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Being Fat Won’t Kill You: What We Can Learn From The Latest Obesity Research… And What We Can’t (But I Wish We

Posted Jan 07 2013 1:39am

elsie

In 1912, a 24-year-old co-ed named  Elsie Scheel  was proclaimed “the world’s most perfect woman” and “without physical flaw.” (Which on the surface seems like the best compliment ever but on second thought might have been a lot of pressure to put on a young girl who said she would return to her parents’ farm instead of studying mechanical engineering, which she would have liked to do if only she were a man.) Elsie sparked debate with this pronouncement however because, well, “perfect” is awfully subjective. The 5’7″ brunette weighed in at 171 pounds which, while she was “perfectly healthy in every way”, was deemed “much too large” by the opposing camp who decreed that she “cannot be reconciled with the accepted ideal of female beauty.” (I know, how would you like to literally be called out as ugly in the New York Times?) Indeed the first Miss America,  Margaret Gorman , crowned just a few years later, was a Polly Pocket-sized 5’1″ and 108 pounds. Elsie handled the criticism like a pro however, saying that she “played guard [for the Cornell basketball team] where my weight helps.” She also added that loved “long tramps” in the woods and avoided all sweets (she was also an early fan of intermittent fasting).

In the end however, Scheel and Gorman are simply anecdotes – albeit fascinating ones (turns out the comparison may have been moot as they both lived to be 90 years old!) – and not research. So what does the research say? Only one thing, really. But it’s a really big thing.

You may have seen all the breathless headlines over the past few days: “ Being Overweight May Protect Against Premature Death “, “ Being Overweight Lowers Risk of Early Death “, “ Study Suggests Lower Mortality Risk for People Deemed to Be Overweight ” and my personal favorite variation:  “Looking at a Picture of a Skinny Model While Dieting Might Actually Make You Gain Weight, But That’s OK Because a Little Extra Weight Is Just Fine “. All of these articles are talking about  a recent meta-analysis  of current obesity research that came to an interesting conclusion exactly 100 years after the Elsie-Margaret throwdown. While it isn’t a new one – lead researcher Katherine Flegel reported these same findings in a CDC study ten years ago to much derision – it’s certainly a controversial one.

Here’s what we know from this study of nearly three million people: Being overweight or slightly obese according to the BMI (body mass index – a measure of weight and height) is correlated with a 4-9% less risk of dying, even controlling for factors such as smoking, chronic illness and age . News flash: Being overweight, on its own, won’t kill you. In fact, it might even make you live longer.

But like many things – Bill Clinton, Area 51, mystery-flavored Dum-Dums – what we don’t know is way more interesting than what we do. Join me for a journey of speculation?

1. Does the range of “normal” for the BMI needs to be recalculated? Despite all the “obesity crisis” headlines in the news over the past two decades, the research has been remarkably consistent: the people with the highest risk of dying are people classed as underweight or at the lower end of normal, according to the BMI, even when controlling (as much as one can) for mitigating factors. Slightly overweight to slightly obese people (BMI 26-33) live the longest. Severely obese people have the second highest risk of dying. All of which says to me that the BMI as a measure of health is basically worthless. It either needs to be recalibrated or scrapped altogether.

2. Does this mean you should gain weight to be healthier? Not necessarily. Many of the reactionary experts were quick to caution people that this doesn’t give us all license to run out and gorge on the brought-back-for-the-holidays McRib sandwich (because nothing says “the most wonderful time of the year” like unidentifiable meat product that can be molded like Play-Doh?). To me, what this means is that there is a wide variety of healthy body types and if you eat healthfully then eventually your body will settle at where it feels best at – and we need to stop judging people for where that set point ends up for them. We need to learn that a healthy overweight person is not an anomaly.

3. Does age matter? It appears from the data that the protective effect from extra body weight increases with age, with thin elderly women 30% more likely to die than overweight elderly women. So perhaps our ideal healthy weight changes as we age – maybe we really aren’t meant to weigh what we did in high school. And perhaps there’s a reason that women tend to gain weight after menopause and find it so much harder to take off.

4. Does the type of fat matter? It’s long been known that where you carry your fat makes a huge difference to your health (another factor, along with lean muscle mass, that the BMI cannot account for). Subcutaneous fat seems to be relatively harmless (and makes you a better hugger) but intra-abdominal fat around your organs seems to be correlated with heart disease, diabetes and the whole metabolic syndrome which is  linked in the research to premature death. Plus, like I’ve pointed out before,  research has found  that women with larger thighs and booties have smarter babies thanks to the type of fat stored in those areas. Women need fat - we need to eat it and we need to have it on our bodies.

5. When will people learn that eating healthfully and exercising moderately are so important for reasons that have nothing to do with weight loss? Okay, so that question is basically rhetorical but it’s a pet peeve of mine. Maybe this research will help.

6. Is money a factor? I hate to be a cynic but teaching people to be happy with themselves doesn’t sell product and the multi-billion dollar weight loss industry is big business.

7. What about quality of life? “Still, death is not everything,” says one of the researchers. Indeed, I think most of us would prefer a slightly shorter life in excellent health than a longer one with many painful complications. (But perhaps that’s just me?) As some commenters on the Times piece pointed out, being overweight may not make you die younger but it makes your joints hurt, can make it more difficult to do things you enjoy and, sadly, subject you to the derision and ridicule of living in a thin-is-best society. But on the other hand, what kind of quality of life do you have if you spend all your years trying to diet to a size that wouldn’t be good enough even if you could get there? My grandmother was bulimic until the day she died (in a car accident). 63 years old and still holding herself to an untenable standard. I think about that a lot.

8. Why do I care? It’s this last question that has had me most stymied ever since I read the reports. I’m an intuitive eater. I’m healthy by every measure (at least until the day they come up with a quantitative analysis for mental health and then all bets are off). I’m relatively happy with myself and my body (even when I do  Incredible-Hulk the butt right out of my jeans ). I’m supposed to be above caring all this, right? Isn’t this what I’ve been working so hard to achieve the past five years? And yet I do care. I still try and “smooth out” my stomach every time I pass a mirror. I still wish I had a magic shaping tool that could move the fat from my upper thighs to my upper boobs. I still want someone, preferably higher-up as I’m an authority junkie, to give me permission to live in my own skin. But haven’t I done this topic to death by now? Why do I feel the need to keep reminding myself that I’m okay to be me?

Am I the only who gets worked up about this – does this “new” research change anything for you? What does it all mean? Would you rather live a slightly shorter life in excellent health or a longer one in poor health?

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