Bound to be controversial
Replies
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MamaBirdBoss wrote: »PeachyCarol wrote: »Nah i think you are seeing things to black and white and there is a lot of shades of gray in it.
like for example ,Are u familiar with the term metabolically healthy obesity? The american society of endocrinologist have refer about it a lot
Normal bmi= healthy 100%? , as someone who works in a health enviroment you"ll be suprise how that doesnt always works that way.
Not so fast there...
http://annals.org/article.aspx?articleid=1784291&ct=40009Data Synthesis: Eight studies (n = 61 386; 3988 events) evaluated participants for all-cause mortality and/or cardiovascular events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95% CI, 1.02 to 1.55) had increased risk for events compared with metabolically healthy normal-weight individuals when only studies with 10 or more years of follow-up were considered. All metabolically unhealthy groups had a similarly elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR, 2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).
Limitation: Duration of exposure to the metabolic–BMI phenotypes was not described in the studies and could partially affect the estimates.
Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.
there was another study, maybe someone else will have the link handy?? - that found that mortality rates were lowest among people in the *overweight* BMI category, followed by normal weight, then i can't remember which of obese and underweight went to 3rd and 4th place.
now whether the people in the overweight category lived well, as well as just lived more often, i don't know. (i can't remember if they also lived LONGER. i think it was a cross-sectional study. just that the mortality rates among overweight people were lowest.)
i think it was this one
http://www.medscape.com/viewarticle/791407
Most very young people die of accident. People who are overweight are less active and undertake fewer risks, so they are less likely to die of accident at all ages. This becomes statistically significant when you're less than...45, I think it was, because NO ONE who's overweight is yet dying of illnesses caused by weight at that level.
You also need to make sure in the elderly that you separate people who have a low body weight AND fat free mass from those who had a low fat mass and a healthy fat free mass. Many elderly people suffer from malabsorption which causes malnutrition. A risk factor for this is obesity when you're younger. If you don't die directly from a heart attack or cancer due to your elevated risks from being obese, many eventually end up a so-called healthy weight because their body is literally wasting away--fat-free mass included. Low fat-free mass causes you to be extremely unlikely to recover from all sorts of things, from pneumonia to a broken hip. Higher fat-free mass AND lower fat mass is one of the strongest correlations for health among the elderly.
Finally, there are other things that you eventually die from thin that you're more likely to get when you're obese. For example, cancer causes most people to lose a lot of weight. The bad study you're referring to looked at weight AT DEATH and extrapolated from there--which assigns tons of people to normal or below-normal weight who got sick because they were obese.
I think the argument in the study I had seen was that older people who are at bmi around 27 (overweight) achieved the greatest degree of longevity, with longevity at that age, being a U shape around BMI 27 (ish).
One part would be that they may have fat reserves to say deal with a course or two of chemotherapy in case they get cancer... so live longer. Other part argued was that maybe they have more underlying muscle mass and so are better able to function longer into old age.0 -
professionalHobbyist wrote: »Whilst you can be "healthy" whilst obese the statistical likelihood is greater that you won't be in comparison to being normal weight.
I think HAES movement really should be more about AAES - acceptance at any size.professionalHobbyist wrote: »Whilst you can be "healthy" whilst obese the statistical likelihood is greater that you won't be in comparison to being normal weight.
I think HAES movement really should be more about AAES - acceptance at any size.
That is what it is all about!
BMI is no determinant of a persons worth or value as a person.
The concept of beauty being tied to worth runs deep and can be very destructive
no it's not...it's about saying it's fine to be any size when in fact it's not.
if you think this is true again let me say it has to apply to anorexics too then and doctors and family are no longer allowed to put them in special care for it...just let them be
The person above me said it should be about acceptance at any size. And we can accept people no matter what their size is.
I agree that is what it should be about.
Not some crazy idea of healthy at any size.
I stated that plainly earlier.0 -
atypicalsmith wrote: »
When I was 30, I had an ectopic pregnancy which nearly killed me in 1980. My doctor let me talk him out of checking further into it because I was in no pain and had a major project at work. When I blacked out, I was rushed to the hospital and BP was 0/0 and it was amazing that I lived. Later, my friend Debbie, who went to my doctor at my referral, had cramping. He told her to go the hospital RIGHT NOW. She said but she was on her lunch hour. He said he didn't care, to call her office and go to the hospital RIGHT NOW. She argued and he said, "Do you remember your friend Sherry? I will never have a patient nearly die again. If you don't go to the hospital RIGHT NOW, I won't be your doctor any more." She went and her life was saved.It is one thing to encourage the patient to follow a path towards a more favourable outcome.
