Can you be healthy if you are obese?

It seems like a paradox. The notion that obese people can be healthy is completely contrary to any public health message we have ever seen, yet, there is increasing evidence that SOME obese individuals may be just as healthy as their normal weight peers.  The question that arises then is: what is it about being obese that makes a person “unhealthy”?

The simple answer to this question is that obesity is associated with a higher risk of cardiovascular disease, type II diabetes, cancer and early death. This is primarily because people who are obese generally have a poor diet and low physical activity levels; they might also consume more alcohol. In other words, the lifestyle that is leading to their obesity is also leading to higher cholesterol, blood pressure, blood glucose levels etc. These of course are primary risk factors for the above mentioned diseases.

Recent research indicates however, that just because someone is obese it does not necessarily mean that they have these risk factors. In a study published in the Canadian peer-reviewed journal, Applied Physiology, Nutrition and Metabolism, Dr. Kuk and her colleagues used a large database (Aerobics Centre Longitudinal Study) to establish just this. They used the Edmonton Obesity Staging System (EOSS), a risk-stratification system that classifies obese individuals using health indicators on a scale of 0-4 with 0 being low risk and 4 being high risk. Using over 20 such indicators, Kuk and colleagues found that only obese individuals in stage 2 or 3 (they were unable to assess stage 4 because of limitations in the dataset) were at an increased risk of death, cardiovascular disease and a variety of other conditions. In other words, there were some obese people (those in stage 1) who were not at a higher risk when compared to normal weighted people. Interestingly, this was not the case for cancer. Regardless of which stage the obese individual was in, they had a higher risk of cancer when compared to their normal weighted peers. In addition, they found that even when they took into account the diet and fitness levels of their obese participants, the risk remained high for people in stage 3.

So, how is this possible? How are SOME obese people able to maintain normal or near optimal health levels?  The present study does indicate that the obese individuals in stage 1 were more fit than the others. It is also entirely possible that the healthy obese individuals were consuming more fruits and vegetables, were getting 8 hours of sleep, drinking their 8 glasses of water and coping better with life stress. It is possible that these individuals had “healthier” lifestyles than their obese peers and therefore successfully reduced their risk for many chronic conditions.

TAKE HOME MESSAGE: If you are obese make sure you understand what your risk is before setting off on a stressful weight loss program. It is important to realize that weight loss does not necessarily mean improved health. Stop focusing on the scale and re-focus on your overall lifestyle. This will reduce your risk for several chronic diseases and in time (perhaps more time than you hoped) you will lose weight!

And remember, you have control of your HALF!

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