Dear Mark: Healthy Body Weight?

body weight scaleDear Mark,

What do you think about the claim that being heavier doesn’t necessarily mean you’re less healthy than someone who’s thin?

Thanks to reader Corey for his question and for sending the New York Times article that highlights recent research.

The article references a study published in this month’s Archives of Internal Medicine.

It’s true that body weight receives a lot of attention and isn’t always the cut and dry issue it’s made out to be. Let’s first take a look at the study Corey found. The researchers compiled medical information on nearly 5500 men and women to compare height and weight measurements with traditional health markers like “blood pressure, ‘good’ cholesterol, triglycerides, blood sugar and … C-reactive protein.” Their findings showed that, though there was a general association between health and thinness, the connection didn’t always hold. Approximately one-quarter of the thin subjects came up “unhealthy” in two or more of the markers. On the flip side, nearly half of “overweight” subjects were “healthy” according to their markers.

First off, let me address a couple concerns of the research. Although a number of these markers are certainly very useful tools in assessing overall health (blood sugar, blood pressure, C-reactive protein), the others I’d consider more tangential. Furthermore, there are others (albeit some more expensive and too involved for a study of this kind) like stress tests and other inflammation related tests that would’ve been more indicative. Though the markers used are enough to raise some relevant points about body weight, the full picture remains skewed if you ask me. For example, according to the results, about one-third of the “obese” subjects were “healthy” given their marker profiles. To be twenty percent or more over your ideal weight and still be “healthy”? I don’t buy it. Though the impact of this added weight might not show up in the particular markers used (at this point in time for said subjects), it nonetheless stresses the body over time compromising each system of the body.

But let’s get back to the idea of being on the heavier side without being obese. I absolutely believe that some people can be as fit as a fiddle but still not fall into the “svelte” category. While we all share a common “recipe” for a healthy, lowest possible body-fat body, how this recipe plays out for each individual will vary. For example, a man or woman who is predisposed toward ectomorphism can be lean and even reasonably muscular but probably won’t be a likely body-building contender. Likewise, a genetically predisposed endomorph can be remarkably fit and healthy. Though this person isn’t by any stretch “doomed” to be fat, it can be hard enough to get below a certain body fat level for the continued effort to be worth it. Or maybe the added stresses of trying to get below, say, 20% (for a woman) takes a toll greater than the potential benefits. 20% when otherwise well-fed and exercised can still make for a very healthy, attractive and functional body. You can have an attractive, fit, and functional body without driving yourself into the ground to keep that extra five pounds off.

One last note… Some interesting research seems to suggest that a little extra weight may be beneficial for older men and women, particularly those in their 80s and 90s. The study’s authors compared mortality rates of older men and women with recorded BMI. Those who had been of normal BMI when younger but gained weight in their later years fared the best. The researchers noted that other studies have offered similar observations, including a 1985 study that reviewed actuarial data from insurance companies.

Possible reasons behind the benefit of a few extra pounds in later years? I’ve mentioned before that lean muscle mass is directly related to organ reserve, and the effects of this connection are especially dramatic later in life. This research seems to suggest that added weight in general bears some association to organ reserve as well. In the case of major illness, the body has a larger energy reserve to draw from. I want to make the distinction, however, that the benefit of this “extra” weight is a law of diminishing returns. A little additional reserve, being slightly on the heavier side in older age, seems to have its advantages in terms of overall mortality. However, if you carry too much fat, you’re likely undoing any benefit by the stress of the substantially increased weight. At a certain point also, added weight impacts your quality of life – a point most people are just as concerned about as overall mortality. I’d suggest that this is a case of a little (extra) goes a long way.

Thanks as always for your great questions, and keep ‘em coming!

Jill Greenseth Flickr Photo (CC)

Further Reading:

All Past “Dear Mark” Posts

10 Rules of Aging Well

The 7 Habits of Thin (Healthy) People

Skinny Fat: Where Skinny Doesn’t Necessarily Mean Healthy

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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16 thoughts on “Dear Mark: Healthy Body Weight?”

