Wonder if he's classified as obese in both pics.
Posted on 03/30/2009 12:50:17 PM PDT by nickcarraway
Weight loss not for everyone, says top obesity specialist
One of Canada's top obesity doctors says it's time to stop recommending weight loss for everyone who meets official criteria for obesity.
Dr. Arya Sharma says being obese doesn't necessarily doom people to poor health and that weight loss recommendations should be targeted at those most at risk because of medical problems.
Many people who meet the body mass index criteria for obesity "are really not that sick at all," says Sharma, chairman for cardiovascular obesity research and management at the University of Alberta and scientific director of the Canadian Obesity Network.
"It's not unusual to find someone come into your practice whose BMI is 30 or 32 (technically obese). This might be someone who is physically active, who is eating a good healthy diet. If you followed the guidelines to the letter you would be prescribing obesity treatment when there's really no reason to do that, because they're not medically obese."
"It's not enough to just know how big someone is. In order to make medical decisions, you need to know how sick someone is."
His appeal comes as evidence begins to mount that a significant proportion of fat people are metabolically healthy. One in every three people who are obese -- and half of those who are overweight -- may be resistant to fat-related abnormalities that increase their risk of cardiovascular disease, according to new research from Albert Einstein College of Medicine in New York.
The concept of "benign obesity" has been known for more than 20 years. Only now are researchers discovering the scope of the phenomenon.
"Obesity was far less common when it was identified, and then obesity became this gigantic epidemic, with just the assumed outcome that everyone is going to be at risk for vascular disease and a whole bunch of other things," says Rachel Wildman, an assistant professor of epidemiology and population health at Albert Einstein College.
"As it turns out, it seems not to be the case. There is at least a proportion of obese individuals who at this point don't seem to be at elevated cardiovascular risk." Not only is their risk fairly minimal, "in some instances it's better than individuals who are normal weight."
Hardly a week passes without a headline warning the overweight are eating their way toward a premature death, and there's a huge amount of money to be made by encouraging hysteria around the issue. The weight-loss industry is worth $50-billion in the U.S. alone. But there's growing recognition that the risks associated with obesity are not uniform.
In Wildman's study, nearly 17% of obese men and women possessed not one of the heart or metabolic abnormalities the researchers considered.
"What's very clear is that people in the range of 25 to 30 BMI -- the 'overweight' category -- live longer than lighter people," says Paul Ernsberger, an associate professor of nutrition at Case Western Reserve University School of Medicine in Cleveland, Ohio.
Researchers have shown that while overweight people are more likely to have a heart attack and heart failure, they're also more likely to survive it.
One theory is that high blood pressure, a leading cause of heart disease, is less dangerous for fat people than for lean: Obese people with high blood pressure tend to have higher blood volume and higher cardiac output. Lean people, on the other hand, have high blood pressure because of increased resistance -- that is, their blood vessels are clamped down more tightly.
Having more blood circulating isn't as harmful as having blood vessel changes, Ernsberger says.
He and others believe the concept of "overweight" should be abandoned, "because that implies that you are over the ideal, that there is some magical weight you shouldn't be over." He says a person's weight begins to affect their health at around a BMI of 30.
Wildman, of Albert Einstein School of Medicine, agrees that it may be time to deal with the obesity epidemic in a more nuanced way.
Her team's analysis of a sample of 5,400 American adults 20 and older found 23.5% of normal-weight adults were metabolically abnormal, whereas 51.3% of overweight adults and 31.7% of obese adults were metabolically healthy, at least when it comes to their risk for heart disease.
One theory is that some obese people are less sensitive to the hormones and inflammatory chemicals secreted by fat tissue. Another is where the fat is stored. It may be that the healthy obese have less visceral fat -- the kind of fat that wraps around the intestines, liver and other organs that's more metabolically active than peripheral fat.
So, if there are healthy obese, who are the unhealthy fat?
To answer that question, Ernsberger took genetically obese and genetically thin rodents and made the thin ones fat by feeding them a high-sugar, high-fat diet. "They both had obesity related problems, but the one that has a poor diet is much less healthy -- they have worse blood sugar, worse blood pressure and worse cholesterol.
"So all risk factors are worse off, even though they may not nearly be as heavy as the genetically obese." He says some people are naturally obese and other people are naturally thin but that they force their bodies to become obese by over-eating and under-exercising. "And that's probably the unhealthy obese."
Public health recommendations tend to lump everyone together. "It's like saying not everybody who smokes dies of a heart attack or develops lung cancer and yet we recommend to everybody not to smoke," says Dr. Andreas Wielgosz, an Ottawa cardiologist and spokesman for the Heart and Stroke Foundation.
OBESITY BY NUMBERS
Body mass index is a ratio of height to weight.
A BMI of 25 to less than 30 is considered overweight. A BMI of 30 and over is obese. Someone who is five-foot-10 who weighs 174 to 208 pounds would be considered overweight, according to their BMI. More than that, and they're obese.