It is another thing to deny care pending patient compliance (even if such compliance would result in slightly more favourable odds)
Sherry I think we're in agreement here/not 100% sure.
I am arguing that doctors SHOULD encourage obese people to lose weight, without shaming them and without announcing to the whole office their height and weight and BMI. A perfectly normal discussion of "this is what your risks are. This is how to mitigate them." And yes, this is what you weigh.
Not wanting to hear your weight is a ridiculous cop out. If you have a psychological problem that precludes you from hearing your weight your doctor should be made aware of that and proceed as per his professional understanding of which approach will cause you less harm.
BUT, I am also arguing that the doctors should NOT deny obese people care "unless you lose x-amount of weight".
It is one thing to say to a patient: you will have y-benefits by losing x-amount of weight and I think we should operate on you when you've done that; vs I am not going to operate on you until you lose x-amount of weight because it is a waste of my time and the medical system's money.
<however; I will accept the: "I will refer you to another doctor for this operation because your body is physically too large for me to operate on given my own physical dimensions" argument if it is true!>
Note that I am GLAD you survived and that your example resulted in your doctor giving the right advice to your friend! But would the doctor have given the same advice to you had you been obese at the time?0 -
MamaBirdBoss wrote: »PeachyCarol wrote: »Nah i think you are seeing things to black and white and there is a lot of shades of gray in it.
like for example ,Are u familiar with the term metabolically healthy obesity? The american society of endocrinologist have refer about it a lot
Normal bmi= healthy 100%? , as someone who works in a health enviroment you"ll be suprise how that doesnt always works that way.
Not so fast there...
http://annals.org/article.aspx?articleid=1784291&ct=40009Data Synthesis: Eight studies (n = 61 386; 3988 events) evaluated participants for all-cause mortality and/or cardiovascular events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95% CI, 1.02 to 1.55) had increased risk for events compared with metabolically healthy normal-weight individuals when only studies with 10 or more years of follow-up were considered. All metabolically unhealthy groups had a similarly elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR, 2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).
Limitation: Duration of exposure to the metabolic–BMI phenotypes was not described in the studies and could partially affect the estimates.
Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.
there was another study, maybe someone else will have the link handy?? - that found that mortality rates were lowest among people in the *overweight* BMI category, followed by normal weight, then i can't remember which of obese and underweight went to 3rd and 4th place.
now whether the people in the overweight category lived well, as well as just lived more often, i don't know. (i can't remember if they also lived LONGER. i think it was a cross-sectional study. just that the mortality rates among overweight people were lowest.)
i think it was this one
http://www.medscape.com/viewarticle/791407
Most very young people die of accident. People who are overweight are less active and undertake fewer risks, so they are less likely to die of accident at all ages. This becomes statistically significant when you're less than...45, I think it was, because NO ONE who's overweight is yet dying of illnesses caused by weight at that level.
You also need to make sure in the elderly that you separate people who have a low body weight AND fat free mass from those who had a low fat mass and a healthy fat free mass. Many elderly people suffer from malabsorption which causes malnutrition. A risk factor for this is obesity when you're younger. If you don't die directly from a heart attack or cancer due to your elevated risks from being obese, many eventually end up a so-called healthy weight because their body is literally wasting away--fat-free mass included. Low fat-free mass causes you to be extremely unlikely to recover from all sorts of things, from pneumonia to a broken hip. Higher fat-free mass AND lower fat mass is one of the strongest correlations for health among the elderly.
Finally, there are other things that you eventually die from thin that you're more likely to get when you're obese. For example, cancer causes most people to lose a lot of weight. The bad study you're referring to looked at weight AT DEATH and extrapolated from there--which assigns tons of people to normal or below-normal weight who got sick because they were obese.
