Healthy and Overweight a Myth?

RosaliaBee

Research is what moves us forward. It's not always a "no duh". Sometimes, research reveals the opposite of what we think is true.

Agree, it's what makes the difference between genuine knowledge and mere opinion.

Another thing that can happen, is that by careful analysis we can learn the all important 'why' behind certain results. The 'why' behind obesity being linked to diabetes for example. We know obesity is considered a risk factor in developing diabetes, but I've yet to read anything that tells me *exactly how* they are linked. Is it a bad diet that also contributes to the obesity, is it inherited genes that also make the potential sufferer more likely to become obese, or is it physiological changes in the body that occur once a person becomes obese?

seltzermint555

That makes sense to me. All of my numbers are amazing...but my extra weight is still an added stress to my body. I'm proud that my numbers are so good, because that is one less thing to worry about, but it certainly doesn't mean I don't need to lose the weight. I think if I were to believe I don't need to lose weight because my numbers are healthy...it would just be a blind. I'd be in denial and ignoring the issues I do have.

EXACTLY my thoughts!!

I think the problem for me is the way people want to be so incredibly black and white about this. It's simply not a black/white issue. Not all obese or overweight people have the same health problems and although we may share many health risks, it's just unfair to assume that because Janet is 5'5, 190 lb and has bad cholesterol, fatty liver disease, and Type 2 Diabetes (for example), Mary at 5'5", 220 lb definitely has all of those same health problems. She might not have ANY of them currently. People don't look at it that way.

bcattoes

"Healthy and overweight" is not the same as "overweight obesity". The difference between overweight and obese can be as great or as small as the difference between healthy weight and overweight.

The only evidence I've seen for healthy and overweight" is that people who are moderately overweight (nearer to healthy weight than obese, but still technically overweight by BMI) who exercise regularly can be as healthy as those within the healthy weight category. This just seems like common sense since exercise is as much a factor in health as weight.

cafeaulait7

The article uses the term overweight, but the quotes from the researchers only use obese. Oy.

Because it makes no difference whether we're talking about obesity or overweight, I guess. Makes sense to me. Fat (at all) = bad in the media, no matter how precisely research may be done.

cafeaulait7

Yeah, looks like the article in the OP's title (and the post's title) is incorrect, according to what was actually found:

http://annals.org/article.aspx?articleid=1784291

"Background: Recent interest has focused on a unique subgroup of overweight and obese individuals who have normal metabolic features despite increased adiposity. Normal-weight individuals with adverse metabolic status have also been described. However, it remains unclear whether metabolic phenotype modifies the morbidity and mortality associated with higher body mass index (BMI).

Purpose: To determine the effect of metabolic status on all-cause mortality and cardiovascular events in normal-weight, overweight, and obese persons.

Data Sources: Studies were identified from electronic databases.

Study Selection: Included studies evaluated all-cause mortality or cardiovascular events (or both) and clinical characteristics of 6 patient groups defined by BMI category (normal weight/overweight/obesity) and metabolic status (healthy/unhealthy), as defined by the presence or absence of components of the metabolic syndrome by Adult Treatment Panel III or International Diabetes Federation criteria.

Data Extraction: Two independent reviewers extracted the data. Metabolically healthy people of normal weight made up the reference group.

Data 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.

Primary Funding Source: Intramural funds from the Leadership Sinai Centre for Diabetes."

ThickMcRunFast

This was an interesting article, but people miss things about it in the discussion

1) it was not its own study, but a meta-analysis of 8 already published studies.
2) it concluded that 'overweight and metabolically healthy' subjects saw adverse effects down the road, but so did 'normal weight and metabolically unhealthy' subjects. You can be unhealthy at any weight, basically.

I used to think that the conclusion of 'its not healthy to be overweight' fell into the 'hurr and/or durr' category, I've seen enough posts of people yelling at each other over 'fat acceptance' to think otherwise.

my overall conclusions: Its not healthy to be overweight. Its not healthy to be a normal weight and eat 1800 calories of crap (300 calories of crap and 1500 calories of nutrient dense awesomeness is fine, though). We shouldn't be d*cks to people because of their weight.

rgugs13

NPR has an article on this subject as well. I think body composition is a better indicator than weight or BMI.

The NPR article talks about a study that found that individuals with a slightly overweight BMI actually live longer than individuals with a healthy BMI. That study came under scrutany because very sick people often lose weight and would fall into a healthy BMI category. When they went back and added current health factors in, the results changed. It talks about how even if overweight people have are currently within healthy levels for Bp, cholesterol, etc, that is likely to change as they age and the extra weight strains their bodies.

http://www.npr.org/blogs/health/2013/12/02/248206955/overweight-and-healthy-a-combo-that-looks-too-good-to-be-true?device=iphone

cafeaulait7

This was an interesting article, but people miss things about it in the discussion

1) it was not its own study, but a meta-analysis of 8 already published studies.
2) it concluded that 'overweight and metabolically healthy' subjects saw adverse effects down the road, but so did 'normal weight and metabolically unhealthy' subjects. You can be unhealthy at any weight, basically.

