Topic 9 - Is It Unhealthy To Be Fat?
 

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My thoughts on that would be, as in many other things: moderation.

I believe you can be 'fat but fit', but to a certain extent only. The word 'fat' contains a very wide range of possibilities, from the person who is 'only 20 lbs overweight' to the person who is 'morbidly obese and on an oxygen tank because her lungs are failing under her weight'. The first one could be pretty fit all the same (well you can be overweight and able to run marathons, that's not a problem in itself), and another part of the whole range could be as well; on the other hand, past a certain weight (or percentage of extra weight, depending on the size), it must become difficult to ignore that at least one's endurance is getting lower (mine sure was, and this at only 165 lbs...), that one can't climb stairs as easily as before... That sort of things. So what, it doesn't appear on a blood test. It's still annoying and 'not fit' all the same.

IMHO, we cannot totally discard the potential related health problems. There are thin people with health problems, and obese people who don't suffer from HBP, diabetes, etc, but I wouldn't go and use that as a 'proof' that being fat = no health problems can be linked to that. To me, it just means that not everyone necessarily gets all the shaft from genetic combinations; sometimes, you're unlucky for some things, and lucky for others.

I'm afraid my opinion might seem in ill-taste, but all in all, it looked like some kind of half-assed justification to me. Something along the lines of "we don't have any choice at all, and all that is left to us is to clutch at this as to some kind of poor consolation because it's all we'll ever have". Maybe I'm wrong; yet it's the way I've perceived it all the same.

This said, I don't believe either that we NEED to become rail-thin to be in good health.

I`ll agree with you about selective reporting and pure speculation.

We are one of the first obese populations. I don`t think enough time has elapsed for a good study. In any case, I think this would be about being "slightly overweight and fit" instead of "fat or obese and fit", which makes more sense. It would then go against those other "studies" that tell you that your chances for a heart attack cuadruple if you`re 20 pounds overweight.

If anything, this chapter was maybe intended for those people who are considered 20 pounds overweight. There is nothing healthy about being 80 pounds overweight.

I find these conclusions totally bizarre and totally against anything I have ever heard or personally experienced. It's like throughout this book, there is an overwhelming fatalistic attitude toward permanent weight loss. Therefore it sumises to say that "fat is healthy" and we shouldn't try to change it. I for one, hope people who are struggling with their wt. don't read this and think "it's no use".

I do believe there is a spectrum where being a little overweight for some people is not totally dangerous (especially is the person is able to still be physically active). I , myself , didn't have overwhelming health problems when I was 20 lbs. overweight. But, as most of you know, I ended up with high blood pressure,congestive heart failure, asthma, diabetes, hypertension, continuous shortness of breath, fatty liver disease (besides my other genetic liver diseases), tachycardia. I was literally a heart attack or stroke waiting to happen. Now , How could that be healthy?

I am more likely to believe that those who are severely overweight or obese that have no health problems are a medical miracle or just plain lucky and that it will eventually catch up with them (like it did with me). I think most every single one of us know, how much harder every single one of our organs including heart , lungs, kidneys, liver, pancreas etc. have to work to support a heavier weight. Not to mention the added stress to our bones and joints.

In a way, this really makes me angry that such an irresponsible message is now out there for people to see and some (who don't know any different) to believe.

I'll have to agree with the ladies who have already posted. I've read in several places recently that people who are slightly overweight have a longer life span than people who are at "healthy" weights. I don't know why, but I'm willing to believe this. I am not, however, willing to believe that being morbidly obese or obese at all is healthy. I've been there and done that, I know that I'm healthier now than I used to be, I feel it with every breath and step I take...but that's just me.

I printed out Meg's post and discussed it with the gals at work. It would be impolite to type what most of us thought. ;) Obviously the author has never nursed someone who is very over weight. Their troubles only multiply ... it matters not to me if the obesity caused the illnesses from which they suffer, they're going to die quicker!

I think the author is once again comparing apples to oranges. Perhaps it does not adversely effect our health to be slightly overweight but you cannot use that as evidence pointing to morbid obesity as healthy.