They later adjusted for things like smoking and age and found no difference
"In a subsequent analysis that excluded 34 studies that were considered possibly overadjusted (ie, adjusted for factors such as hypertension that are considered to be part of the causal pathway between obesity and mortality) and 10 studies that were considered possibly underadjusted (ie, neglected to adjust for factors such as age, sex, or smoking), results for the remaining 53 adequately adjusted studies did not significantly alter the results. "
(no idea if they excluded car accidents etc)
though it seems they were more careful than you assume.
http://www.nature.com/news/the-big-fat-truth-1.13039
Here's a good discussion of it, including the criticism and the response.
I'm inclined to believe that the evidence that there's a health risk to being BMI 25-27 is pretty weak, barring other issues (I want to maintain at more like 20-22, but that's vanity, I don't deny it). However, OP specifically said "very overweight," so I see this discussion as more about claims that one can be over 30 BMI and yet have no increased health risks.0 -
atypicalsmith wrote: »It is one thing to encourage the patient to follow a path towards a more favourable outcome.
It is another thing to deny care pending patient compliance (even if such compliance would result in slightly more favourable odds)
When I was 30, I had an ectopic pregnancy which nearly killed me in 1980. My doctor let me talk him out of checking further into it because I was in no pain and had a major project at work. When I blacked out, I was rushed to the hospital and BP was 0/0 and it was amazing that I lived. Later, my friend Debbie, who went to my doctor at my referral, had cramping. He told her to go the hospital RIGHT NOW. She said but she was on her lunch hour. He said he didn't care, to call her office and go to the hospital RIGHT NOW. She argued and he said, "Do you remember your friend Sherry? I will never have a patient nearly die again. If you don't go to the hospital RIGHT NOW, I won't be your doctor any more." She went and her life was saved.
How are you arriving at that %? Bioimpedance scale? Even if true, you are not that far from the % for a healthy female.well there is a few of you using the term "being fat". I am at a healthy BMI for my heigh smack dab in the perfect zone.. but I have 33% body fat.. so... I am.. fat, but you know not fat. I also have an auto immune disease that will never go away so I guess I'm not healthy either. The word healthy is so relative to the person talking about it. I was a marathon swimmer with just about no body fat and my blood work always had something wrong with it. Does all of this correlate to weight? hell no it doesn't. being "fat" means your fat... being "unhealthy" can happen at any weight.
Did someone say that not being obese is a guarantee of health?
The question is whether MOST obese people can be BOTH obese AND healthy. The obvious, to me, reference being as to whether obesity BY ITSELF brings about health complications... which... well... it DOES when you consider obesity over time.
Now, whether that is true or not (that obesity has health consequences over time), so do thousands of other things that people do. From driving a car, to drinking alcohol, to smoking cigarettes, to going out for a run in the forest when there is a wind storm.
Should this affect how they receive health care?
Is the obese person less worthy of health care than the BMX biker who face planted after a 9ft jump in the forest?
Well funny you mention that because my hubby rides BMX for a living riding for big companies and he doesn't get health care so he has to pay out of pocket and his premiums are triple mine because of his career. so yea lol
In Canada, where I am, he is just as well covered as an obese person would be! Actually better, because no one would deny him surgery pending losing some weight!
oh Canadian health care... how I envy thee!!!0 -
lemurcat12 wrote: »MamaBirdBoss wrote: »PeachyCarol wrote: »Nah i think you are seeing things to black and white and there is a lot of shades of gray in it.
like for example ,Are u familiar with the term metabolically healthy obesity? The american society of endocrinologist have refer about it a lot
Normal bmi= healthy 100%? , as someone who works in a health enviroment you"ll be suprise how that doesnt always works that way.
Not so fast there...
http://annals.org/article.aspx?articleid=1784291&ct=40009Data Synthesis: Eight studies (n = 61 386; 3988 events) evaluated participants for all-cause mortality and/or cardiovascular events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95% CI, 1.02 to 1.55) had increased risk for events compared with metabolically healthy normal-weight individuals when only studies with 10 or more years of follow-up were considered. All metabolically unhealthy groups had a similarly elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR, 2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).
Limitation: Duration of exposure to the metabolic–BMI phenotypes was not described in the studies and could partially affect the estimates.
Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.
there was another study, maybe someone else will have the link handy?? - that found that mortality rates were lowest among people in the *overweight* BMI category, followed by normal weight, then i can't remember which of obese and underweight went to 3rd and 4th place.
now whether the people in the overweight category lived well, as well as just lived more often, i don't know. (i can't remember if they also lived LONGER. i think it was a cross-sectional study. just that the mortality rates among overweight people were lowest.)
i think it was this one
http://www.medscape.com/viewarticle/791407
Most very young people die of accident. People who are overweight are less active and undertake fewer risks, so they are less likely to die of accident at all ages. This becomes statistically significant when you're less than...45, I think it was, because NO ONE who's overweight is yet dying of illnesses caused by weight at that level.
You also need to make sure in the elderly that you separate people who have a low body weight AND fat free mass from those who had a low fat mass and a healthy fat free mass. Many elderly people suffer from malabsorption which causes malnutrition. A risk factor for this is obesity when you're younger. If you don't die directly from a heart attack or cancer due to your elevated risks from being obese, many eventually end up a so-called healthy weight because their body is literally wasting away--fat-free mass included. Low fat-free mass causes you to be extremely unlikely to recover from all sorts of things, from pneumonia to a broken hip. Higher fat-free mass AND lower fat mass is one of the strongest correlations for health among the elderly.
Finally, there are other things that you eventually die from thin that you're more likely to get when you're obese. For example, cancer causes most people to lose a lot of weight. The bad study you're referring to looked at weight AT DEATH and extrapolated from there--which assigns tons of people to normal or below-normal weight who got sick because they were obese.
They later adjusted for things like smoking and age and found no difference
"In a subsequent analysis that excluded 34 studies that were considered possibly overadjusted (ie, adjusted for factors such as hypertension that are considered to be part of the causal pathway between obesity and mortality) and 10 studies that were considered possibly underadjusted (ie, neglected to adjust for factors such as age, sex, or smoking), results for the remaining 53 adequately adjusted studies did not significantly alter the results. "
(no idea if they excluded car accidents etc)
though it seems they were more careful than you assume.
http://www.nature.com/news/the-big-fat-truth-1.13039
Here's a good discussion of it, including the criticism and the response.
I'm inclined to believe that the evidence that there's a health risk to being BMI 25-27 is pretty weak, barring other issues (I want to maintain at more like 20-22, but that's vanity, I don't deny it). However, OP specifically said "very overweight," so I see this discussion as more about claims that one can be over 30 BMI and yet have no increased health risks.
Thanks for that!
I'd read the OP more broadly (bc of the title) but yeah, you're right.
I do think the idea of "metabolic obesity" being something people of normal weight can experience is interesting (if that's where at least some of the risks associated w obesity are really coming from), and am curious about why it happens etc0 -
MamaBirdBoss wrote: »PeachyCarol wrote: »Nah i think you are seeing things to black and white and there is a lot of shades of gray in it.
like for example ,Are u familiar with the term metabolically healthy obesity? The american society of endocrinologist have refer about it a lot
Normal bmi= healthy 100%? , as someone who works in a health enviroment you"ll be suprise how that doesnt always works that way.
Not so fast there...
http://annals.org/article.aspx?articleid=1784291&ct=40009Data Synthesis: Eight studies (n = 61 386; 3988 events) evaluated participants for all-cause mortality and/or cardiovascular events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95% CI, 1.02 to 1.55) had increased risk for events compared with metabolically healthy normal-weight individuals when only studies with 10 or more years of follow-up were considered. All metabolically unhealthy groups had a similarly elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR, 2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).
Limitation: Duration of exposure to the metabolic–BMI phenotypes was not described in the studies and could partially affect the estimates.
Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.
there was another study, maybe someone else will have the link handy?? - that found that mortality rates were lowest among people in the *overweight* BMI category, followed by normal weight, then i can't remember which of obese and underweight went to 3rd and 4th place.
now whether the people in the overweight category lived well, as well as just lived more often, i don't know. (i can't remember if they also lived LONGER. i think it was a cross-sectional study. just that the mortality rates among overweight people were lowest.)
i think it was this one
http://www.medscape.com/viewarticle/791407
Most very young people die of accident. People who are overweight are less active and undertake fewer risks, so they are less likely to die of accident at all ages. This becomes statistically significant when you're less than...45, I think it was, because NO ONE who's overweight is yet dying of illnesses caused by weight at that level.
