The Obesity Paradox

Shortly after my last post, highlighting the cracks appearing in the research regarding the role of dietary fat and heart disease, a friend posted an article even more damning to the status quo in the medical and research fraternity regarding size, weight and disease (which I at the time failed completely to make the time to write about – sorry!).

In this article from the NY Times, Harriet Brown reports how several studies have shown that not only does obesity not put people with certain diseases at greater risk of death, but seems to actually lower this risk. Diseases like heart failure, heart disease, stroke, kidney disease, high blood pressure and – most recently – diabetes. Yup, that darling of fat shaming scare tactics and overly-concerned-about-our-health commentators everywhere.

  • “Diabetes patients of normal weight are twice as likely to die as those who are overweight or obese”
  • “In study after study, overweight and moderately obese patients with certain chronic diseases often live longer and fare better than normal-weight patients with the same ailments.”
  • “One study found that heavier dialysis patients had a lower chance of dying than those whose were of normal weight or underweight.”
  • “Overweight patients with coronary disease fared better than those who were thinner in another study”
  •  ”In 2007, a study of 11,000 Canadians over more than a decade found that those who were overweight had the lowest chance of dying from any cause.”

The article goes on to speculate about possible explanations for what the researchers have dubbed the Obesity Paradox. A lot of the possible theories put forth sound to me like people desperately trying to make the data fit into their narrow world view (such as “maybe thin people who get these diseases have a genetic disposition making them more likely to get the disease and to then die from it” – the unspoken flip side being that fat people who get it are just getting their just desserts). However, one of the possibilities brought up is the failings of the BMI scale.

As anyone who’s read up even a little about the fat acceptance movement knows*, BMI should stand for Bullshit Made Insidious. It’s a useless metric used to fat shame and scare across the world and, more worryingly, across the medical profession. The article points out how it doesn’t take into account fat to muscle ratios, metabolic abnormalities and “other nuances of physical composition” (if diversity of gender, build and age can be called nuances).

Lastly the article focuses on fitness versus weight, and points out how fitness seems to have a much bigger impact on health than size or weight alone. Its nice to see some mention of Health At Every Size, as well.

I am greatly encouraged by the data coming out and although there is a reluctance to accept and sometimes even publish the findings, and although it will probably take a very long time for attitudes to change and for new ways of thinking to filter down to the point where they affect our everyday lives and help address the stigma associated with being fat, I for one remain optimistic.

And, in searching for what I was sure was Kate Harding debunking the BMI* for linking above, I discovered that most of this isn’t even new news, as she links to or mentions this stuff here. From 2006. Oh, well, the diabetes thing is fairly new, and I’m still glad the science is continuing to strengthen the case and that it puts the whole issue back in the public focus.


* I wanted to link to a debunking I’d read when just starting on my fat acceptace journey, but the link provided on Shapely Prose is now broken. However, you literally just have to Google “bmi flaw”. You’ll find a lot of mention of the practical flaws of using the BMI; some advanced reading might be to try and learn more about it’s origin (hint: it had nothing to do with determining “correct” weight for height).

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  • Patsy Nevins

    You can find many articles about the ‘obesity paradox’ stating pretty much the same things you have written at, researched & collected by Sandy Szwarc. I find it in interesting that the mainstream media is now publishing articles saying the very same things Sandy has been telling us for years, even if they do mention the research as briefly as possible & try to bury it as quickly as possible.

    My very fat brother inherited kidney disease from our mother, who inherited it from her father & grandfather. My mother was the luckiest of the group, as she lost a kidney shortly before her 45th birthday, but lived over 40 years longer. Her father & grandfather, who were NOT fat, both died of the disease. My brother was on dialysis for some time, but voluntarily took himself off it, as he said he had poor quality of life & didn’t want to continue. Nevertheless, he lived until a few weeks before his 75th birthday, while his grandfather & great-grandfather, who were not fat (& who also did not have the benefits of modern medicine, I admit) died 12-15 years earlier. My mother was also fat, as was her mother, who lived to be 90, so my brother also had the benefit of longevity genes from that side of the family. Overall, in my own family, fat people tend to live longer than the few thin members (my thin brother is built like our father.) My mother’s family has been mostly fat & almost all of them have lived to a ripe old age. There is no disease called ‘obesity’ which kills us, but the quest to be thin often does.

  • Jen_in_FL

    When are they going to stop calling it a paradox and just admit that they were wrong to conflate “thinness” with “health” in the first place? Gah.

  • Eldrid

    Very interesting, I’ll be saving and sharing this, thank you!

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