The Obesity Myth: Is Overweight Healthy?
The Obesity Myth challenges widely held beliefs regarding healthy weight. Written by Paul Campos, a Columbia Law professor and newspaper columnist, this book takes on the diet industry, respected medical journals and even the US Surgeon General.
Campos begins this expose with a thorough examination of "obesity research" and concludes:
- Overweight to moderately obese people have a longer average life span when activity levels and a balanced diet are accounted for.
- It is more harmful to your health to lose and then regain weight than it is to remain overweight.
- Most dieters are unsuccessful; therefore advocating weight loss for health is irresponsible.
Frankly, the amount of information presented in the beginning is overwhelming but necessary as the book takes on such giants.
In later chapters, Campos examines how society's views about weight influence our culture. His book is filled with sad and sometimes humorous anecdotes, including Campos' own story.
This book raises new doubts about relying on other's interpretation of data. It also confronts the destructive attitude that our country has about size.
Many thanks to Jill Gray who submitted this review.
Editor's Note: A new article in the Scientific American challenges this viewpoint. It claims that research showing overweight people have slightly better mortality than normal weight is flawed. - Jim
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Interesting.
In India and Tibet my monk friends always say that fat is healthy. I think they are talking from a real primitive point of view - if your fat you're eating and therefore not starving.
I know this guy might have some good arguments but heart disease being the number one killer with diebetes and so on also on the list you couldn't say it is healthy to be overweight.
RT
ReplyHow many overweight 80 year olds do you know?
It's quite hard to eat healthily AND be overweight unless you overdo the olives, avocados and nuts because natural food generally has a low caloric density and a high nutrient density.
Your plate can be piled high with food -- maybe twice the volume of a normal serving. Yet less calories.
I've heard stuff like this too... like in Africa, fat Westerners being admired. I guess if your struggling to get enough food, being fat would be a good thing. Fat = successful.
Cheers
Reply~Mike.
I think that there's some point to this stuff - it's probably a lot healthier to be 5-10 pounds overweight with healthy habits than not eating enough to have any energy or working out to the point of injury because your body just doesn't want to lose that weight and totally stressing out over it.
I'm guessing that unless someone is carrying so much weight that it's putting a lot of stress on their joints and organs, it's the habits and not the weight that will contribute to health problems.
The thing is, healthy eating and excercise will lead to a weight within the "healthy" range in most people. Eating junk and not working out, usually won't.
And the Scientific American article addresses some criticisms about the study, however, it in itself is fairly flawed. No, that study doesn't *prove* anything, but the researchers did look at a full sample - both including and excluding those who were thin due to illness - simultaneously.
It drives me nuts how much stigma is placed on weight in our society. It's not weight that's the issues. It's the habits that in most people are correllated with their weight. And that does not give us license to judge and call it "concern about a health crisis."
ReplyOne needs to read the book before one can make a meaningful criticism of the ideas it expounds. For instance, Campos brings forth evidence that overweight people do NOT have a higher incidence of heart disease or diabetes than average-weight people. His discussion of the way health statistics are analyzed by insurance companies is fascinating and eye-opening. One reason that lower body weight is associated with longevity is that younger people tend to be lighter than older people, and not surprisingly a 20-year-old has a greater expected remaining lifespan than a 50-year-old. He also describes a study in which X number of people maintained a program of daily exercise and healthy eating. All of the people in the program saw improvements in their blood pressure, cholesterol, etc. The average weight loss was 4 pounds. The results of the study were announced as "Losing 4 pounds improves your health." But in fact, even those participants who lost one pound, two pounds, or _no weight at all_ had the same improvements in their stats (not improvements proportional to their weight loss; the SAME improvements). The results should have been reported as "Regular exercise and healthy foods improve your health"--it had nothing to do with fatness.
We are all so emotionally invested in the idea that fat = bad, and that fat people are lazy gluttons, and all they have to do is eat a little less, that it's difficult to accept--or even consider--other theories. People who are not fat get the satisfaction of feeling morally superior and blaming fat people for their condition; people who are fat get to maintain a shred of hope that they can change it. Accusing fat people of being unhealthy is always the ultimate argument, the bludgeon that no one can escape. Now we see the health angle may not be valid, or may have much less relevance than previously believed.
For every theory advanced, one can find a different expert to refute it or support it. We see study after study twisted and misinterpreted and fubared to the point that we simply cannot rely on what we're hearing, whether it's Campos or his "opponents." When it comes to weight loss, especially, I find that the best thing is to rely on my own directly-perceived individual experience (which is not incompatible with Campos' ideas). This is a sad commentary on our current media, that subjective anecdotal experience is more to be relied on than published scientific studies.
