, which I also am). I simply am fat. I don’t get a second body offered to me, so I might as well make up my mind to treat this one the way I think it ought to be treated. And that means treating it with a combination of respect and compassion.

    After all, that’s how I strive to treat the people around me. How can I possibly do less for myself?

  3. Meg

    Just to clarify, I was not trying to start a fight or upset anyone. I’m not willing to fight about this and, were it possible, I’d delete my comment as I do not think that a respectful discussion of this topic can happen here. I’m quite sad about that.

  4. AcceptanceWoman

    Meg, your comment makes me think of a quote I read on David Mendosa’s blog from Dr. William Polonsky.
    He starts by asking if the following statement is true or false:
    “Diabetes is the leading cause of blindness, non-traumatic amputations, and end-stage renal disease in America.”
    “What’s true is that poor management [of diabetes] causes those problems. Well managed diabetes is the leading cause of NOTHING.”

    I also like that by using the phrase “well managed diabetes” — it implies that there are multiple factors in managing diabetes, it’s not all about blaming the person with diabetes. I don’t know much about Dr. Polonsky’s HAES-related credentials, but I did find this statement in one of the brochures for people newly diagnosed with diabetes on the web site of his institute “Focus on developing a healthier lifestyle, not weight loss.”

  5. Patsy Nevins

    Sorry, Meg, but ‘overweight’ people do NOT need to lose weight, nor is it possible for most of us to do so, certainly not long term. And losing & regaining & the process of dieting is so harmful to one’s health. There is NO illness which happens to fat people which does not also happen to thin people & when it does happen, fat people can benefit from the same treatment. And there is no disease for which deliberate weight needs to be part of the treatment. As for the ‘fat people can be as fit as thin people & live as long, often longer’, that is NOT news. There have been studies showing this for many years & I have known this for many years. It is always good, however, to see it stated again.

    As a woman who will turn 62 in September & who has & has had many fat relatives who lived from their late 80’s to mid-90’s, if & when health problems rear their heads, I will not accept a prescription of weight loss as part of the treatment. Not only is it not possible for most of us & dangerous in & of itself, it also becomes more dangerous with age, so that, by the time you are my age, weight loss increases mortality risks by several hundred percent. And I have had much too much over the past 31 years since I have been part of fat acceptance of people telling me that they worry about us present the truth a positive attitude about being fat as “an endorsement of obesity.”

    • katja

      thank you for your input! You said it better than I did, that this response that somehow data showing that fat people can be healthy is “endorsing obesity” is absurd.

  6. Meg

    I think the “obese people who are otherwise healthy” is the catch to this. I’m not sure what they define as otherwise healthy. An individual can be diabetic, but well managed and it’s not an issue. Is that considered healthy? My worry with a study like this is that a lot of bigger people who do need to lose weight will look at this as an endorsement to stay obese.

    • katja

      “Obese participants were categorized, using a modified EOSS definition, as stages 0 to 3, based on the severity of their risk profile and conditions (stage 0, no risk factors or comorbidities; stage 1, mild conditions; and stages 2 and 3, moderate to severe conditions). Compared with normal-weight individuals, obese individuals in stage 2 or 3 had a greater risk of all-cause mortality (stage 2 hazards ratio (HR) (95% CI), 1.6 (1.3–2.0); stage 3 HR, 1.7 (1.4–2.0)) and cardiovascular-related mortality (stage 2 HR, 2.1 (1.6–2.8); stage 3 HR. 2.1 (1.6–2.8)). Stage 0/1 was not associated with higher mortality risk. Lower self-ascribed preferred weight, weight at age 21, cardiorespiratory fitness, reported dieting, and fruit and vegetable intake were each associated with an elevated risk for stage 2 or 3.”
      Someone with diabetes would have a comorbid condition, so even if well-managed, that would increase morbidity and mortality. Someone with no comorbidities (diabeter, heart disease) who also had a balanced diet and a good level of fitness would be categorized as group O, and have the same risk as their lean counterparts. Does that answer your question? Your reaction is what I am seeing in the media also about body acceptance. Please take some time to read the comments from the linked post on Jess Weiner. Health needs to be first measured by behavior and actual health markers. This is another study that says using weight alone is not the be all and end all. Even the American Heart Association says that “BMI is not an adequate predictor of risk”… Do you believe that an obese person can be healthy? I do not advocate ignoring “health,” I just think we frame the discussion in a way that is telling only part of the picture and is more harmful than helpful. Again, most weight-loss attempts fail, and we know that HEALTHY can be improved regardless of weight in several studies, so why not start with the health discussion, and see what happens with the individual’s weight? It is nuanced…

    • Living400lbs

      My worry with a study like this is that a lot of bigger people who do need to lose weight will look at this as an endorsement to stay obese.

      Meg,

      There isn’t exactly scientific evidence that a lack of “endorsement” makes weight-loss methods work better in the long term, or makes weight losses of more than 8-15% any more attainable.

      This might be part of why people are assuming you’re trolling.