I used to think that the conclusion of 'its not healthy to be overweight' fell into the 'hurr and/or durr' category, I've seen enough posts of people yelling at each other over 'fat acceptance' to think otherwise.

my overall conclusions: Its not healthy to be overweight. Its not healthy to be a normal weight and eat 1800 calories of crap (300 calories of crap and 1500 calories of nutrient dense awesomeness is fine, though). We shouldn't be d*cks to people because of their weight.

I don't have a subscription, so I can't see the part that indicates this: "2) it concluded that 'overweight and metabolically healthy' subjects saw adverse effects down the road..." Can you hook up a quote, please?

ThickMcRunFast

This was an interesting article, but people miss things about it in the discussion

1) it was not its own study, but a meta-analysis of 8 already published studies.
2) it concluded that 'overweight and metabolically healthy' subjects saw adverse effects down the road, but so did 'normal weight and metabolically unhealthy' subjects. You can be unhealthy at any weight, basically.

I used to think that the conclusion of 'its not healthy to be overweight' fell into the 'hurr and/or durr' category, I've seen enough posts of people yelling at each other over 'fat acceptance' to think otherwise.

my overall conclusions: Its not healthy to be overweight. Its not healthy to be a normal weight and eat 1800 calories of crap (300 calories of crap and 1500 calories of nutrient dense awesomeness is fine, though). We shouldn't be d*cks to people because of their weight.

I don't have a subscription, so I can't see the part that indicates this: "2) it concluded that 'overweight and metabolically healthy' subjects saw adverse effects down the road..." Can you hook up a quote, please?

here's a quote from the results section, though I'm combing through their statistics now

"In pooled analysis of 8 studies, the metabolically unhealthy normal weight group had increased risk for all-cause mortality or CV events compared with metabolically healthy normal-weight persons (RR, 3.14; CI, 2.36 to 3.93) (Figure 2, A)"

ETA: conclusion paragraph:
"In conclusion, our meta-analysis supports the concept of heterogeneity of metabolic status among individuals within the same BMI range. Metabolically healthy obese individuals are at increased risk for death and CV events over the long term compared with metabolically healthy normal-weight persons, suggesting that increased BMI is not a benign condition even in the absence of metabolic abnormalities. In addition, all metabolically unhealthy individuals (normal weight, overweight, obese) had increased risk for events compared with metabolically healthy normal-weight individuals. Thus, in evaluating CV and mortality risk, it is important to consider both BMI and metabolic status to reliably estimate long-term outcome."

RosaliaBee

This was an interesting article, but people miss things about it in the discussion

1) it was not its own study, but a meta-analysis of 8 already published studies.
2) it concluded that 'overweight and metabolically healthy' subjects saw adverse effects down the road, but so did 'normal weight and metabolically unhealthy' subjects. You can be unhealthy at any weight, basically.

I used to think that the conclusion of 'its not healthy to be overweight' fell into the 'hurr and/or durr' category, I've seen enough posts of people yelling at each other over 'fat acceptance' to think otherwise.

my overall conclusions: Its not healthy to be overweight. Its not healthy to be a normal weight and eat 1800 calories of crap (300 calories of crap and 1500 calories of nutrient dense awesomeness is fine, though). We shouldn't be d*cks to people because of their weight.

I don't have a subscription, so I can't see the part that indicates this: "2) it concluded that 'overweight and metabolically healthy' subjects saw adverse effects down the road..." Can you hook up a quote, please?

here's a quote from the results section, though I'm combing through their statistics now

"In pooled analysis of 8 studies, the metabolically unhealthy normal weight group had increased risk for all-cause mortality or CV events compared with metabolically healthy normal-weight persons (RR, 3.14; CI, 2.36 to 3.93) (Figure 2, A)"

ETA: conclusion paragraph:
"In conclusion, our meta-analysis supports the concept of heterogeneity of metabolic status among individuals within the same BMI range. Metabolically healthy obese individuals are at increased risk for death and CV events over the long term compared with metabolically healthy normal-weight persons, suggesting that increased BMI is not a benign condition even in the absence of metabolic abnormalities. In addition, all metabolically unhealthy individuals (normal weight, overweight, obese) had increased risk for events compared with metabolically healthy normal-weight individuals. Thus, in evaluating CV and mortality risk, it is important to consider both BMI and metabolic status to reliably estimate long-term outcome."