ReplyArgh! I hate the way the reporting of studies exacerbates this.
You know what makes people gain weight? Quitting smoking. What makes people lose weight? Drug addiction. Clearly one is a healthier habit than the other.
I am so with you on this, Marla. We don't demonize people who don't wear their seat belt or don't properly wash their cutting boards unless we know them well and truly care about them. The health argument is an excuse to judge and it incenses me. If you want to be shallow and judge people, admit it. People can be shallow. But it doesn't make you morally superior to look down your nose at someone for their body size - quite the opposite in fact.
This emphasis on being thin and thinner and thinner is not healthy. The emphasis should be on the habits, since they're what's healthy. The overwhelming stress we put on being thin is just as likely to lead to unhealthy means of getting there as it is to actual good health.
The way this stuff is presented, it's as if thinness is correllated with immorality. Thin people get cancer, too, and get million-dollar treatments to extend their life a year at the end. Hell, thin people can get heart disease and high cholesterol. Everyone dies of something, and lots of things - weight related or not - can cost a lot of money in medical treatment.
I hate that people are going to take this as me trying to make some sort of excuse, but what I hate even more is that the ridiculous amount of attention I see paid to this "obesity crisis" makes me feel guilty for not having an eating disorder. Because really I'm only ten pounds from being overweight. (yes, this demonization of weight stuff often leads to me being annoyed and facetious, but that last part? sadly serious)
ReplyWell, technically speaking, based on the national Behavioral Risk Factor Surveillance System (BRFSS, and excluding territories), the median prevalence rate of overweight (30 > BMI >= 25) increases with age from 26.9% of 18-25 year olds to 40.2% of 65+ year olds. If you collapse the overweight and obesity categories, you then get a different picture. The median prevalence rate of overweight (BMI >= 25) increases by age group, but then drops for the 65+ year olds. Granted one of the biggest limitations to the BRFSS is the fact that it's self-reported data, so the National Health and Nutrition Examination Survey would better assess this since they actually measure height and weight.
Anyway, the truth of the matter is, it's hard to prove causation, but the fact that there have been a number of statistical associations between BMI and chronic conditions, you betcha I've been working hard at losing weight. I actually might check this book out for a light read. I don't know many studies that show it's healthier to remain overweight than to lose and regain. If it's a true lifestyle change, you won't be regaining much.
ReplySo the point should be HOW you get fat or HOW you lose it.
RT
ReplyMost diets don't work. If they did work, then everyone would be slim and the diet industry wouldn't be making billions. Just because you are a bigger person does not mean you are unhealthy or will live a shorter life. Mostly, it means you will have to deal with a certain amount of prejudice in this country.
ReplyIt is clear that in todays world, thin is in. In Victorian times being overweight was considered beautiful. Then there was the time that not tanning was beautiful and women walked around with umbrellas to shade themselves from the sun. And today? Despite evidence that tanning is bad for you, our society wants us to bake!! If you ask me, the point here is clear, your physical health is not merely judged by numbers on a scale or by your appearence. I am overweight, actually according to the weight charts, OBESE but when I have asked my doctor's to please help me I am laughed out of the office, because there is NOTHING WRONG WITH ME. I do not have high cholestrol, diabetes, or any other chronic, life threatening or not, illness. Could this be because I enjoy a wide variety of foods and activities? Could it be that because I am a female, my body is naturally inclined to save weight, save energy for childbearing? Whatever the reasons, health is NOT mandated by a scale. When I can't even get my doctors to take my weight seriously, how can I be expected to? If you ask me, thin is out, healthy is in. And I am healthy!
ReplyNo matter how many points you put in favour of obesity, obesity is bad for health (heart attacks, stroke,etc.). Plus the fact of being obese in a society where image counts a lot, can have tremedous psychological effects.
ReplyI think at the point that you're carrying around serious weight and straining your joints, having sleeping problems, etc. yeah, it's bad for you. But for most weight-related issues, theyr'e not so much related to the *weight* as to the things that often make people gain weight in the first place. Not getting any physical activity, eating a diet based on processed, nutrionless food...
And the tanning example above is great. Heavy tanning is TERRIBLE for you. But we don't scowl at people on the street and make nasty comments in the guise of their health (unless maybe it's to the point of unattractiveness).
