Yes, You Can Be Fat and Healthy

A new study confirms that there is indeed health at every size

Our culture has the idea that obesity is a risk factor for disease -- if not a disease itself -- so firmly ingrained that what I'm about to tell you may come as a shock, even though I bet you know someone just like this: Around 20 percent of obese people are perfectly healthy.

As in, their arteries aren't clogged. Their blood sugar levels are stable. They aren't on their way to an early grave. They may not look like your idea of health, but they are, in fact, functioning just fine.

This news is courtesy of two studies (culling data from over 37,000 people) out this week in the Canadian Medical Association Journal and Applied Physiology, Nutrition and Metabolism. Researchers at York University found that Body Mass Index (BMI) did not predict how likely a person was to die in the next 16-20 years as well as the Edmonton Obesity Staging System, a ranking system that considers a variety of other health factors in addition to height and weight, and was designed by Arya M. Sharma, one of the studies' co-authors.

The researchers told CNN that one in five patients with a BMI over 30 counted as "healthy obese" according to the Edmonton Obesity Staging System and were "at no greater risk of dying than normal weight individuals. It challenges the notion all obese individuals need to lose weight." Oh, you mean the notion we were discussing just last week, when body image activist Jess Weiner announced her plans to lose another 30 pounds to protect her health -- even after her doctor told her she was focused on the wrong number? 

That would be the one -- because we have a hard time looking at an overweight person and not seeing "unhealthy" stamped on their forehead. Especially if that person is looking back at us from a mirror. We boil our definition of health down to the number on the scale when other markers (like blood pressure and cholesterol) matter more in terms of our long-term survival. And day to day, factors like your energy level and ability to sleep through the night impact your well-being more than the size of your jeans. (For more on how to put this principle into practice, check out Health at Every Size.)  

Of course, 20 percent is not a majority. Eighty percent of the obese people in these new studies did have health problems. And yes, more research is needed before scientists truly understand whether obesity causes such health problems, or merely tends to correlate with them. We could also use a study that analyzes the mortality of subjects with BMIs in the normal and underweight ranges. If you eat a lot of junk food, don't exercise and somehow defy the odds and stay thin, how are you any better off? What about if you regularly restrict calories or skip meals?

But this research does say one thing loud and clear: "I can't tell you how healthy someone is if you tell me height or weight on a scale," Dr. Sharma (who is also chair for obesity research and management at the University of Alberta) told CNN. "I have to do additional tests." Added co-author Dr. Jennifer Kuk, assistant professor in York University's School of Kinesiology & Health Science in Toronto: The Edmonton ranking system could help doctors "to identify who should actually lose weight and who are we torturing for no reason." 

 

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