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Can You Be Overweight and Healthy?

Getting to the Weight of the Matter


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I think this is a fabulous article! It's funny - we get mad at our docs when they mention our weight - it is important and needs to be dealt with - but I think it would also have gone a long way to praise the positive results as well.

I have a question regarding the metabolic syndrome criteria you posted. We also use fasting glucose as a measurement, and if it's 100 or higher, it's also considered a risk factor. I have not seen total cholesterol tied in with the HDL risk - I thought that was interesting. If you happen to see this post could you let me know where your guidelines came from? I'm just curious. Thanks! Report
Like SNAPSHOTSTACY below, and the person in the article, I had a similar experience. I had lost 40+ pounds and was so very excited not to be obese anymore. Sure, I was still overweight, but I had come a long way and was thrilled. So I had a work physical and that nut job doctor told me that I needed to start eating a certain way and exercising, etc. She did not listen to a word I said about my eating habits or exercise routines. I was so disgusted. Report
The dr. at the beginning of this story is a moron. Lori may need to lose more weight, but for heaven's sake, praise the improvements that she HAS made! Good bp and cholesterol numbers are great progress. Then suggest that you hope she can keep it up and maybe see a little weight loss in the future! Report
I think the key phrase here is "When assessing overall health risk, we need to look at many factors, not just the number on the scale." Yes, someone who is a little overweight CAN be healthy if they maintain a healthy diet and a regular and consistent exercise program and, of course, if their physiological stats and test are indicative of a healthy person.

Having said all that, I personally have never known someone who was obese and was truly and honestly fit and healthy according to those standards (healthy diet, regular exercise plan and healthy stats and tests). While I definitely agree that an obese person can IMPROVE their overall health (and should definitely be commended for it), until they lose a significant amount of weight, they will probably not truly and honestly be "healthy" or "fit". "Healthier" and "fitter" yes.

On another note, I too agree that BMI is a ridiculous gauge of "health" and "fitness". Like others, I too know someone who according to his BMI would be categorized as "overweight" but to look at this guy is like looking at one of those airbrushed photos of a model. Yeah, his BMI is almost 26 but BFD!!! He is so buff and athletic looking!!!

Lastly, I have my own story of being healthy and fit where for the past few months I haven't lost any weight even though I have dieting and exercise just as hard and as consistently as I was when I lost the 62lbs. However, during this same time, I went from a size 10 to a size 8, which meant that even though I didn't lose anymore weight, I was still losing inches.

Even though I haven't reached my goal weight, which btw was set based on my "healthy" BMI when I started, I'm now considering tossing out that goal weight and just go with my actual body sizes and measurements as my new gauge. To me, this seems so much healthier than working towards some silly number on a scale that doesn't really reflect the true and honest assessment of my overall health and fitness. JMHO Report
I'd be finding a new doctor. Report
As far as I can tell, there is NO evidence that BMI tells us anything specific about an individual. Yes, fat is implicated in some cancers and for some other conditions less is better, but there is NO reason to think than a BMI of 25 is magically better than 26. I have lost nearly 70 lbs, but still weigh 273. I am the healthiest I have ever been. My blood numbers are enviable and I bike 100-200 miles a week. I haven't been sick in four years. I know that my weight still puts me at risk, especially for orthopedic injuries, which could serious compromise my fitness level, so I am working to lose more weight. I know, however, that I am far more healthy than lots of people who weigh less.

My conclusion, based on looking at a lot of studies, is that fitness is the best SINGLE predictor of health and far, far, better that BMI or even percent fat. That said, excess fat is also not good for the body and in the absence of fitness is even more pernicious.

With regard to the doctor referenced in the article: get another doctor. Good motivation comes from supporting success, not undercutting them. Report
My husband died 021613 from heart disease. He was 46. He was thin (6ft tall 170 lbs). But his cholesterol was elevated but not scary high. His triglycerides were very high (400+). And he was a 2 pack a day smoker. But he did not consider himself to be unhealthy because he was thin even though his vitals said otherwise. He would put me down because of my weight even though my vitals were better than his (even though mine definitely have room for improvement). He refused to do anything that would improve his health. His death has been my wake up call. But I am looking at this as a life style change and not a diet. I am exercising at least 3 times/week now and am making healthy changes to my eating habits. I hope weight loss will be a side effect from these changes. Report
Quite honestly, I wish the whole diet industrial complex would finally get the message that BMI is a statistical tool meant for entire populations, not individuals. I'm at a higher point of the so-called "normal" BMI range, yet I'm far more likely to develop certain co-morbidities (e.g. a replacement knee) than people in the "obese" range simply because of my medical history and- oh no!- physical activities.

