Thursday, January 3, 2013



I hope I inserted a sufficient number of exclamation points above. In the last couple of days, a study published in one of the top medical journals is challenging the foundation of what we consider to be healthy weight. To summarize, it seems that there is an advantage to be what is now classified as overweight and even mildly obese. I repeat - ADVANTAGE.

I think everyone will agree that, if this is accepted as true by the medical community, this will be nothing less than a revolution in our approach to obesity. Note how I say "if this is accepted" because, and this should be no surprise to anyone, there are many who are challenging the conclusions of this study. There are in fact many ways in which to challenge these conclusions and they all come down to basic principles in how research is done. The point is that there is now a solid argument for reconsidering what constitutes a healthy weight.

Now, the BIG concern of the medical community is that people will read this report and abandon healthy lifestyle practices. And this would be a disaster. Because all this new study argues is that weight ALONE (or the famous BMI which is a way to compare weight amongst people of different heights) is not the KEY factor in health. And the truth is, we have known this for a long time.

We have known for a long time, based on many studies, that even a small weight loss (as little as 5%) can dramatically improve the health of a person. So, a patient who weights 250 pounds (but "should weigh" 150), can still achieve dramatic health improvements by losing as little as 12.5 pounds. Now clearly, losing this little amount of weight does not make the person skinny. But it does have a positive health effect, that is actually difficult to explain. One explanation is that it is NOT about weight at all and that the health benefits come from the lifestyle changes. So whether a person is of lower weight or mildly obese, as long as they eat right and exercise regularly, they will all be as healthy as the other.

The truth is always somewhere in the middle, and there probably is an ideal weight range for best health BUT we don't seem to know what that is yet. Also, you have to treat extremes as a whole separate issue. The 500 pound patient and the 75 pound patient both have issues related specifically to their weight and these must be addressed. BUT most people do not suffer from such extremes. And the message of this new study is that their focus, as far as health is concerned, must be on staying fit and eating healthy. Hopefully (but I am doubtful), people will stop obsessing about a number on the scale and instead will focus on their blood sugar, cholesterol, fats and blood pressure. If all of these factors are within the normal range, then it is very possible that losing weight will not improve health.

Of course, the focus on weight is for many an aesthetic issue and has little to do with health. And I do not expect the diet industry to go bankrupt overnight because of this study. But I do hope, at least in the doctors' offices, that there will be a different mood when dealing with overweight and low grade obesity.

I want to also raise the point here that as one ages, the rules also change. Older studies have shown that older patients (above 65) benefit from having "a few extra pounds". Whether this is because of the extra fat, or extra muscle mass, that comes with being heavier, no one knows. But the idea that a BMI of 20 is not ideal for everyone is actually an old concept.

I hope that more studies like this are done and that they continue to relax the pressure on people who are overweight. And maybe, just maybe, this will be the first real step to all of us becoming healthier.

Thanks for listening.

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