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!