# The Obesity Paradox



## Swede (Apr 2, 2013)

compulsiverambler said:


> I didn't say the data were debunked, I said the studies and theory were. The study design has been exposed as so flawed that the data are useless for the purposes of testing the hypotheses the studies were designed to test. The theory the OP is implying support for (yes, "theory" - a word with a popular non-scientific definition, which makes me feel less dirty using it to describe incompetent/bought excuses for science like this), that being overweight is not unhealthy, is clearly demonstrated to be false by this point. There's no mystery and nothing more to say about them, they're just some anomolous research findings that have been explained in ways that fit all the related data we have. So why bring them up at all, giving the impression that they represent a any level of challenge to the standard medical advice on this issue? The socio-political agenda the OP explicitly contextualises the thread with is probably the answer. Critical thinking is significantly reduced when we want something to be true.


Nowhere in OP or the quoted articles does it state that being overweight is healthy. You are reading that into the text somehow. If this is what you mean when you say that the "theory is debunked", you are addressing a statement that was nowhere to be found in OP.

What is does state is that when it comes to *mortality rate *or *certain diseases* (listed in OP), the relationship to BMI is different than what expert have believed in the past. That is not a theory, that is fact proven by data in several scientific studies (analysis of gathered data), including meta studies.

This is exactly why the finding is referred to as the obesity *paradox* - meaning that _even though_ people who are overweight (BMI 25-30, not above) might generally be less healthy over all (also debatable, ex excessive drinking & smoking or other substance abuse, too much stress or too little sleep does not have to show up as overweight), they demonstrate a higher survival rate in certain cases.

The theories are the actual hypotheses explaining this unexpected phenomenon, not the data itself. Several hypotheses have been listed in OP as well, but no one has been able to prove one of them right to date. My suspicion is that there are more than one explanation.
If anything has been debunked, it's the fact that BMI is a good predictor when it comes to mortality rate. This is an important finding for many reasons - especially since it means that being within the normal range is not something that means that you should feel too safe, on the contrary, you might want to make sure that your medical caregiver makes sure that you get the best care possible. This is actually one of the hypothesis behind the obesity paradox - overweight people get superior care, since they are seen as high risk patients.

Critical thinking is based on the premise that we read what the articles actually state, not what we personally believe the 'hidden agenda' to be. 

I do believe that your statement about healthy women having visible rib-cages is more a personal value than anything else, since people tend to have extremely different builds, including bone structure (rib-cage size) as well as fat-distribution.
Link me to the scientific medical reports that states that this is the case and I might reconsider. 










@marblecloud95, your pics very likely show people with BMIs well above 35, so they are not included in the obesity paradox - in other words, not real relevant.


> It was not until people had a BMI >35 that there was a clear increased risk of heart disease related morality (80 percent increased risk) compared to normal weight people. This observation is a classic “U” shaped survival curve with the highest risks seen in those that were severely underweight or overweight, with the lowest part of the curve in those considered slightly overweight (BMI from 25-30).


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## marblecloud95 (Aug 12, 2015)

Catwalk said:


> Many fat individual(s) skinny shame constantly; (blinded by bias) - ''skinny'' individual(s) are called ''not real'' or ''not real women'' & constantly shamed (via) having naturally high metabolism + cannot be happy; of course this is ''justify'' in so far as obesity / fat / curvy = good // happy n' skinny = bad, these day(s). ''Body acceptance'' does not include skinny individual(s).
> 
> ______________
> 
> I have yet to see anyone assert ''models'' (i.e., anorexic(s)) are healthy; this appear(s) delusional + going to turn into yet another passive aggressive ''skinny hate'' thread at the expense of lifting up fat / obese people.


Yeah, the only way to combat hate is to spread love, love for every size, no matter how much fat hangs beneath your thighs.