There are four categories of BMI ranges:
underweight (BMI less than 18.5);
normal weight (BMIs 18.5 to 24.9);
overweight (BMIs 25 to 29.9), and
obese (BMI 30 and over).
Wonder if he's classified as obese in both pics.
1. Get on your bike
2. Ride
I’d be comfortable using the phrase benign obesity to describe my own 283 lb. 5’ 3” situation.
Glandular? = sorry.
Eat too much? = eat less. exercise. lose weight.
I myself stuff my face while watching TV and that made me gain a ton of weight. So I said screw it and started exercising like crazy. And now I stare at myself naked all the time.
But the bad part is my work has been suffering. Not calling clients back, ignoring emails. Too tired with all the exercising.
That said, there is a huge PC issue here involving nationalized health care, because if/when we get to it, the obese and going to become targets, and there WILL be a "fat police" unless they can come up with some science to show that they really aren't that "unhealthy."
Well, see, there you go. You're not overweight, you're undertall.
"Exceeding the CVATT may result in a number of metabolic disturbances such as insulin resistance to glucose uptake by cells. Metabolic profiles of patients with visceral obesity may substantially improve after only modest weight loss. This could reflect a significant reduction in the amount of VAT relative to peripheral or subcutaneous fat depots, thereby maintaining VAT below the CVATT. The CVATT may be unique for each individual. This may help explain the phenomena of apparently lean individuals with metabolic syndrome, the so-called metabolically normal weight (MONW), as well as the obese with normal metabolic profiles, i.e., metabolically normal obese (MNO), and those who are "fit and fat."
They can target the obese as long as they are also willing to single out those who engage in risky anonymous sex in washrooms while using a variety of unknown pills, powders, and intavenous drugs....
Tell me about it, for my height, I should weigh what I did in Jr. High (before I stopped growing). Granted, I could drop a few pounds, but I ain't getting back to what I weighed at 13 or 14.
Buddy of mine is a cycling fanatic. He rides, literally 100+ miles weekly, and the only fat on him is whatever he ate for lunch.
He's also got a stocky build. At his physical, his doc took one look at his BMI and told him to drop 20 pounds. "From Where?" my friend said.
Then he got a new doctor.
I’ll admit it. I’m considered obese, yet I have no issue with blood pressure, blood sugar or anything else. I have always said I’m the healthiest fat person I know. There are thin people who are way less healthy than I am.
Would I like to lose the weight? You bet I would and I have tried. I will likely keep trying. Maybe one day I’ll succeed.
There was a time when “obese” meant “really fat”. No longer. Now it means “not skinny”.
I wonder if that picture is a photoshopped one or if he really has lost the bodybuilder’s physique. In a suit, he still looks muscular.
Near all these “studies” on health and behavior have a hard time when it comes to causality or correlation. More people who are thin exercises, might eat healthier foods, etc. and weight and a high BMI might simply be a manifestation of unhealthy choices, but not the problem itself. What about someone that's heavier but exercises and eats well?
In the end, your quality and quantity of life will be determined more-so by genetics (excluding acts of God, crime or war) than anything else. You can drink bourbon and smoke cigars and make it to 100 as George Burns; or you can run marathons, not smoke or drink and fall over dead at 52 as Jim Fixx did of a massive heart attack.
What all this nonsense really boils down to is a few basic concepts. (1) We can't accept the idea of some sort of biological determinism. (2) We like to over simplify things and cook them down to some over simplistic idea, focusing on some singular variable. (3)People are lazy, so are many doctors and health care providers. This is the easy answer for everything. (4)We are an EXTREMELY trendy society where butter is healthy one day and vilinized the next. (5)Money talks, even in a socialist society, and those that use tobacco, consume alcohol, or engage in some other behavior or indulgences are seen as a cash cow. Insurance providers love smokers.
When you have a health issue and a doctor states it's because of smoking, being over weight, etc., I would go find another doctor. In most cases I would think it to be the easy answer that requires little thought, money, or any other effort. Real world example. My wife is a bit over weight, but by no means morbidly obese. She had hip problems and for years doctors told her that she needed to loose weight. The simple answer. We eventually found a real doctor who upon further investigation found she had a deformed hip joint, and ended up repairing the problem. Think about this though. Literally three US Army doctors looked at her, some X-rays were taken once (No MRI or CAT scan) and the answer more or less was always “It's your fault, loose some weight.”
These so called “risk factors” are all to often the lazy and simple answer, IMHO.
What you have to realize is that under the communist government Bozo is planning, there will be very little food per person. Can’t stir up dust you know during farming, can’t hurt little insects while farming, can’t plant this or plant that and people can’t grow their own food because of huge taxes on backyard gardening. This is the way it is done in communist countries, kill off the food production and then control what little food there is, a weak, starving people are less likely to revolt plus an undernourished brain cannot think well. We will all be skinny(read that starving)therefore having fat police will not be necessary. I am not joking.
See, good news *is* news.
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