Bound to be controversial
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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.0 -
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/7914070 -
So... Healthy at every size
I keep hearing and seeing people talk about being healthy while being fat, overweight or obese.
I can inderstand being healthy while a bit fat but it seems fat and health have a negative correlation.
So am I wrong in thinking that you can't be healthy while very over weight? It just seems logical to me that more fat equal less healthy.
But healthy at every size people seem to be common. Maybe my thinking is outdated.
So healthy at any size... Yay or nay?
It's like saying that you can be a healthy smoker. Weeeeeeell, by some measures, yes, you can be very healthy while also being a smoker. But you're completely delusional if you think that the smoking isn't impacting your health now and might have dire consequences later.0 -
nvsmomketo wrote: »I agree with those who say age is a HUGE factor. An obese, active person who is 25 is going to be healthier than an obese, active 45 year old almost every time. Young people, (I would define as about age 30 or younger) haven't had enough time being fat for their health problems (caused by what they eat) to catch up to them yet. It most likely will.
It's like smoking. The smoker who has been doing it for 10 years probably doesn't have obvious health problems from that activity YET, but the 50 year smoker is the one who is more likely to have issues from their addiction.
I think some overweight poeple can be healthy, mostly those who are working on reducing their weight. If you eat like a thin person, your blood and body will reflect it before you get thin. If an overweight (or thin person) is eating like a fat pesron, their blood won't stay healthy for many years.
I do agree that exercise at any weight will make you healthier. Note that I said healthier and not healthy. My 72 year old mother goes to the gym 3 days a week. I am sure she has better muscle tone than many 60 year olds, but she is 100lbs overweight - there is only so much going to the gym will do for her. It helps, but it isn't enough.
yeah, i think that it's likely to show up sooner or later, for most.
my top bmi was 30. i had no health problems at that time (in my 20s). what i've read though is that having been obese can still put you at risk of metabolic disorders even after you lose weight, i.e. that some of the hormonal / metabolic markers are more or less permanent.
i am now at a bmi of 22 (but of course older) and now have borderline high cholesterol. i wonder how much having been obese made a difference. (but then i also have genetic risk).
i also wonder how much body fat percentage plays into health, given that fat is endocrinologically active. bc have also had low vit d and low creatinine levels (reflecting what is very probably an obese-range body fat %, although i'm bmi 22 - classically skinny fat). vit d is fat soluble - wonder if high bf % means less of the vit d is getting where it needs to go.
***
http://www.nature.com/ijo/journal/v24/n1/full/0801082a.html
Mortality associated with body fat, fat-free mass and body mass index among 60-year-old Swedish men¾a 22-year follow-up. The study of men born in 1913
RESULTS: The risk of dying was a linear function of percentage fat and fat-free mass, and increased from a relative risk of 1.00 in men belonging to the lowest fifth to 1.4 (95% confidence interval 1.11-1.99) in men in the highest fifth of percentage fat mass. For BMI the lowest risk was observed for men belonging to the middle fifth of BMI. When the relative risk was set at 1.00 for subjects belonging to the middle fifth of BMI the risk associated with the low BMI fifth was 1.3 (95% confidence interval 0.94-1.68) and that with the highest fifth was 1.5 (95% confidence interval 1.09-1.96). Analyses including both body fat and fat-free mass showed that total mortality was a linear increasing function of high fat and low fat-free mass.
****
which arghalsdkfjaskdfj sucks because i cannot lift heavy weights right now
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I don't know that having been obese is a factor in cholesterol issues. I've been obese a while, still am hovering on the cusp of obesity/overweight, have a genetic predisposition to high cholesterol, and just from losing the weight I've already lost, I've managed to drop mine down to normal range. I think I'm older than you too.0
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Can a few outliers be obese and healthy?
YES. One or two very athletic people, assuming they didn't take steroids to get there, can!
YES. A lot of younger or recently obese people can.
YES. A still obese person who just lost a lot of weight and has been exercising, can!
