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New Research Says There Is No Such Thing as “Healthy Obese”? [Women are supposed to have fat! Busting the flat abs m

Posted Dec 12 2013 3:06am

If we’re sincere in our desire to “just be healthy” that may mean embracing more fat – both in our diets and on our bodies. Psst, Adele – LOVE you. Lose the cigs!!

Yes Virginia, There is a Santa Claus! Or at least there was until he died from having a belly like a bowl full of jelly. Yeah, yeah, he got lots of exercise making toys and flying them around the world in nanoseconds but apparently even being “metabolically healthy” wasn’t enough to save the old guy. Or maybe he just died because he was like 900 years old. Whatever. You still have the Easter Bunny, so stop crying.

Ever since a new meta study examining the life expectancy of “healthy obese” people came out there have been some big headlines making waves through the health and fitness communities. For years now scientists have acknowledged the existence of people who are obese but also have healthy metabolic markers like blood pressure, cholesterol and blood sugar. However, the study published in the Annals of Internal Medicine last week, said that while these obese people may look healthy on paper, they’re still dying younger – by about ten years. That’s a lot of life.

Since then I’ve seen a lot of responses to the study. Jezebel posted an interesting takedown of it. While most other news organizations ranged from “I guess that makes sense” to “I TOLD YOU FATTIE McFATTERSONS SO!!!” It’s been ugly. And I wasn’t going to comment on it until a dear friend, who happens to be one of the most genuinely kind people on the planet and works in community health, posted about it on Facebook and tagged me in it:

“Not the news I wanted to hear. Now I’m pondering how we can counter the effects of individual, societal, and clinical “fat shaming” while helping each other achieve a healthy weight? I hope to dig into these articles to see if the authors discuss mental health and health body image as crucial aspects of “health,” along with other nuances. Sigh…. How about we just dance and have fun?”

Good question. Really good question.

My first instinct was to try to pick apart the study and find out what’s wrong with it. For one, it’s a meta analysis, meaning that they simply looked at data from previously conducted research rather than doing their own research to directly investigate the question. But then, no research is perfect and meta analyses have a lot of strong points. Numbers, for example. The new study evaluated eight previously published studies of 61,386 people. That’s a huge (no pun intended) sample size.

The researchers found that “people of any weight who had metabolic abnormalities were more likely to die earlier from all causes. They also were more likely to have cardiovascular disease. And the risk increased as the amount of excess weight increased. And the more risk factors someone had, the higher the likelihood of early death and disease. People who were obese without having metabolic syndrome also had a higher risk of death, so they weren’t protected by being healthier.”

Honestly I think they’re probably right. First, everyone should take note that people who had high blood pressure, high cholesterol and insulin resistance died younger no matter what they weighed. (For some reason that’s not getting reported quite as loudly. Go figure.) Second, it always seems to be the extremes that are unhealthy. People who are extremely overweight have complications. As do people who are extremely underweight. The trick is in finding that healthy sweet spot – and I still maintain that that isn’t as small as most of us think it is.

“Get ripped in the new year!” “Have the lean body of your dreams!” “Six-pack abs in 6 weeks!” “Burn fat up to 400 times faster!” Thanks to the advent of Resolution-Making Season (also known as the fitness industry’s Santa) and an e-mail address that seems to be on every marketer’s PR list, I’ve been getting a slew of “get shredded” pitches every day. The products are wildly variable – everything from mushroom pills to different exercise equipment to books – but the end goal is always the same: to help women get as lean as possible. Inevitably these pitches are all illustrated with pictures of 18-year-olds with perfectly sculpted abs. I don’t even need to describe them further because you already know exactly what I’m talking about. They’re in every magazine and on every website, everywhere.

But these photo (-shopped?) beauties with amazing muscle definition distract us from a very important fact: women are supposed to be fat. I’m not knocking these girls, especially because I give them mad props for putting in the work required to get those muscles but while there is a nod to health with most fitness experts acknowledging that women shouldn’t go “too low” (although that varies wildly as fitness competitors are often under 10% while most medical professionals will tell you not to go below 16-18%), people completely forget that getting as close to the minimum of the healthy range as possible is not the same when it comes to health as being a few percentage points higher. And of course there is such a thing as too fat although if you need me to explain that to you then clearly you don’t have enough lady mags in your life. Body fat is integral to a woman’s health and there is no on/off health switch; it’s more a of a sliding scale with risk of death a disease increasing rapidly at both ends of the spectrum.

So if too low and too high are too bad then what’s a Goldilocks girl in our weight-obsessed world to do? Where is the sweet spot when it comes to fat? According to science, it’s more than we think. Gina Kolata, a science writer for the New York Times who predominantly covers health and fitness research, blew my mind a few years ago with her book Rethinking Thin: The New Science of Weight Loss—and the Myths and Realities of Dieting . Her basic premise is that we suffer from a bizarre dichotomy wherein we are told that the ideal standard for both health and beauty is as lean as possible while many Americans carry an unhealthy amount of fat. Both are as ubiquitous as they are unhealthy. While many of us can easily point out what is unhealthy, very few can identify what is healthy because it turns out that healthy is what many of us think of as “fat”.

