The Fat and Skinny—There’s More to Consider

With a national adult obesity rate of over 35 percent and over two-thirds of the country either obese or overweight, there has been a major push toward educating people about the health risks of being overweight with particular focus on the harmful effects of the accumulation of belly fat. Not for nothing, the obesity epidemic certainly calls for increased awareness and change—something’s gotta give (other than waistlines). But we overlook the entirety of the story if we simply vilify people based on their overweight-ness.

Yes, measuring BMI and waist circumference is important, but only if it accompanies other measures of metabolic health, such as cholesterol, blood pressure, blood sugar, insulin, gut function, stress, toxin exposure, and overall fitness (to mention a few). This applies to everyone—fat and skinny alike. We all know that skinny person who seems to be able to eat anything and not gain weight. But it is these very people who may not dig deeper because they assume they are healthy based on outward appearances. Many of these people are normal weight and yet have abnormal blood levels of important health markers that go undetected. This phenomenon is known as skinny fat, and it’s more prevalent—and dangerous—than you think.

On the other hand, we also assume that because a person carries extra weight that they are destined for heart disease, diabetes, etc. While obesity does predispose people to heart disease and related conditions, not all obese people are metabolically doomed. This phenomenon is known as the obesity paradox, and it was recently highlighted in a study published in the European Heart Journal.

The study found that there exists a subset of obese people who are metabolically healthy. That is, these obese people do not have insulin resistance, diabetes, high cholesterol, or high blood pressure. Forty-six percent of obese individuals were found to be metabolically healthy, and had a 38 percent lower risk of death than their metabolically unhealthy obese counterparts.

The explanation? The metabolically healthy obese individuals had greater cardio-respiratory fitness—in short, they exercised. “Based on the data that our group and others have collected over the years, we believe that getting more exercise broadly and positively influences major body systems and organs and consequently contributes to make someone metabolically healthier, including obese people.”

I have a feeling that the estimate of “metabolically healthy” as defined by these researchers is not quite as stringent as some experts would agree on. For example, when you take a closer look at cholesterol levels, healthy total cholesterol levels, or even healthy LDL cholesterol levels may not actually tell the whole story once you take a closer look. So don’t read this article and assume that if you’re overweight and exercise, you’re good to go. What I do want to emphasize is the importance of taking the whole story into account. Look at a range of metabolic measures as well as lifestyle factors such as diet, exercise, stress, toxin exposure, and digestive health for the best determination of your health. It’s got to be a comprehensive approach, or you’ll miss some important details.

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