To say that "people will make fun of you, so you shouldn't be fat" is pretty bad reasoning. Yeah, people are jerks sometimes, but the people being judgemental are the ones with the problem. I'd make an analogy, but I don't want to incite anything. Though I will point out the more I find myself judging others, the more insecure I end up becoming. It's particularly pronounced about weight.
ReplySeveral studies I have read have seemed to support the idea that the negative behaviors (unhealthy foods, lack of activity) are the real cause for health problems, not the weight itself.
My doctor tells me I don't need to lose weight despite being 20 lb overweight because he's seen my exercise and food logs and my physical stats -- blood pressure, resting heart rate, etc.-- actually, since I have a history of disordered eating he prefers I don't do it at all (though I am anyway)
I believe I am much healthier than a thin person who does not exercise.
ReplyFactual correction to the review: I think Campos is at the University of Colorado (the place that hired Ward Churchill), not Columbia. I somehow don't think you could hold down a job as a law professor at a tough law school like Columbia while moonlighting as a fat acceptance advocate.
ReplyI am not an advocate for being overweight, or for being thin. I am an advocate for being healthy. You can be..what I am, which is "obese" according to weight charts, but not the naked eye, and be in perfect health.
There are points to be made for working out, and then there are those that take working out to the extreme and destroy their joints by excerting too much on their bodies, whether it be through weight lifting or running their knees into the ground.
I am not at risk for heartattacks, or strokes, which is probably due in large part to what I eat and my activity levels. But those things have not changed the weight I gained during my first pregnacy. It has been what it is for 17 years, and yes I have tried my fair share of diets, and gyms. My doctors, many different ones over the years, have laughed when I reached out for help because even though the scale says I am obese, they can plainly see that I am healthy, in good condition and should not be worried over what some chart says.
If you dont like who you are, or what you look like, then by all means, do something to change it. But please dont let society dictate to you what is beautiful and therefore "good". Make that choice for you!!
ReplyI agree that healthy habits are way more important than weight. There are lots of factors that could make a thin person more unhealthy than a fat person...drug use, smoking, osteoporosis, illness, etc. I figure as long as a person has a healthy cholesterol level, healthy BP, fairly decent resting heart rate and good muscle tone, weight shouldn't be an issue. I think daily exercise is a big factor in determining health...a fat person who gets a lot of daily exercise is probably a LOT healthier than a sedentary thin person.
ReplyEven though I am a surgeon, I have a strong interest in health and fitness. I would just like to add these words of 'advice.' If you are under, let's say, 40 years of age, do not underestimate the protective factors of 'youth'. I hope it doesn't happen, but if you are setting yourself up for an 'illness' two things. One, you won't like it when it happens and two, it's much wiser to avoid a disease than to recover, if ever, from it. Prevention is our last, best hope.
ReplySpectra
Thank you. That is the point I keep trying to make. Thin does not mean healthy anymore then fat means unhealthy. Health is not measured by a scale or a weight chart. A perfect example: You lift weights, you are active, you eat well and you feel good, but when you get on the scale the number says you are obese. You know there is some fat on you, but by no means are you unhealthy.
Look, I am a firm believer health. Not appearance. You wont find me baking on some beach because some fool decided that to be attractive you have to be a golden brown color. Just like you wont find me in some gym killing my elbows and my knees trying to look like some supermodel who eats a muffin and works out for 3 days!
ReplyWonderful words from what I take to be a very smart person. Prevention is the key to health. (And health is not about how you look!)
Don't smoke or use drugs, be active, eat your fruits and veggies and laugh people!!
ReplyBy the time people reach that age, they may have medical problems that cause them to lose weight or lose their appetites or they're on medications that have that effect. Or they've gone through chemo, surgery, etc.
And there is something called age-induced anorexia--the elderly lose their appetite as the body prepares to shut down. So this is another case in which thin does not always equal healthy--in the elderly, it can signal serious health problems. I had a grandparent who wasted away with age-induced anorexia. He was a skinny 80 year old, but he sure wasn't healthy.
ReplyHmmm I'm not convinced. In my whole life I never met an overweight 80+ person. The one sure thing we know about longevity is that calorie restriction works.
Look at the Okinawans and their cultural practice of hari hachi bu -- eat til 80% full only.
The story of Luigi Cornaro is a fascinating read of the power of calorie restriction stumbled upon by an sickly Italian nobleman I think it was in the 1800's
There's lots of data on this.
Cheers
Reply~Mike
Then apparently you've never met any of my family members! I know TONS of overweight elderly people.