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  1. Thank you so much for this article. I have extremely wide shoulders for my height, and from what I have read I am close to obesity, then I look down and I am seemingly fit and muscular. I think these things are overlooked in the health and medicine profession.

  2. In regards to the elusive “healthy weight,” I use a program called FitDay to track my weight loss progression. Next to my weight is a chart estimating my BMI and placing me in a body image category “healthy weight, overweight, or obese.” At 6’0″ male, apparently my healthy weight lies somewhere between 134lbs and 184lbs. 134lbs?! Seems we’re still a long way from separating the ideas of “healthy” and “skinny.”

  3. Sleeper, we use fitday a lot here to track macronutrient breakdown. Unfortunately, it seems they also use standard whacky BMI stuff and a bizarre estimation of your daily caloric expenditure (I usually run a 1000 calorie a day deficit according to them….I should have lost 30 pounds in the last three months, but my weight is exactly the same)

  4. “To be twenty percent or more over your ideal weight and still be “healthy”? I don’t buy it.”

    Of course, this relies entirely on how you determine “ideal weight.”

  5. I find it interesting that you speak of the “stress” of the excess weight. If for instance you have normal blood pressure, normal blood sugar, and good cholesterol markers, it would seem that being overweight is not “stressing” your body very much. There are definitely overweight, even obese, people who exercise daily and eat a healthy paleo diet. If tests show their serum markers are excellent, I think it’s a mistake to assume their weight MUST be stressing their body in some way.

    Bottom line- it’s your activity level and what you eat that make the biggest difference. If you exercise and eat right, you may be indeed be very healthy even if you have a high BMI.

  6. Lisa, the post in general agrees with your comments. However, I would suggest that if one is eating paleo or “Primal” and exercising, s/he will not be obese. They might not get to their “goal weight” because of the genetic issues we discussed above or because they keep a very high caloric intake, but they will not be obese. As for the added stress of fat, that has more to do with fact that body fat is a repository for many of the body’s toxins. That may be why body fat and cancer risk are correlated.

  7. Mark,
    have you ever considered putting pic’s up of your meals to let the reader’s see.Everyone saw your salad video but show us breakfast,dinner,snack’s etc.

    thank you Bill

  8. You made some good points there. I did a search on the topic and found most people will agree with your blog.

  9. A great article! I think body shape should also be taken into consideration. One of my gym instructors is fit as a fiddle, yet she still has a little bulge over her stomach. Me, I’m trying to come to terms with the fact that I’ll always have “junk in the trunk”. Childbirth only made my hips wider, and no matter what I do I keep losing on top, never bottom. Oh well!

  10. Pear shaped, no matter what. I have lost weigth in the past, my breasts almost disappeared, my ribs were showing and my butt and thighs were unchanged. So, I thought i could never lose inches on my bottom half. But after 2 months on Paleo, I can see and feel my entire body getting leaner. I have been stuck between a size 6 or 4 and realized i am more comfortable being a 4 with a latina booty. If you have trouble finding pants to fit a small waist and curvy booty, I shop at Ann Taylor, good quality and affordable.

  11. I have recently stumbled upon “Mila” the miracle seed. I am wondering what your take is on this omega-3 seed?? I am a 44 yr old woman who crossfits and feel this would be a great supplement for ALL crossfitters. Thoughts?

  12. Does that mean at 27, 200lbs and 26% body fat I need to lose more weight or am I healthy to stay where I am.

  13. As a Muslim, I have to fast from sunrise till sunset for 29 to 30 days a year (during the Arabic month of Ramadan), except on menstruation days (and these have to be compensated some other time of the year). It is also “bonus” to add Mondays and Thursdays on any time of the year. Other “bonus” days are the three full-moon nights in the middle of Arabic months (which are lunar months).