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

by Charlotte on January 7, 2013 · 20 comments

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?

{ 19 comments… read them below or add one }

Redhead January 7, 2013 at 6:57 am

A few thoughts. I’ve heard anecdotally that carrying a few extra pounds (not enough to pt you in the obese, lots of health complications category) can help protect you from bone breaks and fractures if you fall, which makes sense. But it also makes me wonder if there’s a lot we still don’t know about the long term damage of dieting. (the latest thing that all the morning radio djs here are doing is “the 8 hour diet”- eat whatever you want for 8 hours and then don’t eat for 16! You don’t have to exercise! That gives your body time to process the food! While I suppose it works by restricting calories (and excluding religious fasting because the motivation is different), I’d imagine it sets you up to binge, or at least make poor food choices durin your 8 hours. What are the long-term effects of that?)
I think you still care because so much of society says you should and tells you the opposite of what you think, and sometimes it’s nice to hear a little reassurance when you hear so much discouragement :).
And I’m inclined to say I’d rather live shorter but healthier-but I’m young and healthy. I’m not sure how I’d feel if I were actually facing the end of my life, or living with pain.

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Von January 7, 2013 at 7:02 am

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Abby January 7, 2013 at 8:56 am

I know you do, but make sure you give yourself some credit Charlotte. You’re not super human (Incredible Hulk thing aside, lol) and it’s normal to have some things you wish you could change about your body. You’ve still made sooo much progress, I’m super impressed! And I think you have the right attitude about this research. It’s interesting but when what you’re doing is working, don’t mess with it. My thoughts are kind of all over the place today about the research and the public reaction but I just wanted to say that :)

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Geosomin January 7, 2013 at 8:59 am

This is really interesting. In the last 6 months or so I’ve gained back 5-10 Lbs (it varies) and have been told by friends, hubby and coworkers that I look much healthier than I did when I was a bit thinner. It surprised me, as I was a bit frustrated at the few pounds that have crept back on, but it made me think more about whether I should leave my “ideal” me behind and just focus on being strong and healthy. This could just be me actually getting some sleep and food after finishing grad school, but this recent information makes me think a bit more about what is best for my health. I’m trying to find the “happy” weight my body wants to settle in at and go with that, instead of what “they” think I should be.

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Crabby McSlacker January 7, 2013 at 9:08 am

I’ve seen studies like this before and it often seems like they get buried quickly; for some reason the press and healthy and fitness media seem to LIKE the idea that extra weight is dangerous. Sure, obesity is, but especially for older women, a few extra pounds don’t seem to be a health risk and may actually be protective.

Which fits in well with my plan to abandon all self-restraint when it comes to treats once I hit my mid seventies. I figure the long term cost/benefits to cutting back on junky stuff I love may shift decidedly by then. Check back with me in 20 years!

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Meghan@themeghamix January 7, 2013 at 10:49 am

I was talking with my mother-in-law yesterday after she came to cheer us on for a CrossFit Competition on Saturday. She commented that one gal in particular at the competition was REALLY buff. She wondered whether people can eat or train so that their bodies don’t have to get so buff. My husband (a certified trainer) told her that part of it is just genetics, but I reminded her that different people have different goals. A lot of women may workout to look a certain way , but this woman probably cared a lot more about what her body could DO than how she was gonna look. Finding CrossFit was the first time I really started to care more about what I could do than how I looked (although so far that’s been a nice perk). I think to a degree the fat/skinny issue is related. What do you want out of life? We can’t do/have everything…some people are willing to trade health complications later on for enjoying life now by not having to eat “healthy” food they hate or giving up time with family to work out. Thought provoking as usual, Miss Charlotte!

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R January 7, 2013 at 11:41 am

It makes me sad that for the majority of women (at least the ones I know), there’s no happy medium. I feel like it’s so easy to be criticized for being too thin, too fat, “kind of chubby”, too muscular… If “health” is really what we’re supposedly concern-trolling about, why would a really buff woman be criticized for being “too” fit? (I know that wasn’t the main point of your comment, your story about your mother in law just reminded me of some things I had read, recently.)