I'm going to veer off track just a little here and talk about cause of death. Many of the elderly die after breaking a hip. Did they die of a broken hip? Of course not! Suppose Mr Q dies of unresolved congestive heart failure, that's what Dr X will write on the certificate. If Dr X is feeling wordy and has lots of time he might write that the CHF was secondary to Mr Q's 387 lbs!

A persnickity statistics collector could then grab that as meat for this preposterous theory!

Yes, skinny people die too. Many actually waste away as they near death. Does this fact support shorter life spans for the underweight? I suppose it could if I was building my own ridiculous collection of nonsense.

I'd better stop rambling now ... grrrr ....

Meg, I had exactly the same reaction! Selective reporting is what I thought, too. And I also got lost. I did not find it persuasive. However, given that she claims overweight (but not obese) is healthy, and I am overweight, I WANTED to believe her! :D

Susan -- She doesn't say obesity is healthy, just "overweight". But, as I said, it wasn't necessarily really persuasive.

Forgive me ... I have not re-borrowed the library copy I had and admit that this stuff made me angry! ... I was rambling.

However ... am I the only reader who will make that mistake?

"Higher weights could be the unintended consequence of the nation’s general better health, or maybe even a contributor to it."(p 222)

I am not sure that we can say the nation has better health than say 50 or even 100 years ago. Yes, we live longer because of findings in the medical community such as insulin, antibiotics, heart bypasses, etc. but while we are living are we healthier? From what I see we're not. Children with obesity, heart disease, type 2 diabeties were not happening 50 years ago. Nor were there nearly as many obese people.

I would wonder what her definition of 'better health' is.

I do not agree with her conclusions.

That's what I mean Denise ... we are living longer, some folks who have things we now consider pedestrian (congenital heart defects, Rh incompatibility, low birth weight, even broken hips) would have died in an earlier era. That's certainly an improvement in national health. But to combine that with weight increase stats to make a case ???? I dunno

"Higher weights could be the unintended consequence of the nation’s general better health, or maybe even a contributor to it."(p 222)

Not to be a downer, but frankly, I'd be one to think it's rather an unintended consequence of all the refined grains/foods and whatever junk our oh-so-great era has introduced in our diets... Except that slightly higher weights are logical if we take into account the higher heights of people, I didn't really see the cause-to-conesquence link in that one. :dizzy:

Hi Everyone,

I'm sorry I missed so much of the discussion - just returned from a ME vacation. From my personal experience, being overweight has NOT been healthy. I believe that my high blood pressure and type 2 diabetes are direct results of my being overweight.

Lynn

Lynn -- It's really tempting to use our personal experiences in these cases. I think we all do it. In fact, when I read her book, I immediately referenced my own experiences!

But Kolata's argument is based on studies of large populations. She doesn't say that all overweight people are healthy, just that, when you look as a whole, and try to control for other factors, that overweight people are healthier than "normal" weight people. Take a look at this great post by Sarah44 about the "ecological fallacy" and why we can't assume that population statistics apply to every individual.
http://www.3fatchicks.com/forum/show...cy#post1744682

So, it's very possible your health issues are because of weight, but doesn't negate Kolata's argument.

That being said, I just have trouble accepting Kolata's argument wholecloth. The research is conflicting, and she basically seems to tell us that the statistics for one argument are wrong and the other one is right, but really doesn't give us enough detail to understand why. At least, I didn't understand it. So, at this point I feel left a bit in limbo on the issue.

What I thought was most interesting was the discussion over the research which was flawed, and how when they released their study, with the affected persons already counted or backed out, their research was basically ignored. And yet the other research that kept touting the serious health risks of obesity, those are the ones that the journals picked up. I thought that part was fascinating and frightening. Do you guys remember that section of it?

I came across a blurb...can't remember where or how....but they were talking about fewer fat people die from heart attacks and strokes than do thin people.

