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Monday, December 9, 2013

The Healthy Obese. Nope. That doesn't exist.

Can obese people be fit? 
Maybe they can. Certainly some of them can perform physical exercise tasks that many much slimmer people cannot. So, in that respect they are fitter than some. 
Can obese people be healthy? I contend in this blog that they cannot. Not if you consider it relative to as healthy as they could be. If they are obese, they are never relatively healthy. This is not a minor point. Relatively speaking, the gap between how healthy they are as obese and how healthy they actually would be if they were just a bit overweight (as most of us are) is a very wide gulf, whether they realize that or not.
Some people are just born heavier and will always be somewhat overweight. But, I don't think anyone is born obese or has a metabolism that makes them obese. Sure, many people burn weight no matter what they eat and can eat the things that those who aren't so fortunate cannot. But when you get to the point that you are obese, it is not something nature hoist upon you in the womb or in your parents DNA. How do I know this?
In the wild, you don't see obese animals. Why is that? Because they would be easy prey and nature would take care of them the way nature does. They would be killed and eaten by another predator. Over time, the obese gene would be bred out by natural selection. Those that are would not survive to breed and carry the gene. Survival of the fittest and all that jazz.
Humans have managed to set up a society that circumvents that natural process. Obese people can live productive and long lives, assuming the obesity doesn't cause severe health situations that lead to illness and premature death. Most times though, it does lead to illness and premature death as a general rule and average. That is a fact that most would not dispute.
So, yes, obese people can be fit and survive very well in our society. We aren't hunter gatherers anymore and we don't live in the wild. Nobody will hunt us and force us to compete for our place in the food chain. We have been for many centuries the top of the food chain. 

Last week I was watching a news item and the title of the piece was "Obesity Myth" which suggested that obese people can be and are healthy sometimes. 
The lead in to the story was read by the anchor as this:

"Some health studies in recent years have suggested that being obese may not mean that a person is unhealthy."

The first few words used by the reporter in the story were these:

"Can you be fit and overweight? Absolutely."

In some instances, I can agree with this. Not most, but some. a point. Obese, likely not. Not as fit as you could be. Fit, in a relative term to some others, yes. 
Then they showed a woman who was obviously very obese. Yet, she is very active, walks or runs half marathons all the time, and has metabolic factors which are well within healthy norms. She had the following to say:

"I can honestly say that I have never felt healthier in my life."

Yes, she probably is pretty fit, and healthy. Now. In a relative since. But that is how she feels. Not how she is. 
They site their good metabolic numbers, blood sugar and cholesterol to back that up.

 "It is clear that obesity is tightly linked to a host of chronic illnesses, among them heart disease, hypertension and Type 2 diabetes. That there are metabolically normal obese adults suggests that there is a way to safely carry excess fat. But to what extent is not clear."

-from the above article.

Your first instinct is to think that is just foolishness. But, they did have some science to back it up. What was that science?
The usual markers they use to measure how healthy or unhealthy someone is; blood pressure, cholesterol level, ability to perform physical exercise without an elevated heart rate that is dangerous and things like that. They found that many obese people did have "normal" markers and were "healthy" if you just used these markers as your determining factor for healthy. 
Then, another study found that this is a short sighted way to view it. In the short term, these people appear healthy, but long term they still will likely have very unhealthy consequences for carrying the kind of weight that obese people carry relative to those who don't.
And that makes perfect sense. 
Think of it like your car. The more you tax the parts, the faster they will wear out. In a car, you can replace the parts. In humans it is not that easy. You only get one heart, one set of lungs, and all the other parts that keep humans alive and well. Sure, you can medically and surgically repair some, but for the most part you will live a much shorter life and have a much lower level of satisfying lifestyle towards the end of your life if you wear the parts out faster. 
When you have a car and you wear out the tires, you can just go get new tires. When you weigh too much and wear out your knees and ankles, you can only repair them so many times until you are immobile. The human body isn't a car. It isn't disposable. You only get one and you can't go to NAPA and just replace the parts as you see fit. An unhealthy car is eventually discarded and you just go get a new one. Your human body cannot be discarded. If it dies, you die. 

"Metabolically healthy obesity is found more frequently among younger adults, as a large study in the journal Diabetes Care demonstrated in August. There is growing evidence that it may be a transition state, and that if followed long enough, some, if not many, people in this category will eventually develop the expected metabolic disturbances."

-from the above article. 

So, is it correct to say that obese people are healthy? No being obese always mean you are unhealthy. The proper thing to say is that being slim doesn't mean you are healthy. 
It is backwards logic and reasoning to say that you are healthy even if you are obese if you can do certain things and have normal metabolic levels when most who are obese do not.
Maybe you are even somewhat fit, but you aren't healthy. You are unhealthy. You are taking years off your life. That is just common sense.
In the news item, after the usual folksy interview of a few overweight people who claim they are healthy because of their good metabolic numbers and active lifestyle, he interviewed a doctor/researcher who didn't buy it. So, she did her own study to see just how healthy they actually were.

"Dr. Caroline Kramer didn't buy it. So, she decided to do her own long term analysis. 'So, we are clearly showing that it is not okay to be obese, even if you don't have any kind of metabolic problems'...her results are based on 8 studies that tracked over 60,000 people over 10 years. The results showed that obese people who had normal metabolic numbers had a 24% increased risk for heart attacks, stroke and death."

They concluded in the story by saying that being skinny and unhealthy can be just as deadly. 
 I think the correct way to put it was that some obese people are relatively healthy in the short term. Not healthy. If they were not obese, then they would be healthy in more of an absolute sense. 
But in real terms, in almost every case, anyone who is obese for a significant amount of time is never truly healthy and will pay the price for that over the long term no matter what their metabolic factors and exercise level and ability is. 
I have a family full of dead relatives who died too young to back that up. 
The only myth is that being obese is okay in terms of your health. It never is, no matter what a few crazy researchers say.

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