Thank you for highlighting this clarification.

cafeaulait7

This was an interesting article, but people miss things about it in the discussion

1) it was not its own study, but a meta-analysis of 8 already published studies.
2) it concluded that 'overweight and metabolically healthy' subjects saw adverse effects down the road, but so did 'normal weight and metabolically unhealthy' subjects. You can be unhealthy at any weight, basically.

I used to think that the conclusion of 'its not healthy to be overweight' fell into the 'hurr and/or durr' category, I've seen enough posts of people yelling at each other over 'fat acceptance' to think otherwise.

my overall conclusions: Its not healthy to be overweight. Its not healthy to be a normal weight and eat 1800 calories of crap (300 calories of crap and 1500 calories of nutrient dense awesomeness is fine, though). We shouldn't be d*cks to people because of their weight.

I don't have a subscription, so I can't see the part that indicates this: "2) it concluded that 'overweight and metabolically healthy' subjects saw adverse effects down the road..." Can you hook up a quote, please?

here's a quote from the results section, though I'm combing through their statistics now

"In pooled analysis of 8 studies, the metabolically unhealthy normal weight group had increased risk for all-cause mortality or CV events compared with metabolically healthy normal-weight persons (RR, 3.14; CI, 2.36 to 3.93) (Figure 2, A)"

ETA: conclusion paragraph:
"In conclusion, our meta-analysis supports the concept of heterogeneity of metabolic status among individuals within the same BMI range. Metabolically healthy obese individuals are at increased risk for death and CV events over the long term compared with metabolically healthy normal-weight persons, suggesting that increased BMI is not a benign condition even in the absence of metabolic abnormalities. In addition, all metabolically unhealthy individuals (normal weight, overweight, obese) had increased risk for events compared with metabolically healthy normal-weight individuals. Thus, in evaluating CV and mortality risk, it is important to consider both BMI and metabolic status to reliably estimate long-term outcome."

Thank you for highlighting this clarification.

Yes, thank you for the extra quotes!

But if you look closely, 'overweight and metabolically healthy' subjects did not have any adverse effects. It was the obese folks and the metabolically unhealthy who did.

lovemuffin6

I've been a healthy weight most of my life, I have been overweight but only by a few pounds before losing some to get back into the healthy range. I was shocked when I looked at my body fat percentage and waist to height ratio and fell into obese categories. Even now I have blood pressure higher than someone my age (20) who runs 5 times a week !

ldrosophila

Fat is interesting how is it that something as simple as too much adipose tissue can reduce your mortality outside of any other metabolic complications? I'd love to know the mechanism going on here is it some sort of hormonal leptin loop thing? What an interesting disease, so the next question to ask is can this disease be reversed or can it only be managed? If one is to lose weight do they actually reduce the risks or are there still underlying risks because the fat cells themselves have not changed just shrunk? I'm in my 30's, so if I lose 200lbs can I expect an increase in life expectancy or has the damage already been done? Guess you would never know.

Oh and were talking about morbid obesity correct? Not just overweight as some studies have shown being overweight is more protective in later ages. Want to make sure the terms are correct.

BeautyDoll

Hee hee hee! Thomas the Tank Engine! LMAO!

BarbieAS

Well, yeah. I find the title slightly mis-worded, but after reading the article (and the additional info posted through the thread)...just, yeah.

I'm obese, but I'm healthy RIGHT NOW. Cholesterol, blood pressure, blood sugar are all stellar at this point in time.

However, I'm not so arrogant as to believe that at 50+ pounds overweight I'm going to STAY healthy for very long, especially compared to dropping the weight sooner rather than later.

(Edited for poor sentence structure...though I don't know if it's much better now )

acpgee

Research is what moves us forward. It's not always a "no duh". Sometimes, research reveals the opposite of what we think is true.

Agree, it's what makes the difference between genuine knowledge and mere opinion.

Another thing that can happen, is that by careful analysis we can learn the all important 'why' behind certain results. The 'why' behind obesity being linked to diabetes for example. We know obesity is considered a risk factor in developing diabetes, but I've yet to read anything that tells me *exactly how* they are linked. Is it a bad diet that also contributes to the obesity, is it inherited genes that also make the potential sufferer more likely to become obese, or is it physiological changes in the body that occur once a person becomes obese?

The Newcastle study pretty much attributes Type 2 to excess fat in pancreas and liver. The BMI threshold at which people develop diabetes varies, depending predisposition to storing fat in pancreas and liver, according to my understanding.

http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

SapiensPisces

Tagging to read through this thread later. Lots of really interesting commentary and discussion sofar.

j6o4

I think you can be overweight and healthy because carrying excess fat comes from having a high bodyfat percentage and not from a person's weight. I would say health is better determine with bodyfat percentage rather than weight.