Fat people may be healthier than slim people

by Julie Smith

Many of us are anxious about obesity and the risks of incurring heart disease and diabetes. But the strange fact is you could be healthier than many slim people. "Concentrating on people's weight is a big mistake," says Dr Paul Campos, author of The Obesity Myth and a professor at the University of Colorado. "The culprit for health problems associated with weight is a sedentary lifestyle and poor nutritional practices, not the weight itself, except in extremely obese cases".

Statistics from the prestigious Centers for Disease Control (CDC) in Atlanta warned obesity was a new plague and approximately 400,000 overweight and obese Americans die every year as a result of being overweight. When the CDC data was reanalysed by the US National Center for Health Statistics, while obese people were at greater risk of premature death compared to those of normal weight, overweight people were at lesser risk. The centre's Dr Katherine Flegal says: "Although people think there is all this evidence out there showing a high mortality risk associated with being overweight, in fact the literature doesn't show it."

Further evidence was shown in 2005, when statistics published in a top medical journal showed people who were overweight were less likely to die early than those classed as normal weight.

BMI is the current measure of how fat we are. 18 to 25 is normal and healthy, over 25 to 30 is overweight, and over 30 is obese. The problem with BMI is that it does not take into account the location of where fat is located in the body. Dr David Haslam, chair of the UK National Obesity Forum says "you can get athletes packed with muscles who show up as overweight, and people can be slim but unhealthy".

Where is the extra fat located on your body? When comparing health and weight, location makes a big difference.Additional fat packed around the organs in the abdomen is more metabolically active. It releases acids that raise heart disease risk, along with factors that increase blood pressure and blood sugar. The fat on arms and legs may have a protective effect. This isn’t what women want to hear but with a very high BMI of 48 they have half the heart attack risk of women of normal weight, providing their weight was on their hips and buttocks rather than their waists. "We'd really like to see GPs measuring patients' waists," says Dr Haslam. "It's much simpler and more useful; over 40 inches for a man and 35 for a woman are the danger signs".

What is the best way to lose visceral fat or lower your BMI? The standard recommendation would be to diet and the new drug Acomplia claims to be effective in reducing visceral fat as well as raised level of fats in the blood. But evidence suggests that diets themselves can create problems over time. Last year a study involving 3,000 people, reported in New Scientist, found the most successful dieters were at higher risk of dying early. This may be because yo-yo dieting is bad for the immune system. Research suggests that women who had gained and lost 10lb at least four times before the menopause were more likely to have reduced blood flow to the heart. Women whose weight was stable had a more active immune system.