You also need to make sure in the elderly that you separate people who have a low body weight AND fat free mass from those who had a low fat mass and a healthy fat free mass. Many elderly people suffer from malabsorption which causes malnutrition. A risk factor for this is obesity when you're younger. If you don't die directly from a heart attack or cancer due to your elevated risks from being obese, many eventually end up a so-called healthy weight because their body is literally wasting away--fat-free mass included. Low fat-free mass causes you to be extremely unlikely to recover from all sorts of things, from pneumonia to a broken hip. Higher fat-free mass AND lower fat mass is one of the strongest correlations for health among the elderly.
Finally, there are other things that you eventually die from thin that you're more likely to get when you're obese. For example, cancer causes most people to lose a lot of weight. The bad study you're referring to looked at weight AT DEATH and extrapolated from there--which assigns tons of people to normal or below-normal weight who got sick because they were obese.
They later adjusted for things like smoking and age and found no difference
"In a subsequent analysis that excluded 34 studies that were considered possibly overadjusted (ie, adjusted for factors such as hypertension that are considered to be part of the causal pathway between obesity and mortality) and 10 studies that were considered possibly underadjusted (ie, neglected to adjust for factors such as age, sex, or smoking), results for the remaining 53 adequately adjusted studies did not significantly alter the results. "
(no idea if they excluded car accidents etc)
though it seems they were more careful than you assume.
I didn't mention smoking.
I mentioned the things they absolutely DID NOT adjust for, and I also mentioned the fact that the study design made the entire conclusions invalid because it was based on weight at death, not at development of the fatal condition.
And the large study DID find different risk factors at different ages. THey found being obese, even, didn't substantially raise your risk of being dead, lol, under 40-something, I for get the number, and that it was "safer" to be obese at 20 than it was to be a healthy weight at 20 (because morbidly obese 20-year-olds are way less likely to do stuff like drive around like idiots and fall off a boat drunk in the middle of a lake).0 -
lemurcat12 wrote: »MamaBirdBoss wrote: »PeachyCarol wrote: »Nah i think you are seeing things to black and white and there is a lot of shades of gray in it.
like for example ,Are u familiar with the term metabolically healthy obesity? The american society of endocrinologist have refer about it a lot
Normal bmi= healthy 100%? , as someone who works in a health enviroment you"ll be suprise how that doesnt always works that way.
Not so fast there...
http://annals.org/article.aspx?articleid=1784291&ct=40009Data Synthesis: Eight studies (n = 61 386; 3988 events) evaluated participants for all-cause mortality and/or cardiovascular events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95% CI, 1.02 to 1.55) had increased risk for events compared with metabolically healthy normal-weight individuals when only studies with 10 or more years of follow-up were considered. All metabolically unhealthy groups had a similarly elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR, 2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).
Limitation: Duration of exposure to the metabolic–BMI phenotypes was not described in the studies and could partially affect the estimates.
Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.
there was another study, maybe someone else will have the link handy?? - that found that mortality rates were lowest among people in the *overweight* BMI category, followed by normal weight, then i can't remember which of obese and underweight went to 3rd and 4th place.
now whether the people in the overweight category lived well, as well as just lived more often, i don't know. (i can't remember if they also lived LONGER. i think it was a cross-sectional study. just that the mortality rates among overweight people were lowest.)
i think it was this one
http://www.medscape.com/viewarticle/791407
Most very young people die of accident. People who are overweight are less active and undertake fewer risks, so they are less likely to die of accident at all ages. This becomes statistically significant when you're less than...45, I think it was, because NO ONE who's overweight is yet dying of illnesses caused by weight at that level.
You also need to make sure in the elderly that you separate people who have a low body weight AND fat free mass from those who had a low fat mass and a healthy fat free mass. Many elderly people suffer from malabsorption which causes malnutrition. A risk factor for this is obesity when you're younger. If you don't die directly from a heart attack or cancer due to your elevated risks from being obese, many eventually end up a so-called healthy weight because their body is literally wasting away--fat-free mass included. Low fat-free mass causes you to be extremely unlikely to recover from all sorts of things, from pneumonia to a broken hip. Higher fat-free mass AND lower fat mass is one of the strongest correlations for health among the elderly.
