Being fat is not the same as being unhealthy.
While the conventional thinking has been that obesity is a medical problem unto itself, two studies indicate that it’s possible to be overweight and be perfectly healthy.
Instead of the more common measure of obesity, body mass index (BMI) – a ratio of weight relative to height – the studies used the Edmonton Obesity Staging System (EOSS), which considers an array of physical and psychological factors in determining a person’s health.
Researchers found that a person’s fitness level, waist circumference, genetic predisposition to chronic diseases, and other factors are a greater predictor of future health and risk of death than weight.
“Using the EOSS criteria, we see that there are many obese individuals who are healthy other than (having) an excess body weight,” says Jennifer Kuk, assistant professor at
York University’s School of Kinesiology and Health Sciences in Toronto and lead author of one of the studies published in the scientific journal Applied Physiology, Nutrition and Metabolism.
“For these healthy obese individuals, the value of weight loss is questionable. This tool will help physicians to prioritize treatment for those who need it the most, and identify those healthy obese who do not need to lose weight.”
Kuk’s study followed 6,000 obese Americans over 16 years and compared their risk of death to that of thinner people.
“Although excess fat generally causes negative health, this is not always true,” she says. “You cannot use body weight alone to judge health, as there are some obese individuals who show no other health problems. These individuals have a healthy lifestyle, and factors such as diet and exercise may be just as important for your health.”
The EOSS, developed by Dr. Arya Sharma and other scientists at the University of Alberta, is modeled after staging systems classifying cancer and heart disease. It involves five stages of obesity that consider BMI and waist circumference, as well as obesity-related medical conditions such as high blood pressure, diabetes, and heart disease.
In another study published in the Canadian Medical Association Journal, Dr. Sharma reported findings similar to those from Kuk’s study.
“You need to use a more well-rounded approach like the Edmonton Obesity Staging System that examines physical, physiological and psychological aspects of health to determine whether people are healthy,” Kuk says.
However, while healthy obese people may not have to worry about losing weight, they should focus on limiting further weight gain and living a healthy lifestyle, Kuk says.
Avoiding “yo-yo dieting,” periods of rapid weight loss followed by regaining the pounds, is particularly important. Such dieting has been linked to greater weight gain over time, and an increased risk of death from cancer and heart disease, she says.
If you are obese but otherwise healthy, it’s better to stay at a stable weight than to have dramatic swings from repeated dieting.
Adds Professor Kuk: “Weight does not equal health, and there are many obese individuals who are healthy other than an excess body weight.”
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