Also, do you do CrossFit at an official CrossFit gym or just at home? I hear about it so much and I would love to try, but I’m not strong enough for some of the things to work (ex: can’t do pullups yet, so a workout with a ton of pullups isn’t gonna do anything but frustrate me!)

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Leth January 7, 2013 at 12:49 pm

Actually, you can still do a crossfit workout at the gym, even if there are some of the exercises you’re not yet strong enough for. For instance, there are bands you can loop around the bar and put your foot through which will assist you on a pullup (I’m excited that I’ve graduated down one level, but the band I use is still pretty big).

What you want to do at crossfit is to find one where they’re really good at teaching and providing modifications. And if you’re not comfortable with an exercise, definitely speak up and ask for help, modification, or an alternate exercise. I’m often doing something slightly different than the prescribed workout, but it still kicks my butt.

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Meghan@themeghamix January 7, 2013 at 1:29 pm

I agree! We girls cannot win, with ourselves or the world! Too skinny, too buff, too fat, too fit. Enough already!

We do CrossFit at an official gym…Mercer Island CrossFit in the Seattle area. I echo Leth – you can do modifications for anything, but it helps to have qualified coaches who can show you the ropes and how to modify wisely. It is pricey but worth it. And you could totally do a drop in at a local “box” – most have first class free or reasonable drop-in fees.

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Nicholle January 7, 2013 at 10:55 am

We need to start pursuing health over body image. I’m in my early 50s and overweight (menopause throws HUGE curve balls–consider yourselves warned), but I also lift heavier, run faster, and have more endurance than I did when I was younger. Some of this is attributable to mental fortitude acquired by surviving various life challenges, but much has to do with a healthier, whole foods diet, drinking less alcohol, going gluten free, and generally not taking things so seriously (probably the most important of all). However, there are days when I wish I still looked good in a bikini (sigh).

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Alyssa (azusmom) January 7, 2013 at 11:43 am

I’m finding that, finally, I care a little bit more about how I feel than what I look like. However, I DO worry sometimes that if I’m this big at 43, what’s gonna happen when I hit menopause in 10 years (or less)?
But there’s been a shift over the past few weeks. I’m not sure what, exactly, caused it, but I find myself standing taller, feeling more confident, and walking with a bit more swagger. I feel, well, sexier. I think it MIGHT be yoga. The more frequently I practice, the more in tune with myself I get. Which leads to more confidence, less trying to please other people, and less obsession with external stuff.
Even if I do still want that fabulous pair of boots I saw at Target.
I also find myself NOT wanting to look like either the girls (and they are girls) in magazines or fitness models. Quite honestly, I’m tired of seeing women who basically all look the same: Perfectly toned bodies, long hair, skinny jeans, high heels. Clones, clones clones. Boring! I’m more interested in what they can do, what they think, and how they they feel than what they look like.
One more point, then I’ll shut up. A few years ago Hubby and I were in a store. I pointed out a Sports Illustrated swimsuit calendar & asked if he wanted it. He shook his head & said “Nah, it’s boring. If they were rock climbing, I’d be into that!” I did, eventually, find such a calendar, and I got it for him. And it was REALLY cool; those those ladies are strong, and smart, and capable! Many of them were freeclimbing (without ropes), and it was pretty amazing to see. It’s the kind of sport that takes guts AND brains, ’cause you have to plan your route and always be thinking. So you don’t, y’know, die.
I love that my husband likes THAT kind of woman, not just some 19 year-old in a bikini.

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Sylvie @ StruggleswithaFatA January 7, 2013 at 2:45 pm

“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?” — This really strikes me, because I’ve been “dieting” for the majority of my 20s, falling back on my comfort food every time I’ve had a crappy moment in life, which I can pin point.

Also, husband is skin and bones, so I have to keep some cushion to keep snuggling comfortable. If I were too skinny we would never want to touch each other. All those bones poking each other in odd spots like the ribcage or thigh. Ugh.