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## compulsiverambler (Jan 7, 2010)

Swede said:


> What is does state is that when it comes to *mortality rate *or *certain diseases* (listed in OP), the relationship to BMI is different than what expert have believed in the past. That is not a theory, that is fact proven by data in several scientific studies (analysis of gathered data), including meta studies.
> 
> This is exactly why the finding is referred to as the obesity *paradox* - meaning that _even though_ people who are overweight (BMI 25-30, not above) might generally be less healthy over all (also debatable, ex excessive drinking & smoking or other substance abuse, too much stress or too little sleep does not have to show up as overweight), they demonstrate a higher survival rate in certain cases.
> 
> The theories are the actual hypotheses explaining this unexpected phenomenon, not the data bunked, it's the fact that BMI is a good predictor when it comes to mortality rate.


All of that *is* exactly what got debunked. Overweight and obese people (i.e. those who are overweight or obese for most of their life) have a higher rate of mortality and all of those diseases than those who've spent most their life within the healthy weight range. But by the time they get ill, the obese typically lose a lot of weight, and those studies would have miscategorised all such cases as slightly overweight or healthy range because they only recorded weight at the time of the survey. If you've been obese since childhood but slimmed down to healthy weight or slightly overweight when you become diabetic, after decades of continuous obesity, it's absurd that you would be recorded as an example of a healthy or slightly overweight person who got diabetes or died young. Yet that's what those studies did. Now do you see why I find them so preposterous? It's beyond belief that so much time and money was wasted on multiple studies that a three year old could have pointed out the hole in.


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## Swede (Apr 2, 2013)

compulsiverambler said:


> All of that *is* exactly what got debunked. Overweight and obese people (i.e. those who are overweight or obese for most of their life) have a higher rate of mortality and all of those diseases than those who've spent most their life within the healthy weight range. But by the time they get ill, the obese typically lose a lot of weight, and those studies would have miscategorised all such cases as slightly overweight or healthy range because they only recorded weight at the time of the survey. If you've been obese since childhood but slimmed down to healthy weight or slightly overweight when you become diabetic, after decades of continuous obesity, it's absurd that you would be recorded as an example of a healthy or slightly overweight person who got diabetes or died young. Yet that's what those studies did. Now do you see why I find them so preposterous? It's beyond belief that so much time and money was wasted on multiple studies that a three year old could have pointed out the hole in.


I don't think that a lot of time went into the studies, seeing that the data already existed. That is the whole point behind meta studies - the data already exists, just collect and analyze. 

As mentioned a number of times now, the higher mortality rate has been demonstrated for a few specific diseases - not overall, which you seem to refer to above. You are talking overall health/mortality, which is not the topic of this thread.

The hypothesis you mention is one of many, so a link to some data driven studies that proves that this particular hypothesis is the key explanation would be appreciated. Otherwise, it's still just one theory among a range of other plausible explanations. Does a statistically significant number of people who die from these particular diseases lose a relevant amount of weight right before they die? Maybe, maybe not. I haven't searched for that data.
You can also flip it; did a lot of people live most of their lives underweight and managed to get into a 'healthy' BMI just before they died (probably less likely looking at average BMI)? Or did a bunch of the healthy weight people abuse worse substances than calories? Were they less aggressively treated or did they not take the warning signs seriously because they thought that they were 'safe'? 
The point is that obesity (or BMI) is just one of many risk factors, which is not really that unexpected.

Other major factors are genetics (if you are fit and have a heart problem, you might be worse off since the treatment might be trickier - weight loss won't fix anything), muscle/fat ratio (supposedly many women and some men have a higher fat content than what is viewed as ideal even though they are listed within a healthy BMI range, so they are actually overweight), % liver fat (not necessarily related to body fat), energy stored to fight throug disease, etc. Unless they are also recorded and weighted in, it can't be know for certain what causes this phenomenon. 
As I already stated before, I think that it's more than one factor.

All right, my last response in ts discussion.


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## IDontThinkSo (Aug 24, 2011)

It might actually get worse if you can't store some fat and indulge with food to compensate for chronic anxiety. People who are thin and stressed all the time generally don't live to grow old. They don't discharge their stress through exercise and might rely on drugs to calm themselves instead.. 