Ever worked in a rest home? Trust me. They exist!
My grandfather lived well into his 90's and was considered "obese" by BMI charts.
I've lost over 70 pounds this last year through diet and exercise. I am much healthier than I have ever been in my whole life yet I'm still considered "overweight" according to the BMI.
I can go to the gym and workout for 90-120 minutes. I'll see thin girls come in, walk for 10 minutes on the treadmill and have to sit down and eat a protein bar. Where's their superior health and energy?
ReplyI wonder if this guy addressed quality of life, since I believe that obesity may cause chronic illness.
I only skimmed through other comments, but I’ve noticed that someone pointed out that there aren't a lot of elderly fat people. But I don't think you can make an accurate conclusion with this, since diabetes at its late stages causes you to lose lots of weight.
Reply@Passion for Health
Eating until 80% full (assuming that means satiated but not stuffed and not still 20% hungry) is generally good practice, not calorie restriction.
The studies showing that true calorie restriction may lengthen life are very preliminary. Not only are they in rats, not people, but the reason rats live longer is because their metabolisms slow and their reproductive systems shut off. Maybe it lengthens lifespan, but that doesn't sound particularly healthy to me.
But, yes, not stuffing yourself and eating only when hungry are pretty good. Hell, the feeling of eating until 100% full and can't eat anymore is not only bad in the long term, but feels painful in the short term.
ReplyAs a family doctor I can tell you that most of my diabetic patients are overweight. And some of those patients have ended up on dialysis and have had leg amputations. Granted, these are the patients who refused to take care of themselves. But my point is that if they weren't obese, they wouldn't have been at such a high risk of diabetes and it's associated horrible complications. Which is why I will do anything (including stand-up comedy) that I can to convince people to eat better, exercise and lose weight. This book cannot be taken seriously by anyone who has taken care of patients.
ReplyMike/Passion for Health, I know there's lots of data on the benefits of CR and I try to be aware of how much I'm takin in--I was just pointing out that unfortunately in the US, many elders have health problems which affect weight. And yes, many health problems are connected with how we take care of ourselves; our lifestyle is not as healthy as the Okinawans. And FWIW, my stocky grandmother lived until she was 88. She was never very slim to begin with and enjoyed butter and wine.
And stand up doc--do you tour or just perform locally?
ReplyMike!
ReplyGood to see you writing on Diet-Blog, mate!
I did some reading up on C.R. and I see that it has been studied in several amimals, including primates, with life extention being proven in every study! I also read that in the human studies, every biologic marker indicating the potential for a healthier, longer life is increased. They can't study actual life span, because these darn people just won't die! Only kidding :-)
Hey Doc :-) Well I'm always lurking in the background :-)
Did you come across the biosphere project? That's quite interesting. They lived in self-sustaining contained eco-system that was supposed to be able to feed them but it didn't produce enough food.
Apparantly they all got really healthy.. or some such thing. Sorry to be so vague, the biosphere is on my radar but I haven't gone into it in a lot of depth yet.
There's a really wacky guy here in the UK who's a scientist and mad into CR. He gets a lot of his calories from beer! Why does the UK produce so many eccentrics? :-)
On your diet I reckon you gotta be seeing 100.
Take care,
ReplyMike.
That's great. We don't know how long she would have lived if she wasn't stocky though eh? There's always going to be exceptions due to the normal distribution of statistical facts. My grandmother died age 93 and her diet was rubbish but wasn't overweight and had VERY good genes.
The last 20 years or so we're gradually failing health. Eyesight and hearing gradually disappeared, recurrent infections and so on. For me personally, long life wouldn't be worth it if there wasn't also quality. I've had 13 years as a zombie with CFS and I've had quite enough of that :-)
I'd like health, health, health and more health followed by sudden death (I fall asleep with a smile, to the sound of my great grandchildren singing lullabys and don't wake up, age 123, leaving a million dollar inheritance for my family)
~Mike
ReplyI would imagine the benefits mount up the less you eat with diminishing returns to the point where the benefits stop and you start starving :-)
Eating is a stress as well as a necessity. All that processing of food. I think maybe the oxidative stress is a big factor -- although I'd have to check that.
When I did an all raw diet to heal from CFS, I reckon I was eating around about 1400 cals and maintaining my weight of around 147-154lbs. That's only a very rough estimate thinking back to what I used to eat.
The funny thing is though that 1400 is what I'd be doing if I was doing CR to the max. But on all raw, I wasn't thin or losing weight but easily maintaining weight.
