A phenomenon recognized as the obesity
paradox might change the paradigm of weight management and weight-loss
strategies in the future. The obesity paradox is a phenomenon which has
been observed in several clinical studies in recent years showing that
individuals who are overweight or slightly obese live longer their
underweight or ideal weight counterparts. The obesity paradox was
initially recognized with chronic illnesses, most notably type 2
diabetes, heart disease, chronic lung disease and chronic kidney
disease, but according to the most recent study reported in the January
2012 issue of the American Journal of Medicine the improved survival
rate for overweight and slightly obese individuals was noticed across
the board irrespective of any specific disease.
To
understand how the relationship between body weight and the risk of
dying is studied it is important to note that weight categories are
arbitrarily defined based on the body mass index or BMI which is a
person's weight in kilograms divided by height in meters squared
(kg/m2). A BMI less than 18.5 is considered underweight. A BMI between
18.5 and 29.9 is considered ideal weight. A BMI of 30 or greater is
categorized as obese. In the study mentioned above obesity was sub
categorized into grades 1, 2, and 3. Grade 1 obesity is a BMI between 30
and 34.9. Grade 2 obesity is a BMI between 35 and 39.9. Grade 3 obesity
is a BMI of greater than 40.
The study was a meta-analysis of 97
past studies conducted in various countries throughout the world in
which the records of 2.9 million people and 270,000 deaths were
reviewed. According to the study results being obese in general was
linked to a greater risk of dying compared to being of normal weight and
being severely obese was associated with a 29% greater risk of death.
Being merely overweight however was linked to a 6% lower risk of dying
and being slightly obese (grade 1) was linked to a 5% lower risk of
death compared to normal weight. The study did not provide any
explanation for the link between being overweight or slightly obese and a
lower risk of dying, but certainly illustrated the degree of disconnect
between reality and conventional wisdom.
How these results will
impact future recommendations with respect to weight-loss programs and
weight management strategies in general remains to be seen, pending
additional clinical research necessary to better understand the apparent
protective benefits of being overweight or slightly obese. Until the
link is better understood, it would behoove one to be more thoughtful in
setting weight-loss goals and more meticulous while engaging in
weight-loss efforts including dieting.
The weight-loss goals
should be reasonable so that the rate of weight loss does not exceed 1
to 2 pounds per week and the BMI does not drop below 18.5. Additionally,
during a weight-loss program, special attention should be given to any
change that might occur with any known chronic disease or any signs of
development of a new chronic disease. Ideally, a weight loss program
should be closely supervised by a physician but for the individual who
is inclined otherwise, early disease detection home test kits or an
online lab service should at least be used for chronic disease
monitoring and early disease detection, and abnormal or questionable
test results should be immediately reported to a physician.
Since
it is possible that deficiency of organ-specific nutrients might have
played a role in the higher death rate seen among underweight and ideal
weight individuals in the study discussed, it is important that
weight-loss diets are nutritionally balanced and not just crash diets or
diets with marked restrictions of calories and fat and an abundance of
protein.
The obesity paradox brings to remembrance the words of
Henry David Thoreau (1817-1862). "To know that we know what we know, and
that we do not know what we do not know, that is true knowledge."
Despite the lack of knowledge resulting from the obesity paradox, the
known knowledge is not defied. Morbid obesity is associated with an
increased risk of death. Therefore, acknowledgment of the obesity
paradox is not license to pig out.
This article is for
informational purposes only and is not intended to be legal advice or a
substitute for medical consultation with a qualified professional. If
you are seeking legal advice or are unsure about your medical condition
you should consult an attorney and/or physician.
Victor E. Battles, M.D. is a board-certified internist with 30 +
years of patient contact, including participation as a principal
investigator in several clinical research trials. He is the founder of
Proactive Health Outlet, a resource providing self-help for improving
health. For information about balanced diet meals and other weight loss resources visit Proactive Health Outlet.
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