Taken out of context one might draw a conclusion to eat, drink, and be merry. However, what is interesting is that they did not give any statistics on how they came to that conclusion.

I can think of several scenarios where the facts wouldn't support the conclusions.... however, in the interest of making money.... figures don't lie, but liars figure!! (That means, anyone can skew statistics to show what ever they way to show.) As was previously stated.... maybe a fuller figure is healthier than the twiggies of this world.... but for the truely obese.... poor health is their number one concern. (else we would all weigh about 1000 pounds and be proud of it!!!)

Moxiesd -- Do you remember about "how fat exactly" what you read was talking, if it did? I'm curious, because in our world where being a size 6 is apparently already being fat, I wouldn't be surprised if this involved people who are just 10-20 lbs overweight compared to the 'standards', and really not more. In which case it's indeed very possible and even likely to be in pretty good health and shape in spite of the extra layer of fat.

Shortly after the news was carrying the story about how " being a little overweight is better for your health", I read a follow-up in the news that once the study was corrected by taking out people who were at lower weights due to illnesses, etc, that the study data clearly showed lower mortality in people who were not overweight. I guess that news wasn't as satisfying to report or remember.

In any case, here's a link to an insurance company article, discussing the relative and absolute risks of obesity. It would be great to have you experts in interpreting studies have a look at it:

This one's a PDF, with lots of charts and graphs:
http://www.swissre.com/INTERNET/pwsfilpr.nsf/vwFilebyIDKEYLu/ULUR-7279WV/$FILE/Publ04_Obesity_en.pdf

Rainy

I'll see if I can take a closer look at that link, but one of the problems with interpreting this research is the question: Who were the participants?

If I remember right, this is one of the questions that was addressed in Kolata's book. With work like this, we need to know if the results can apply to everyone -- or to whom they can be applied.

For example, the very famous "nurses study" has followed a large sample of nurses over many years as the women provided a lot of information about their lifestyles. But can the results of this study apply to people who are NOT like these nurses? Is there something about the nurses that make them different from other people? Probably, though knowing WHAT that is -- who knows? They may be smarter, or more detail oriented, or be different in any number of ways...

The only way to have results that are generalizable to a larger population is to draw a sample of people from a group in such a way that EVERYONE IN THE POPULATION HAS AN EQUAL CHANCE OF BEING IN THE STUDY. This is called random sampling or representative sampling.

I don't know if that sounds easy, but it's not. Think about a population such as all the students in a school. You could get a random sample of that population by taking a list of ALL students (this is important), and then sampling a certain number of them. Again, it has to be in a way such that everyone has an equal chance to be picked. Like dumping all names in a hat and picking so many of them.

But you can't get a random sample of a population if you don't have a way to get a list of everyone...

Without a random sample, it's hard to say how the results generalize beyond that sample, because there may be something that makes them different from others. For example, if you collect data at a mall, the people there are all capable of leaving their homes and willing to spend money and at the mall at a certain time. They may be different from the population as a whole in a number of ways: wealthier, mobile, unemployed? Who knows.

So, look at the studies discussed in Kolata's book and her discussion of the participants -- who was taken OUT of the studies and for what reasons? That's an important issue.

I'm sorry to go on and on... I have no idea if this is of interest to anyone and don't want to blather on if not!! :D

Heather, blather on! I think it's absolutely essential for us to be able to evaluate all the conflicting information we get about weight loss and maintenance. So any light that you or anyone else can shed on how to interpret studies is most welcome! :)

Thanks, Meg. I have to be careful when I get into "teaching mode" sometimes. Though, unlike my students, you guys can ignore everything, and not worry that it will be on a test! :D

Of course, in some respects, you all may be MORE interested, motivated, as we are discussing issues that are important to us. Our test is real life! :)

I like that! It's so true, this isn't theory for us. It's practice and it's just about as important as can be.

Sorry..but this seems like the typical "if a little is good more must be better"

Yes the super rail thin are unhealthy, I was certainly healthier at 150 than an anorexic, probably even at 180, but that doesnt mean more is better

Am I healthier now than at 150? I dont know. But I know for a fact that I am healthier than I was at 180.