YES. In some rare cases an obese person who is athletic and exercises and hasn't lost weight, can, maybe (athletic+obese+haven't lost any weight? How often?)!
However, most obese people, after a few decades of being so, and with the weight increasing as time goes on... just can't--not as healthy as they would have been at a lower weight!
This does not mean that they should be denied health care.
This does not mean that health care should be disproportionately rationed when it comes to them.
The things one HEARS about say the rationing of health care in the British public health care system... disturb me.
Then again the things one HEARS about the US health care system from people who have some money but not enough for health care coverage also disturb me.
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)0 -
Mostly, I think there's a range of Healthy weights. However, my sweet sister-in-law is overweight, but has perfect lab values, normal blood pressure, no health issues beyond a broken arm from a fall last year. She's an exception.
LeBron James has a morbidly obese BMI, but I wouldn't call him fat and I would presume his cardiovascular heath is good. OTOH, I would find it surprising if he doesn't have joint damage already that will make his later years very uncomfortable. Is that healthy or not?0 -
The "healthiest" obese people we have are probably NFL linemen. They can easily scale out at 325-350 pounds, and yet they are strong, mobile and fast.
Until they hit their 30s - and then it all goes to **** in a hurry.
Medical problems in 40+ year old ex-linemen are legendary...
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It's not just about being fat - even if you're carrying an extra 100 pounds of PED-enhanced muscle, you're going to have problems, because you're carrying a **** ton more weight than your frame and connective tissue evolved to carry.
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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.0
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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?0 -
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.0 -
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 lol0 -
Something I have noticed as I've gotten older is life catches up to you. Things you could get away with when you were younger seem to come back and haunt you as you get older. Eating crap, being stressed out, being obese, staying up until dawn and going to work the next day is something you can get away with in your 20's. It gets a little harder in your 30's. By the time you hit 40 you're starting to feel it. Just like a car. It's great when it's new but when it hits that 10 yr mark you're gonna be able to tell if a car has had proper maintenance over the years. Human bodies need maintenance. Being overweight puts strain on joints and tendons. Puts strain on the heart and lungs. Not a big deal when you're young but increasingly becomes a problem the older you get.
Yes it's good to love yourself at any weight. But you also need to respect your body. Treat it right and don't assume the health you enjoy when you're 20 will continue into your 40's or 50's.
Oh that made me feel better to read this. I was reading this thread, and was amazed that (almost) no one mentioned the age factor and long-term health damages.
Because what, you are full of energy at 20 years-old? You can run without having a heart attack at 25? Get out of here !
;-)
Now seriously: I am waiting to see a 60 + years-old person who has been overweight /obese most or all of his life, come and tell us that he has no health problems related to his weight or nutrition.
Also, speaking of running ... am all for running and exercise, but being able to run does not in any way indicates that one is healthy. In fact, someone who is not certain to be reasonably healthy should not participate in a long distance or high intensity run.
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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.0 -
The "healthiest" obese people we have are probably NFL linemen. They can easily scale out at 325-350 pounds, and yet they are strong, mobile and fast.
Until they hit their 30s - and then it all goes to **** in a hurry.
Medical problems in 40+ year old ex-linemen are legendary...
A lot of that has to do with the type of sport.
That's another thing...we assume that athletes are healthy, but a number do things that are either bad for them now (like some powerlifters who are obese to make their bases more stable...or some gymnasts who deliberately drop pounds below healthy levels to fly higher) and some are doing stuff that's likely to cripple them later.
"XYZ is a great athlete, so clearly he must be healthy"--that's actually a pretty terrible argument. Just lock at all the football players with neurogenerative diseases and replacement joints at 40-50!
There is virtually NO evidence in ANY direction about the long-term health consequences of having a healthy fat mass and a very high fat free mass (in absences of steroid use--the problems with that are well-documents). I'd be REALLY interested in studies into that! But the population would be hard to find. Not many people who lift like crazy at 20 are doing it at 50, much less 60.0 -
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.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!0
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