Yes, There Is Such a Thing As Fat But Fit

Posted on January 11, 2013

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Yesterday we looked at the insanity of a surgically implanted stomach pump to allow the gluttonous to empty 30% of their stomach contents after a meal, in the endless search for an effortless, sacrifice-free perfect Body Mass Index (BMI).  Today, we look at a rising assertion that many people who are labeled as slightly overweight are actually pretty healthy, and even have lower mortality risks than their thinner peers.  It might seem contradictory, but it’s really not.  It’s an example of moderation versus extremes.

Doesn’t it seem that even in science and medicine, there are fads that come and go?  Salt is bad for you!  … except that it is a necessary mineral.  You must drink milk!  … except that it is actually harmful to many people, far beyond mere lactose intolerance.   And for years, we have been told that there is a magical BMI range that we must fit into if we are to be considered healthy.  And yet… as the New York Times  points out, a woman who was lauded as the very image of health in 1912 would be considered solidly overweight in today’s medical fashion.

Marilyn Wann, writing for CNN, points out a number of recent studies showing that people who are somewhat overweight but “metabolically healthy” actually do better than their thinner peers when it comes to survivability.  The most recent analysis of over 100 separate studies, conducted by Dr. Katherine Flegal, shows that time and again, a slight amount of excess weight has statistically been beneficial to one’s health, although more extreme levels of obesity are proven to be detrimental in direct proportion to the amount of excess weight.

So why is a little fat apparently all right, or maybe even a good thing?  Theories range from having a little extra padding to cushion elderly bones in a fall, to having an energy reserve in case of stressful illnesses or surgeries.

I’m actually not surprised.  For my entire military career, I saw plenty of soldiers who were a bit on the plump side, yet fully capable of passing the Physical Fitness test (Pushups, Sit-Ups, and a two-mile run, all to standards set for age and gender).  These were good troops; good attitudes, good at their jobs, ready to deploy; but let them fall a smidge outside regulatory tolerances for body fat, and they were on the “fat boy” program, as it was very politically incorrectly called.  No promotions, no schools, no nothing until they met the standards and were blessed by the Weight Control folks – and there was also the ever-present danger of being kicked out of the military altogether, sometimes over just a pound or two.  Or a percentage point or two.  This was universally recognized as a not particularly common-sense policy, but the military is very constrained by the regs.

Civilians, not so much!  And yet we torture ourselves (or our doctors torture us) with rigid notions of BMI as an indicator of health, when in fact we should be looking at a larger picture of overall health.   Marilyn Wann points us to one interesting study that found that a very simple and effective predictor of mortality is the “sitting-rising test“:  adults aged 51 – 80 were asked to sit on the floor, then get up unassisted.  For every support used, like a hand or knee, one point was subtracted.  Over the course of six years, those patients who had scored lowest on this simple test were those who proved to have the highest risk of death, and yet the test has little to do with BMI.  I mean, dang, think of all those football players lumbering around the field, or Sumo wrestlers, or weightlifters, the occasional baseball player or golfer.  And these are professional athletes!

So the upshot is this:  people who are slightly overweight, let’s say, pleasantly plump, probably have little to worry about so long as they are otherwise fit and active.  Now maybe it’s time for the rabidly anti-fat machinery in this country to dial their zeal back a notch, and focus their efforts on those who are moderately to extremely obese.

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