And those who do dangerous physical activities, either for work or fun aren't obese. Morbid obesity seems to be an exclusive sort of darwin awards.


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## stormgirl (May 21, 2013)

Victoria’s Secret model Erin Heatherton quit after being told she had to lose weight.

Victoria's Secret model Erin Heatherton quit after being told to lose weight










Yeah…what a cow!

When THAT is considered fat, we have gone beyond being fucked up when it comes to body image.


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## Red Panda (Aug 18, 2010)

stormgirl said:


> Victoria’s Secret model Erin Heatherton quit after being told she had to lose weight.
> 
> Victoria's Secret model Erin Heatherton quit after being told to lose weight
> 
> ...


That's kinda irrelevant to the thread though, she is obviously at an appropriate weight and this shows the absurdness of the fashion industry. I don't think they said she's fat though, just not thin enough compared to the other models. Don't confuse the two. 
What we discussed earlier about Ashley Graham, I remembered that Tessa exists and she's definitely the type of model that that criticism we talked about, applies to.
Since we're talking about this here, the dove commercials are a good example of showing "normal" women's bodies without going into the unhealthy ranges, like this


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## compulsiverambler (Jan 7, 2010)

Swede said:


> I don't think that a lot of time went into the studies, seeing that the data already existed. That is the whole point behind meta studies - the data already exists, just collect and analyze.
> 
> As mentioned a number of times now, the higher mortality rate has been demonstrated for a few specific diseases - not overall, which you seem to refer to above. You are talking overall health/mortality, which is not the topic of this thread.
> 
> ...


You don't seem to have understood my earlier posts.

The specific diseases you're talking about and mortality from them were indeed what I was referring to. There is no obesity paradox for these diseases either. Studies that look at long-term weight status instead of just weight status at the time of the survey, find no such paradox, and they confirm that the interpretation I described is correct. It is not 'just one if the possible interpretations', it's the demonstrably correct one. 

You say that you didn't search for data about how weight over long periods of time instead of shortly before death correlates with these diseases. My point has been that such data does exist, and it shows there is no paradox, just some lazy research that defined obese participants and other weight categories as those who fell into that category on the day they were surveyed, not as those who had spent long periods of time in said category. 

That's like a health study defining 'smokers' as those who had smoked the day of the survey, and 'non-smokers' as those who hadn't. Those who took it up the day before or smoke very occasionally would be classed as smokers while those who'd given up a 40 per day habit the day before would be classed as non-smokers. Studies that do the same with weight should be ignored as worthless just as smoking studies like that would be.


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## compulsiverambler (Jan 7, 2010)

stormgirl said:


> Victoria’s Secret model Erin Heatherton quit after being told she had to lose weight.
> 
> Victoria's Secret model Erin Heatherton quit after being told to lose weight
> 
> ...


Is that what she looked like when they said that to her? Probably not. It sounds like she quit before doing any more work for them, so that image must be from before they said it. What's most likely then, is they told her to get back to looking that, not to get thinner than that. 

Besides, this sort of story doesn't indicate what most English-speaking societies consider fat (or even what the fashion industry considers fat - just what's above ideal for their particular purpose of making clothes look good). Research finds instead that only obese or morbidly obese images are considered fat or clinically overweight by most people. Overweight is the new normal and healthy weight is the new underweight in most people's eyes, especially among young people. If you query 'The Normalisation of Obesity' you'll find a range of studies about the phenomenon.


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## Word Dispenser (May 18, 2012)

It really should be a focus on health, and ignoring weight. Whole foods. A bit of healthy fats, lots of colourful vegetables, complex carbs such as legumes and beans, quinoa, lean proteins. And proper portions per meal, with a modification of meals-per-day depending on the individual.

Generally, I think that if someone strictly ate in such a way, and walked at least an hour a day, it'd be pretty difficult to be unhealthy. Also, supplements/multi-vitamin to fill in gaps in diet. Ignore weight and just do it that way. :kitteh:

No white breads, No white rice, no white sugar, nothing that's premade/processed, unless it's been done so from scratch by you.