There are SOOOO many ways those statistics can be skewed...take for example the study on the hospitals in our area. My local community hospital had a heart attack and stroke mortality rate DOUBLE the bigger city hospitals.

What wasnt mentioned in the report is that my town is a retirement home mecca. Our population is extremely skewed with almost 40% of the population being over 65. A significant # who die at the retirement homes are transported by ambulance to the ER and then pronounced. Technically they "died at the hospital" because they were pronounced at the hospital.

ennay, that's a great example.

I like to say not that statistics are always skewed, but that they are often misinterpreted. That is, people don't take into account all the factors (like the example above) when they try to put them into context.

I wish students learned how to interpret science and research studies more in the public schools! I think we are often scientifically illiterate in many ways because people don't teach us the right questions to ask! So many of us just get frustrated and decide that all research is meaningless, because it seems so confusing! It IS confusing, I agree, but I think we expect "truth" and "answers" and science moves very slowly to give those.

Take the question of this thread: "Is it Unhealthy to be Fat?"

I don't think we know the full answer to that question, not by a longshot. But I'm willing to bet the answer is something like this:

"Well, when you look at people at the extremes, really really skinny, or really really fat, that as a whole they tend to suffer more of this and that and die sooner than people in the middle. Now, as for those in the middle, yes, as weight increases there are increased tendencies to experience this and that problem, but one must also take into account other lifestyle issues. For example, regular exercise plays an important role in reducing x, y and z diseases. And don't forget nutrition! To complicate matters further, people who are deemed overweight may be more likely to experience q and r than "normal weight" people, but they tend to be protected from s and t."

And that isn't concise and doesn't fit on a headline of a news report! :D

I think it would be funny if they did a study of overweight people and found that they were healthier than normal weight people, and it turned out the overweight people were overweight from eating too many vegetables and too much whole wheat bread, while the normal weight people subsisted on a diet of french fries and milkshakes.

I'm not sure how I feel about this question.

I've often been troubled by the idea that seems popular that excess weight *causes* health issues like heart disease, high blood pressure, etc. It seems more likely to me that the behaviours that cause excess weight cause the heart disease & other issues. It's a small distinction, but an important one because it means that theoretically, if one was as Jessica suggested, one could have extra weight due to overeating healthy foods and still be healthy.

There's the question of degree too though, as others have suggested. 15-20 lbs overweight is one thing, 100+ is different. Being obese would put strain on your heart muscles, knees, respitory system, everything. I can see that it would be hard to be considered healthy & be obese.

At 170 lbs, I'm technically overweight, but my blood profiles are excellent, I run 3-4 times a week, weight train, don't smoke, I'm not a workaholic, I eat healthily and sleep well. Do I think the 11 lbs I'm overweight according to the BMI index necessarily means I'm less healthy than my junk food eating, smoking, never exercises, works too hard sister who happens to fall within a normal weight BMI? No. You can't convince me that by virtue of those 11 lbs only, I'm less healthy than she is.

I think for the most part if you are talking morbidly obese, to deny the link is ludicrous. If you are talking obese......well, then fitness, nutrition may balance it some. If you are talking "overweight" well, then I do submit that at some point BMI is only a rough approximation and while you can make assumptions about the "overweight population as a whole" you absolutely cant about individuals. Lifestyle factors are absolutely more than weight.

BUT.....and this is small samples so not statistically significant at all, from my own observation there is ALSO a point at which the morbidly obese (note I say obese, not overweight) seem to also struggle from illnesses that are not technically lifestyle diseases. For example, I have 2 very close morbidly obese friends. In the past year they have both been hospitalized for things that are not technically due to their weight. BUT whether its from difficulty of care, stress on the immune system, or maybe flat out shoddy care from prejudiced doctors (I do firmly believe that the obese receive a lower standard of care overall) the fact remains that they are ill more often than most people, have more complications when they are ill, and are ill far more often than when they were merely obese.