I was having some meals of just fruit--one type and this is very efficiently digested. Very LOW thermic effect.
So, by eating in more natural ways... e.g. one food at a time and low thermic effect (always an advantage in nature when food is hard to come by) there is less stress on the body and so it makes sense that you'd extend life in this way.
Just some random thoughts. A bit wacky for the prevailing mindset and beliefs I know but I reckon, in the fullness of time, will prove to be right.
Cheers
ReplyMike.
Rah! Keep up the good work. You might be interested in a new film coming out next year I think. 6 folks with diabetes CURED in 30 days. Yes CURED by Gabriel Cousins program of raw foods.
http://www.rawfor30days.com/index.html
To quote one of the guys "This program works... that other shit don't work."
The trailer is very inspiring.
~Mike
ReplyOh you are a tease :-) What was his weak link?
ReplyDon't worry--curiosity got the better of me. :-) I looked it up. Very interesting guy! The story goes that he got the disease that killed him whilst in the biosphere -- something to do with the soil giving off gas and polluting the atmosphere. Is that your take on it?
ReplyI know a lot of overweight 80 year olds. Even some in their 90's.
ReplyMike!
ReplyI wasn't sure it was ALS when I typed the comment :-)
I don't think anyone knows why most cases occur. Unfortunately, I think it was as I said:"His weak link." Chance plays a role in all of our lives. We try to stack the odds in our favor and stay out of harm's way, but chance plays a role, for good or evil.
It seems to me that a lot of diseases associated with being obese are actually more closely associated with being obese AND sedentary. My grandmother just got her hip replaced and now she walks every single day for 3 miles. She's overweight, but she doesn't have any blood pressure, cholesterol, or diabetes issues. My MIL never exercises at all and never has...she has type 2 diabetes and high cholesterol.
I plan on staying active as long as I possibly can. I don't plan on being an 80 year old that's stuck in a bed...I'm going to be out there running marathons! :)
ReplyMike,
I don't know what to say about calorie reduction and people being overweight in their 80s. I've read both sides of CR, and I've wondered about separating calories from bulk - that is, does it correlate more with the whole digestive load (which is only partially correlated with calories). And, my family has had plenty of overweight octogenarians. I attribute it to wine and garlic :)
ReplyBlimey :-) My feel is that marathons are very stressful for the body in many ways. Fit doesn't necessarily mean healthy in my view.
Mike.
ReplyYeah, that's the one :-)
You've got good genes then :-) What about garlic wine? That could be good eh :-)
You mean juicing?
Hmmm I wonder if there's any actual data on bodyweight and age of death?
ReplyIn 2006, USA Today ran a piece called "Obesity at age 18, death in middle age"... check it out.
Here's a quote from that piece;
Michael Thun of the American Cancer Society says the new study adds to the wealth of data showing that "obesity is detrimental to health and shortens longevity."
"Wealth of data" are the words that jumped out at me. I'm sure if someone turned their life around and ate right, exercised and so on, then the actual being overweight part wouldn't necessarily be a problem--I'm just guessing but I don't see how the actual fat cells sitting there can do anything harmful.
It's HOW they got there that is doing the damage.
But, eating right and exercise would naturally bring the weight off anyway so.... there we go :-)
Cheers
ReplyMike.
What an amazing discussion!
I have to agree with those that opine that it is largely the habits that have contributed to obesity and not necessarily the obesity itself that is responsible for ill health.
I also have to say that to call obesity-related problems a "myth" is irresponsible. Now, I haven't read the book, so I will reserve judgement until I do. I will, however point out that numerous studies (see below) that do implicate obesity as an individual risk factor for chronic disease.
Science writer Michael Fumento is a pretty big critic of Campos' work and says this about the "Obesity Myth"
"Campos devotes less than two pages to pooh-poohing the notion that obesity causes heart disease, relying on quotes and select studies dating back to 1950. Yet enter "obesity" and "heart disease" into the PubMed online database of science and medical journals and you'll pull up more than 2,900 studies."
Further, I don't think Campos can deny the affect of excess weight on the joints (osteoarthritis).
Again, I believe in the message of health before weight loss and that you can be healthy and carry excess weight. I just hope people don't construe his message that there is no need to worry about being overweight.
http://jama.ama-assn.org/cgi/content/abstract/289/2/187
http://content.nejm.org/cgi/content/abstract/338/1/1
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=15131540
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=15046144&dopt=AbstractPlus
Reply