I agree that physical fitness is a better indicator of health (and future health) than any other, but I also think that's incredibly ableist, classist, and a host of other -ists. Waist circumference ratio is a good tool, I believe, but one that needs further testing against long-term mortality rates.

My final conclusion on the "weight issue"? Every person has to decide for themselves how they feel, whether they want to lose weight or not, whether they are fit or not, whether they are happy. The recent AMA classification of obesity as a disease makes me want to smash something in rage- obese people have been treated the way Lori has by her doctor for far too long, and the association obese=disease is only going to hurt more individuals. Obesity is NOT a disease, obese people are NOT a disease.

Weight is a non-issue for me in everyone who isn't myself. I'll never look at anyone and think "unhealthy" just because of their body shape. I can only hope that doctors, and society, will finally catch up and allow people to just be, without making them into a socio-economic and political tool. Report
Well - the AMA has now classified obesity as a disease and that's going to make it hard to be both fit and fat. Officially, anyway. The argument for this classification is to make doctors take obesity more seriously. (Really? doctors haven't taken it seriously since when?) The argument against it include this quote from the NYTimes:

"...that it is more a risk factor for other conditions than a disease in its own right.

They also say that “medicalizing” obesity by declaring it a disease would define one-third of Americans as being ill and could lead to more reliance on costly drugs and surgery rather than lifestyle changes. Some people might be overtreated because their B.M.I. was above a line designating them as having a disease, even though they were healthy." Report
My recommended BMI is 120-155 lbs. That's a lot of leeway. I was always fit even when overweight, but over time that extra weight was a "drag." Why would I want my heart and lungs to make all that extra effort especially as I got older?
Maybe it's possible to continue to be fit and fat, but I'm enjoying life more now that the "fat" is history.
Yes, I want to be strong too and weight train for that, but I don't need an extra 30 lbs of anything regardless of its composition.
Doctors definitely need education to help their patients and it would be great if insurance companies were concerned with our heath and not just their bottom line. Report
I was really upset to hear how this doctor damaged his patient's sense of achievement and motivation.

Maybe we should research how to help Doctors provide better encouragement? Report
Since the best markers for health and longevity are homocysteine, C-Reactive Protien and tryglycerides; and since doctors do not offer them it is difficult to understand how a doctor can advise anyone they are healthy or unhealthy. Since premature death is anyone who dies before aged 79 years of age you can see why doctors need to review their tests and get scientific (instead of opinionated).
PS the above are solved with B Vitamins and low inflammatory foods you can see it is not rocket science. Report
I knew that I had put on too much weight. So when I went to the doctor for spme health problems he told me I had to loose some weight. But I already knew that because I didn't have the get up and go power. Report
ive been overweight since i was 17 and im happy that now i have a doctor that when i go in for my well woman exams she comments on how good my blood pressure is and how how my cholesterol is normal. she tells me to keep up whatever im doing because its obviously working. she does say that yes weight loss would be a good thing but i told her all im doing and shes not worried about my weight. she also knows i have medical issue that makes it almost impossible to lose weight unless i starve myself. so she sees that my muscles are building and my numbers are healthy and doesnt care about the rest. she just says keep it up and tells me that the weight will eventually come off itll just be extremely slow for me. as long as im healthy im good. Report
About a year ago I did some research into being fit and fat. I have never been fat, but then I found out that as you age it is a good idea to become a little fat, not obese, and to make sure you fit. I decided to become fit and fat and to gain the needed weight slowly. I found out that if you gain the weight slowly you will most likely not be able to lose the weight and will always remain fat.

What I found out to my pleasant surprise is that my body became quite accustomed slowly to being fat, I found I like how I look and feel. Yes I have a belly but it really is not that bad, and yes I work out 5 to 6 dayss an week and yes I am very active. I have never felt so good being fat.

The weight around 30 pounds went right into my belly and since it went on slowly I have come to accept the fact that I will always be rather fat, but I have full intentions of being fit. Now I am just a fat guy, but I am fit.

I checked with my doctor and my blood pressure has stayed the same low, and since I became fat slowly and do exercise my blood sugare is very normal. Report

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