Will EVERY obese person become ill, of course not. Just as every smoker doesnt get lung cancer and every sun goddess doesnt get skin cancer.

But I do NOT believe that the CDC is part of a "conspiracy" with the diet industry.

I'm sorry, of all the chapters this is the most ludicrous. Conspiracy theory?

I think health is a complicated curve and of course there are multiple factors, but I think there is pretty overwhelming evidence. Her "you cant trust THOSE statistics, but here, trust MINE" argument is pretty laughable.

What next? Type II Diabetes is just a sign of the burgeoning health of our youth?

I still dont see how the logical premise of "And the best weights for health consistently included ones in the overweight range. " leads to the conclusion "Could that mean that the obesity epidemic is actually a good thing,"

This is a CLASSIC logical fallacy tactic... take a statement about one group of people (the overweight) and make a conclusion that applies to a second group of people (the obese) as if the groups were the same. (politicians do it all the time:D)

It would be the same as concluding that because moderate drinkers of alcohol have better heart factors than teetotallers, therefore alcoholics must be even healthier.:p

I am willing to concede that the definition of healthy weight and overweight may be a little ....imprecise. I wasnt magically healthier the day I went from 142 to 141. :lol:

oooh.. great point, ennay, about confounding these definitions. If we're going to use "overweight" and "obese" and give them different definitions (as we have) then we have to be sure to take care with how we use them.

[blather]This is another issue I talk about in my classes a lot when discussing research: How did you measure it? We typically use BMI to "measure" levels of obesity, but there's general consensus this measurement is flawed. It only looks at height and weight.

I wonder if the results of these studies would be different if they used percentage of body fat? Of course, the problem there is that it is harder to measure than BMI. BMI is easy to assess, but may be meaningless. BF% is harder to measure, but may be more meaningful.

But it makes me wonder if a lot of the people who fall into the overweight category on the BMI are actually lower in BF, but higher in muscle. And THAT group might be healthy.

So, the sample (who the participants are) makes a difference, and how we measure things makes a difference. When you boil it down, these two issues are what I tell my students to look for in every study they read about. There are more issues to examine, sure, but these are relatively easy to start asking questions about!! [/blather]

I love your blathering, Heather! :) It makes so much sense. Where were you when I was in college? Oh, yeah, probably in grade school. . . :rofl: Anyway, I'd wager to say that many of the folks here at 3FC fall in the "fat but fit" category, esp as they work their way down in their weight loss. Certainly the majority of people who lose significant amounts of weight have an exercise component to their weight loss. There are exceptions, of course. (Just saw a thread called Lost 105 lbs without exercise, or somthing like that) Ah, wherever I was going with this before the phone rang has escaped me. I'll just close and get dressed and on with my day. :)

So do you think Alberto Salazar's heart attack will be used as "proof" that thin and fit isnt healthy( or healthier at least)?

What about vegan Linda McCartney's breast cancer?

No matter how healthy I eat, I can still get hit by a bus tomorrow.

I'm still waiting for my copy of the book, so I hesitate to post, but both extremes of this argument drive me crazy. If being fat doesn't cause health problems, in my experience at the very least, it exacerbates health problems.
But, I am annoyed with doctors who blame everything on excess weight, and dismiss treatment options other than losing weight.

Sending me home to lose weight without doing further tests or providing treatment in the meantime, is often so frustrating. Being fat may have caused my respiratory infection, but I still may need an antibiotic. I had a large ball of fungus growing in my sinuses that went undiagnosed for years because every doctor I went to said my sinus problems were caused by my weight, and that they'd just disappear if I lost weight, so they wouldn't offer any treatment other than an allergy medication here and there.

If I hadn't found a doctor who was willing to help me WHILE I was trying to lose weight, I'd probably still have that fungus growing in my head.

There has to be a middle ground between ignoring the health risks of obesity, and blaming everything but the weather on excess weight.