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Charlotte January 7, 2013 at 2:50 pm

Full disclosure, I do not have time to read the original research and interpret it through my data-analysis-statistician brain so i can’t comment on how that conclusion was reached or what it might mean. But. I think perhaps we might be seeing, here, not the negative effect of higher BMI or the negative effect of lower BMI*, but the negative effect of BMI that is too low or high for that particular person.

Being overweight is bad for you. Being underweight is bad for you. We kind of have that settled – it’s part of what “underweight” and “overweight” MEAN. Maybe the missing piece is as simple as those terms meaning completely different things for different people. That would actually explain both the old research saying “thinner is better” and the new research saying “fatter is better” without any real contradiction.

*Isn’t BMI now pretty much agreed to be uninformative at the individual level? I thought it was only supposed to be used as a population parameter. Anyone know for sure?

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Steph January 7, 2013 at 7:03 pm

I definitely think there’s still a lot we don’t understand about weight and the human body, but I can agree that the BMI system is relatively useless. It doesn’t say a thing about lean muscle mass, which is really pretty important. I’m right on the overweight line on the BMI scale, but I run marathons, so I feel pretty healthy. Every time a doctor tells me I should lose a few, I say, “so…you’re joining me on my 20 mile run tomorrow?”. Geez.

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Di January 7, 2013 at 10:39 pm

The biggest factor we need to address with this research is the BMI! Totally outdated and not relevant to HEALTH. Most of my friends (weightlifters) are obese according to BMI charts. Um, no! BMI doesn’t measure FAT. It measures weight/height. Yes you can have a high fat % but you can also have a low fat % and high muscle mass and be obese on the BMI chart. It’s total BS as a measure of health.
There is pressure from health and fitness professionals to add WAIST measurement to the BMI stats to allow for some assessment of body fat rather than relying on weight alone. Until then any “study” done with BMI is total hogwash and not worth noting IMO

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Marla-Deen January 8, 2013 at 1:11 pm

Charlotte,
I am a regular reader of you, but not a regular commenter. However, the comment about your grandmother has stuck with me all day. It made me so sad. Having struggled with my own crazy eating “stuff” and, hopefully, moved on and over, I know how exhausting, sad, and frustrating it must have been for her. I hope your comment has helped others out there struggling. Thank you.

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Jody - Fit at 55 January 8, 2013 at 1:56 pm

SO MUCH IN HERE!!!! Me, so many things change years after a study or info is put out there so… I am going to keep on doing what feels right to me & whatever happens, happens. :) For now, I feel good with the way I am although it may be to lean for those studies above… but for now, it feels right for me.. :)

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Tamber January 8, 2013 at 3:28 pm

A couple of years ago I used to be about 10 lbs heavier and I’ll tell ya….I was A LOT warmer!!! I opened my own fitness studio and got into a grueling teaching routine that shed some weight off me and now I am chilled to bone. I live in Maine and we have some cold weather here too (I had to give up skiing because I couldn’t bear the weather!). Of course, now I am in the same boat as you Charlotte…I worked out so much that I can’t seem to cut back (major addict here!)…but ultimately I want to because frankly…it’s exhausting and I am in constant pain with back and Achilles injuries…I love reading things like this and I always say I am going to change but it is definitely difficult and I think deep down I am trying to impress somebody out there…society I suppose. It would be nice to find a balance…workout for fun and feeling good and not worry so much about what your body does with it!

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Tahlee January 13, 2013 at 11:13 pm

BMI to health is like GDP to a country – it gives you extremely limited information about what’s working and what isn’t.

I would LOVE for BMI to be relegated to the trash heap of bad science like “balance bands” and “vitamin water”.

Let’s move towards the GNH (Gross National Happiness) equivalent of health where we can measure not only physical health, but also mental wellbeing, emotional resilience, quality of relationships, and depth of purpose. In the end, isn’t that what health is really about?!

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