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Is it Really Healthy to be a Little Obese?

You know the old saying: If it sounds too good to be true, it probably is. From time to time we see an article that indicates being overweight is okay, or even good. The term “fat and fit” is often used. One such article recently published in JAMA, the Journal of the American Medical Association, reported that those who were overweight or mildly obese, but not severely obese, had a decreased overall mortality. Many would interpret this as a reason to not watch what they eat. Not so fast! There are too many variables to draw that kind of a conclusion from this study.

Below are a few reasons you should take the results of this study with a grain of salt and continue to be diligent about maintaining a low body fat.

  • First, keep in mind that even the authors didn’t suggest that we should strive to be overweight.
  • This study used a single endpoint of BMI, not % body fat. BMI is simply weight divided by height squared. It doesn’t tell you if you have too much fat, which is the real issue.
  • If you work out and have some extra muscle, your BMI will be higher and you are quite healthy. This puts healthy people who aren’t fat in the high BMI group.
  • Some people have a normal BMI but increased abdominal fat and low muscle mass. These “Skinny Fat” people are actually at higher risk for disability and mortality, making the normal BMI group appear less healthy.
  • Many patients who are ill lose weight and have a low or normal BMI. They are not ill because they have a low BMI. This puts these sick people in the normal BMI group.
  • All of the above make it difficult to draw conclusions from this study.

Also keep in mind that:

  • The United States is the fattest country in the world. What most consider a little overweight is technically obese! According to the World Health Organization, more than 36% of the US population over the age of 16 is obesenot just overweight! People in the US don’t know what overweight and obese actually mean. What most consider obese is actually severe, or even morbid obesity.
  • Even by BMI, if a 6 foot man is over 185lb, he is overweight. If he weighs more than 225, he is obese. How many people who are 6 feet tall and weigh 225 or more would accept that they are obese? They might consider themselves “a little overweight.”

Countless medical studies have shown that abdominal fat is the key:

  • Increasing abdominal fat is directly related to the risk of heart disease, strokes, diabetes, Alzheimer’s disease and various cancers.
  • Waist circumference (WC), waist to height ratio, and % body fat by DXA are better predictors of disease risk and mortality than BMI.
  • DXA (used by Cenegenics) is the most accurate method of determining total body fat, but more importantly, abdominal or belly fat. (Android fat on your scan)
  • Age related loss of various hormones is associated with increased abdominal fat.
  • Abdominal/belly fat causes inflammation. Inflammation causes disease – heart attacks, strokes, diabetes, Alzheimer’s disease, and various cancers.

Bottom line, it’s all about the “belly fat,” not the BMI! So if it sounds too good to be true, guess what?