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## Dragheart Luard (May 13, 2013)

It's good to see that there are studies that show that relying only on BMI doesn't really tell much about the health of a person. It also confirms that none of the extremes is healthy, as while obesity can cause severe issues, being underweight implies that the person is likely malnourished, specially if that's caused by not being able to get enough food (this tends to be the issue in poorer countries that mostly rely on vegetables because meat is scarce or too expensive and they can't get something else for covering the deficit of nutrients).


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## OrangeAppled (Jun 26, 2009)

Some random thoughts....

First-hand observation tells me the quality of life goes down for obese and very overweight people. They often have trouble moving and generally have more physical discomfort in life. I remember reading this article on how women in Mauritania get fattened up for marriage, as obesity is actually an ideal for women. The once-athletic young women were sad at how they could no longer run...

The assertion that the obese exercise more than thinner people because they are overweight is hilarious too. :laughing:

Obviously more body mass may mean more muscle, but that doesn't mean a higher percentage of lean body mass. I have heard that a minority of people classed as overweight may be very muscular people (ie bodybuilding types) who may be quite healthy, and I wonder if that was taken into account in these studies. Of course, we now have the lovely term "skinny fat" to body shame slender people with high body fat percent, which acknowledges that being thin is not necessarily healthy. Perhaps "overfat" is more of an issue than "overweight".


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## Swede (Apr 2, 2013)

OrangeAppled said:


> Some random thoughts....
> 
> First-hand observation tells me the quality of life goes down for obese and very overweight people. They often have trouble moving and generally have more physical discomfort in life. I remember reading this article on how women in Mauritania get fattened up for marriage, as obesity is actually an ideal for women. The once-athletic young women were sad at how they could no longer run...
> 
> ...


The "skinny fat" is related to BMI because more in-depth studies show that a fairly large percentage or men and an even larger percentage of women who lie within a health BMI weight have a muscle mass that is abnormally low. In other words, being skinny is not enough; a certain level of muscle is necessary in order to classify as healthy.

The graphs below demonstrates that a rather large segment of the measured populations are not predicted accurately by BMI when it comes to actual body fat (negative as well as positive - 18% for both men and women).









But yes, shaming generally does not lead to a healthy solution, be it fat-shaming, skinny-fat, or skinny shaming.

I'd say that it's possible that the health focus is coming from the wrong direction. Maybe it would be better to start telling people (especially women) that building muscle is what's really important, rather than focusing solely on body fat?


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## Stelmaria (Sep 30, 2011)

Swede said:


> I'd say that it's possible that the health focus is coming from the wrong direction. Maybe it would be better to start telling people (especially women) that building muscle is what's really important, rather than focusing solely on body fat?


People are just behaving optimally for their environment (read: cars, sedentary office work). Cities in America (and many other parts of the world) are built around inactivity. Perhaps instead of blaming people, or spending millions on ineffective health promotion programmes, we look at the root causes!


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## Cesspool (Aug 8, 2014)

Human beings are runners. We have evolved to be the best (or at the very least in the top 5) long distance runners on the planet.

Any body that doesn't lend itself to be able to exercise to the level we have evolved should not be considered respectable. I don't mean to say everyone needs to become a long distance runner, but any body that severely limits your athletic ability, whether it be one that has too much mass or one that doesn't have enough, should not be tolerated. 

It really is not difficult to get off your ass and exercise for 45 minutes a day and eat well. That's all you need to stay in shape. If you can't just take off and run for 5-10 miles, *you do not have a body that a human being should have*. A body that can easily run for 5 or more miles will most probably not be a fat body, but it very much can be a thin one, and it should be a muscular one.