Finally, there are other things that you eventually die from thin that you're more likely to get when you're obese. For example, cancer causes most people to lose a lot of weight. The bad study you're referring to looked at weight AT DEATH and extrapolated from there--which assigns tons of people to normal or below-normal weight who got sick because they were obese.
They later adjusted for things like smoking and age and found no difference
"In a subsequent analysis that excluded 34 studies that were considered possibly overadjusted (ie, adjusted for factors such as hypertension that are considered to be part of the causal pathway between obesity and mortality) and 10 studies that were considered possibly underadjusted (ie, neglected to adjust for factors such as age, sex, or smoking), results for the remaining 53 adequately adjusted studies did not significantly alter the results. "
(no idea if they excluded car accidents etc)
though it seems they were more careful than you assume.
http://www.nature.com/news/the-big-fat-truth-1.13039
Here's a good discussion of it, including the criticism and the response.
I'm inclined to believe that the evidence that there's a health risk to being BMI 25-27 is pretty weak, barring other issues (I want to maintain at more like 20-22, but that's vanity, I don't deny it). However, OP specifically said "very overweight," so I see this discussion as more about claims that one can be over 30 BMI and yet have no increased health risks.
At a BMI of 18.5-27, things like fat free mass become more and more important. Greater fat free mass has proven to be protective (in the absence of excessive fat mass). So a girl who has 25% fat mass at a BMI of 26 is very LIKELY to have better survivability of a ton of things than a girl with 25% fat mass and a BMI of 18.5, as long as the heavier girl doesn't have most of her fat in the visceral range.
Within the "healthy" BMI range, I had a waist-hip ratio in the HIGH RISK category. Not even moderate! It wasn't until I dropped below a BMI of 23 that I managed to get into the "low risk." I also had a "high risk" belly circumference with a BMI under 24. My resting heart rate, another indication of cardiovascular health, was just over the "poor" mark for my age. I was also "over-fat," with a body fat percentage over 32%. So a woman who had a BMI of 26 would totally be at far lower risk if she had a better W/H ratio, smaller belly circumference, lower fat percentage, and lower resting heart rate.
OTOH, my Asian mother-in-law has a BMI of 27, and she LOOKS remarkably obese, she has tons of visceral fat, she's has super-high blood pressure and terrible cholesterol, and her doctor has been strongly warning her about her extreme need to lose weight or risk stroke or heart attack for YEARS.
That's one of the reasons that doctors aren't told to tell everyone in the "overweight" range to always lose weight. ALL data of that sort, until you actually die, is about probabilities. BMI is a possible marker of poor health. Context will show you whether BMI is a meaningful assessment of an individual's risk for obesity-related problems. If you're obese (not "overweight"), the data show that it's remarkable UNLIKELY that you won't have major repercussions, in time, and that there has to be exceptional circumstances for this to possibly be the case. Overweight, though, shows that you're in a GROUP that has elevated risks for certain things but that the risks tend to be small and other issues are often more important than your BMI as to whether or not you're at risk. That's why things like waist circumference and W/H ratio were developed specifically for people with BMIs under 30 to have a better assessment for actual risk.
High blood pressure, cholesterol, resting heart rate, and any number of other health markers that have normal, borderline, and high ranges are exactly the same. Yes, borderline high total cholesterol is often something to be concerned about, just like being overweight, but the actual risk depends on things like whether it's LDL or HDL, family history, fat mass, exercise history, and more to assess an individual's real risk from suffering from any serious coronary disease at that particular cholesterol number.0 -
The part on the card that suggested doctors NOT weigh the patient unless asked, I disagree with. Weight is an objective measurement that can point to potential problems, just as a blood pressure reading is, and any other tests. And blood pressure can vary far more than weight does in a day!
I worry too if increasing numbers of patients refuse to be weighed, that national data may be suggesting a reduction in the obesity epidemic when it is actually a reduction in reporting. Knowledge is power, even if the knowledge is frightening or embarrassing.
What I would like to see a reduction of, is an assumption by some that the overweight are lazy or deficient somehow.0 -
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Unhealthy? A burden on the health care system?0 -
....as compared to sugar, @asflatasapancake ? Or perhaps the soda debate? The soda is eviiil threads are like nails on a chalkboard.
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