Coming late to the discussion, but I just finished the book. I finished it, including this chapter, while lying in a hospital bed for 3 days. I went to the ER (because our town doesn't have an Urgent Care and my doc was gone for the day) because of weird burning that was resonating up from my stomach to my heart. They admitted me because my father, obese, died 4 years older than I am now of a heart attack. Once they ruled out the heart as a problem (my heart is actually stellar thanks to the last year of hard work), every suspicion they had was somehow connected to my former weight and how hard dramatic weight loss is on the body (of course, much better than obesity and than weight gain, but the idea is never to get fat in the first place). One theory was a gallbladder attack and/or gallstones. They did indeed find gall stones, typical in people who lose a lot of weight relatively quickly. This was not the cause of the pain, though. The theory that ended up being the cause is that the pain medicine I took following hernia surgery this summer caused an ulcer that was inflamed this past week by stress. The test confirmed this theory, although it is actually 3 ulcers. The hernia was one that developed when I was morbidly obese, but that neither the doctor nor I could feel until the weight surrounding it was manageable.

My long-winded point is this...it was a hard chapter for me to believe while lying in a hospital bed with an ailment that is the direct result of having been morbidly obese and then of having lost a lot of, but not all of, the weight. It made me wonder if the author had ever been obese herself. Now I realize that my own experience does not make for a statistic. However, I know enough obese people to know that my story is not unique. I had to laugh when the doctor came in with the result of the test just after I had read the last page of the chapter, commended me on the weight loss so far, and told me mine was the first case he'd seen that week where the diagnosis was related to LOSING a lot of weight (I was in the cardiac unit -- since that is where they admitted me). He said he'd seen a lot of people that week who were struggling because they were so obese and NOT because they'd lost weight.

At that point, the author lost a good deal of credibility for me and I shared the story with the doctor. We got a good little laugh.

I just finished reading the book yesterday and I got what the author was saying. She did say that people on the extreme ends of the "U" (either underweight or extremely overweight) are more likely to die early so I don't think she was saying that people who are so fat they are immobilized are healthy. I think what she was saying is that "Look, not everyone is going to be in that normal BMI range. That doesn't mean they're going to be unhealthy however."

One of the women in the study seemed like she just couldn't lose a lot of weight despite having a personal trainer and being on a diet. Yet, that woman is probably more fit than my husband who is thin, eat what he wants, and gets winded on the elliptical after 5 mins. I'm probably more fit than my husband even though I'm overweight.

Just yesterday, I spoke to my mother who told me that her doctors gave her the results of her blood work and everything was normal: cholesterol, blood sugar, etc. She has high blood pressure but that is probably more the result of genetics than her weight. My great grandmother had high blood pressure but she was thin throughout her life. My grandmother still had high blood pressure after losing weight and was on medication till she died. I have high blood pressure and I've always been thinner than my mother. My mother has her blood pressure under control with medication. I have my blood pressure under control with medication and exercise.

So I can see what the author is saying. I guess she asking if weight has a cause/effect relationship with various chronic illnesses and whether or not high weight is always bad for you. I think what she is saying is that it's way more complex than the constant reports we hear on the news which say that if you're overweight or obese, you're health is in danger and you're going to die fast! Maybe being overweight or obese by way of not exercising and eating crap can exacerbate health issues. But if you're overweight, healthy and leading a healthy lifestyle, is your life really in danger?

So, the long time maintainers would be considered one offs by this author.

She has good information about diets and the difficulty of losing weight which we can all agree on. I also agree that selective reporting seems to be happening in this chapter.

I definitely will not change my choice of a healthier life even if it does get hard. Too much to "lose" at this point to go backwards. The idea of accepting being overweight because many people go back to obesity is a nonstarter. The books "in Defense of Food" and " Good Fats, Bad Fats" illustrate how as a culture North America has come to this point.

I would hope that anybody struggling with obesity would not buy into the hopelessness of it all by swallowing all of this author's arguments. Funny that she found a maintainer who calls himself a fat person in a thin body. All the more reason to look at our thoughts and how they can continue to influence us.