I'm growing tired of fatties complaining about people being rightfully disgusted by their fatty bodies. Never in our evolution did we evolve to specifically be fat. We are not walruses or elephants. Being fat is a consequence of an unnatural environment, it is not integral to our being. It is not integral to ANYONE'S being (so none of that "I am naturally fat" bs). We are _*supposed*_ to have lean muscular bodies. That is what how we evolved. _The luxuries of the modern world are not an excuse to be out of shape._

This is what we should look like:




















We are NOT supposed to look like this:














That's my post. Now, I'm going to go for a run. It's drizzling out, and I love running in the rain. See ya later


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## angelfish (Feb 17, 2011)

The amount of ignorant hate and fear that is bound up in body discussion is so far beyond rational it's really just hard to comprehend. Overweight people generally want to hide and/or ignore their bodies not just because they're physically uncomfortable but also because of the negativity. Overweight people are met daily with shame, with vocal judgment, with people who think it's fine to call them all sorts of insults because their body isn't to the preference of strangers - the same strangers who then turn around and point out that there aren't many fat people at the gym. 

_Go to the gym, go run, go exercise, stop eating so much_ - that's what people who have never been overweight say about overweight people. They don't understand that many people at the gym stare and whisper. They don't understand how much fat bounces when you go running, and how bad that feels. How it can feel so uncomfortable to exercise. How all the tight clothing seems wrong and unflattering, but how the loose clothing isn't really helpful for exercising in, either. They don't understand how awkward and exposing exercising can feel, compared to the welcoming comfort of having a meal. Even getting dressed for a normal day can be depressing and stressful enough when you are uncomfortable with your own body - especially when you know there are people out there who feel like your body is ripe fodder for their criticism.

Physically it's usually as simple as getting up and exercising and eating differently, but that's not all there is to life. It's also schedules and responsibilities and food availability and comparative costs and ok-fitting clothing and time demands and personal exposure and social shame and thighs rubbing and not wanting to look in mirrors and feeling ambivalent about the beach and all sorts of emotional complexities. 



Catwalk said:


> going to turn into yet another passive aggressive ''skinny hate'' thread at the expense of lifting up fat / obese people.


The problem with the skinny shaming argument is it's akin to white people complaining about "reverse racism". It's true that it's also an issue and that we should be aiming for equality. At the same time, when comparing systematic oppression, fat people face regular disadvantages and bias because of their bodies, while skinny people typically do not.


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## Stelmaria (Sep 30, 2011)

Cesspool said:


> That's my post. Now, I'm going to go for a run. It's drizzling out, and I love running in the rain. See ya later


Those are terrible examples. Visible six-packs in men and especially women means an unhealthily low level of body fat and this is not healthy as you get older. You won't look like that if you simply eat a healthy diet with adequate calories and run regularly. I bet those people won't have bodies like that in 30-40 years time. Aside from that, a family member is an marathon runner and I can say that marathon runners don't look like that.


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## VinnieBob (Mar 24, 2014)

Snowy Leopard said:


> Those are terrible examples. Visible six-packs in men and especially women means an unhealthily low level of body fat and this is not healthy as you get older. You won't look like that if you simply eat a healthy diet with adequate calories and run regularly. I bet those people won't have bodies like that in 30-40 years time. Aside from that, a family member is an marathon runner and I can say that marathon runners don't look like that.



due to illness beyond my control 
my body puts the above pic to shame
my B.F. 0% and to look at me with my shirt off it looks like i compete
veins popping out of hips, waist, shoulders, chest, basically every where
yet i haven't gone to the gym in 10 years

plus one large [no pun intended] factor with the obese paradox is age
those that do not try to lower their weight by age 50+ have a much higher chance of stroke, heart attack 
i seldom see obese people over the age of 60


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## Red Panda (Aug 18, 2010)

Snowy Leopard said:


> Those are terrible examples. Visible six-packs in men and especially women means an unhealthily low level of body fat and this is not healthy as you get older. You won't look like that if you simply eat a healthy diet with adequate calories and run regularly. I bet those people won't have bodies like that in 30-40 years time. Aside from that, a family member is an marathon runner and I can say that marathon runners don't look like that.


