A Better Way to Understand Obesity’s Impact
My mother always fussed at her oldest sister. Aunt Grace was big-boned, with the kind of padding that made her lap a safe haven for a child. Mother worried she would die early if she did not slim down. Aunt Grace died at 84, Mother at 75.
Though both women inherited the same genes, they did not lead the same lives. Aunt Grace was more physically active, ate more fruits and vegetables and experienced far less stress than her slim younger sister. New studies shed some light on why one lived so much longer than the other.
The research challenges conventional wisdom that obese automatically equals unhealthy. Both studies used the Edmonton Obesity Staging System (EOSS) to rank obesity as a series of stages rather than one number. Higher stages mean higher risks.
CBC News reports “The new scale includes five stages of obesity based on traditional measurements such as body mass index and waist-to-hip ratios, as well as clinical measurements of medical conditions tied to obesity, such as Type 2 diabetes, hypertension and heart disease.”
What scientists discovered, in studies published in the Canadian Medical Association Journal and in Applied Physiology, Nutrition, and Metabolism, was a more nuanced picture of the consequences of obesity. Physicians using the scoring system will find it easier to prescribe appropriate treatments. Patients with higher EOSS scores, for example, are more likely candidates for bariatric surgery. Those with low scores are unlikely to need it.
Obesity does not always equal unhealthy
What both studies show is that many factors account for health or disease in obese patients. The yo-yo dieting that often accompanies obesity appears to be a significant negative factor, with a connection to stress, body image and body dissatisfaction. Furthermore, people with healthy diets and high levels of cardiovascular fitness are less likely to develop complications such as diabetes and heart disease.
Dr. Arya Sharma, who was involved in both studies, writes, “it is certainly clear from this study [in Applied Physiology, Nutrition, and Metabolism] that there are a significant number of people who meet the BMI criteria of obesity, but do not appear to have any of the health problems that most overweight and obese folks tend to have. It is certainly unclear whether or not these individuals will experience any health benefits from attempting to lower their body weights, given that most people, who lose weight, will simply put it back on.”
While some reports of the study imply we can stop worrying about the epidemic of obesity, Dr. Sharma insists, “This by no means implies that it is now ‘OK to be fat’, as some media has [sic] chosen to report on this study. At best, it means that for some people, it may well be OK to be fat, but these people certainly become rarer at higher ranges of BMI.”
So the studies in no way mean we should stop addressing the health issues that accompany overweight and obesity, nor studying the environmental and social contributors. Still, the stereotyping and shaming of fat people is wrong and counterproductive. These studies remind us body weight is only one factor in good health.
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