Fat and healthy not an oxymoron

Risk factors still to be avoided

By Jennifer Harper (Contact) | Tuesday, August 12, 2008

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It could be weighty news for the chubby. "Overweight" doesn't always mean unhealthy, according to research published Monday in the Archives of Internal Medicine, a publication of the American Medical Association.

More than half of overweight adults and almost a third of obese adults are considered "metabolically healthy," with normal blood pressure and cholesterol levels despite their weight, according to a team of nutrition and epidemiological researchers at Albert Einstein College of Medicine of Yeshiva University in New York.

This newly identified hefty-but-healthy population is considerable, numbering about 56 million people.

"These data show that a considerable proportion of overweight and obese U.S. adults are metabolically healthy, whereas a considerable proportion of normal-weight adults express a clustering of cardiometabolic abnormalities," the authors wrote.

Slim doesn't always mean safe, either. About a quarter of normal-weight people - 16 million - are at risk for cardiac or cholesterol woes.

The findings are based on national health assessments of 5,440 adults made over a five-year period, comparing body weight with cardiac abnormalities, elevated cholesterol and other factors.

And while the research neutralizes stereotyping, which equates the portly with ill health, the findings do not grant permission to gorge with abandon. Inactivity, smoking and the developing that dreaded potbelly are still considered potentially risky behaviors.

"Know your own risks. The research doesn't mean we should stop worrying about weight all together," said Judith Wylie-Rosett, a co-author of the study.

Some question health assessments based on body mass index (BMI) alone.

"The data from these studies really show that there are limits to relying on BMI as a simple diagnostic test, and you cannot assume that all people who are obese are the same in terms of their health risks. BMI is just one measure of obesity, and clearly does not tell the whole story," said Marlene Schwartz , deputy director for the Rudd Center for Food Policy and Obesity at Yale University.

"I think the message to the public should be that if you have a high BMI, that is like getting a positive on a screening measure. Next, you should see your doctor and have more extensive assessment to find out what exact health risks you are experiencing and what behaviors you can change to improve your health," she said. "In the end, your weight may not change much, but you can improve your health outcomes by improving diet and activity levels."

Paul Campos, author of "The Diet Myth: Why America's Obsession with Weight is Hazardous to Your Health," had a stronger response.

"The BMI measurement is nonsensical. It has zero scientific basis," said the University of Colorado law professor who contends that risks associated with being overweight have been "systematically exaggerated" by public health researchers, some funded by pharmacological companies or the nation's "$50 billion-per-year weight-loss industry."

Weight standards are not the only gauge of health, he said. "Get rid of that ridiculous definition and the so-called 'surprising paradox' of healthy fat people just disappears," he added.

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