This past weeknew research published in Why Women Need Fat: How “Healthy” Food Makes Us Gain Excess Weight and the Surprising Solution to Losing It Forever  (aff) written by an evolutionary biologist and a doctor adds more evidence to the debate. In an interview with , co-author Steven Gaulin, explains how “evolution shows that women’s dieting beliefs aren’t just unrealistic — they’re unnatural.” One of the main points of the book (which I haven’t read but hope to) is to show polyunsaturated omega-6 fats like canola and corn oils for the public health hazards they are. Gaulin says their research shows that processed omega-6 fatty acids are the precursors to endocannabinoids, making them a food that acts like marijuana in the brain “telling the body, “Store the fat you have.” And “Eat more, I’m hungry!” ” He adds, “Many studies in the U.S. and other countries show that the single best predictor of how much a woman will weigh is how much omega-6 is in her diet.”

But the part of the interview that most fascinated me was this gem:

“Many M.D.s have bought this fallacious line that the optimal weight for women in terms of their health is what M.D.s call normal weight, a BMI between 18.5 and 25. And they have thought this to be true because women with higher BMIs exhibit a series of physiological measures that are indeed risk factors for disease in men. But they are not systematically risk factors for disease in women. If you actually look at the data from the National Health and Nutrition Examination Survey and data from studies done in other countries, the optimal weight for women who have had a kid is what doctors currently call “overweight.” I’m not saying that obesity is optimal, but all the findings show that overweight women survive better than “normal” weight women. We walk a fine line in the book because we argue that being overweight is not nearly as bad as your doctor has been telling you, but on the other hand, Americans are heavier than they need to be. There are diseases that still correlate with heavier weights, like diabetes. But if we ate a more natural diet, by that I simply mean the diet that we evolved to eat, we would all weigh less.” (emphasis mine)

There seems to be a paranoia in our society that if we tell women it’s okay to be fatter then suddenly all women are going to balloon up into obesity. This is especially true for women who have had children as we are told that if we don’t get back to what we weighed before we grew an entire human being inside us then we’re a failure. And a lot of women have internalized this thinking that the best way, both from an aesthetic and health standpoint, is therefore to get as low as possible and stay there. Which means we are fighting our bodies for the rest of our lives.

So to answer Grant’s question. Think for a moment what it would be like if we gave women permission to carry fat in places other than their boobs and butts and to still be seen as beautiful – not just because adult women should not have to be shaped like teenage boys but also because it’s better for our health? I think that perhaps we would see less obesity because there wouldn’t be such a huge gap between the ideal and the reality and there would be less shame associated with having body fat.

According to science there is a reason that for centuries the female ideal was closer to this:

Check out that beneath-the-bellybutton pooch on Venus! The full cheeks! Her fleshy thighs and arms (what’s left of them anyhow – they got blown off at such an unflattering angle)! And not a clavicle in sight! She was the standard of beauty for centuries.

Even 50 years ago it was this:

Sophia Loren was considered not only one of the most beautiful women of her time but of all time. Today she’d be doing plus-sized modeling and working with a trainer 5 days a week to tone up.

But then we swung this direction, which most of us now recognize as unhealthy (I’m not commenting on this woman in particular, I don’t know her from Kate Moss):

And now we have this:

The flat-as-a-board tummy. It may be healthier but does it still represent an unrealistic and unhealthy standard? I’ll admit it: I still wish my abs looked like this. Some women are born with a 6-pack but for me, I know what it would take to get my body fat low enough to get a tummy like this and it would not be good for me. I’ve been into single-digit body fat percentage and even though I’d lost my period, was depressed, suppressed my own thyroid and was losing handfuls of hair I still didn’t have a tummy like this. Selling women this standard isn’t telling women that “strong is the new skinny” it’s telling us that now we have to be strong and skinny to be attractive.

But the problem isn’t just that we may be driving ourselves crazy with this shift, even worse we may also be hurting our health. So what’s the magic number for optimal health, happiness and beauty? 42! (Well it is the answer to life, the universe and everything!) Kidding. I have no idea. And I may be overthinking this. Certainly there are women who are naturally very thin and are healthy just as there are women who are considered “large” who are also very healthy. I am not condemning anyone for their natural shape. What I do know is that if we put half the energy into being good as we do looking good, we would have cured cancer by now. And I say that as much as a personal indictment as I do a societal one. I freely admit that I struggle with this concept. I’m not sure what the end is but I think it starts by recognizing that the extremes – whether that’s obesity, catwalk thin or the ultra-ripped standard – are detrimental to our health.

Help me figure this out – What are your thoughts on this meta analysis? Did it confirm what you already thought or was it surprising? How would you answer my friend’s question of “How we can counter the effects of individual, societal, and clinical “fat shaming” while helping each other achieve a healthy weight?”

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