Not to mention how running a marathon isn't exactly healthy, and just because humans can run so much doesn't mean they are supposed to, it's an extreme sport. Even if you look at it from an evolutionary perspective, running so much would deplete all fat deposits and be extremely dangerous for survival so I doubt it humans ever ran so much continuously. Just like humans can get enormously fat without dying, so they can run a lot without dying, doesn't mean it's our "natural" state. And in that sense, we're not necessarily "supposed" to have lean muscular bodies either, especially lean, since that would mean we didn't have enough energy deposits for the times we needed.

My point is, I find @Cesspool's arguments quite poorly thought out, because evolution isn't something that happened once and stopped, people adapt according to their environment and life. That's not to say that being obese is healthy or anything, but being lean and muscular like the photos don't have to be someone's goal, most people are perfectly healthy by having less muscle and more fat than that.
Also, I find the wording completely ridiculous "should not be tolerated", sheesh, get off your high horse dude...


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## Cesspool (Aug 8, 2014)

Red Panda said:


> Not to mention how running a marathon isn't exactly healthy, and just because humans can run so much doesn't mean they are supposed to, it's an extreme sport. Even if you look at it from an evolutionary perspective, running so much would deplete all fat deposits and be extremely dangerous for survival so I doubt it humans ever ran so much continuously. Just like humans can get enormously fat without dying, so they can run a lot without dying, doesn't mean it's our "natural" state. And in that sense, we're not necessarily "supposed" to have lean muscular bodies either, especially lean, since that would mean we didn't have enough energy deposits for the times we needed.


Actually, you are wrong. Humans very much did run that much. It is the way we hunt - we chase an animal for miles until they collapse from exhaustion, and then we can capture them. 



> My point is, I find @Cesspool's arguments quite poorly thought out, because evolution isn't something that happened once and stopped, people adapt according to their environment and life. That's not to say that being obese is healthy or anything, but being lean and muscular like the photos don't have to be someone's goal, most people are perfectly healthy by having less muscle and more fat than that.


Maybe a person who was healthy wouldn't necessarily look like those 3 muscular people I posted, but the DEFINITELY wouldn't look like those 2 fat people I posted. No one is supposed to look like that, our body stores fat not because we are supposed to be fat, but because we need energy when we can't get food.
If you look at the genetic structure of modern humans vs humans 10,000 years ago, we are the same.
Our bodies/genetics are the same as they were, we need the same amount of food/movement as they did. 
My point still stands - if you can't run or exercise to the level that these humans could, then you are not living to the standard that humans evolved to. We have not "evolved" physically away from our ancestors, our genetics are the same, our bodies are the same.
If an eagle couldn't fly, you would not think that that is the proper way of being for the eagle. Flying is an integral part of the bird's existence, just like running/movement is for humans.

The idea that stone age humans didn't live as long is also bullshit - they had a high child mortality rate, but once they passed that they lived to be 70-80, no different from us now. These old people were healthier than most old people today. They also did it living in MUCH harsher environments. 
We are not different from our ancestors, we are not exempt from living to their standard. 



> Also, I find the wording completely ridiculous "should not be tolerated", sheesh, get off your high horse dude...


I like it up here.

I understand that being fat is hard. You get a lot of shit from people that you don't deserve, and even if you lose the weight, it becomes very difficult to keep it off. This is why it is so important to stop people from getting fat in the first place - it becomes a lifelong problem. 

This is especially true if we want a universal healthcare system. I want a universal healthcare system, but not if I have to pay for someone who spent their whole life shoving shit down their throats and smoking 2 packs a day and now has a myriad of health problems that they otherwise would not have had.

Being fat is not natural to anyone, there is no such thing. Calories are units of energy, they adhere to the same laws of physics/thermodynamics as everything else. The ONLY way to become fat is by taking in more energy than you burn over time. It is 100% preventable and 100% your fault for it happening. I don't see why I need to respect someone's body when it is so contemptible.


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