Overweight Doesn’t Mean Unhealthy, But Lose Weight Anyway!

Sarah Mahoney’s article on MSNBC (and Prevention magazine) looked promising:

The overweight debate: Healthy and heavy?
Has science overemphasized the danger of a few extra pounds?

The article itself?  Not so much.  It does start off well, noting how people within the CDC’s “overweight” BMI range have longer life expectancies than those at “normal” weights … and adds

However, no one’s debating that weight loss can be one part of an overall disease prevention plan.

Gee, might it not make sense to mention that people are debating that lasting, substantial weight loss is possible for the majority of obese folk?  No?  I see.

Mahoney then asks, “But is it the most essential first step?  That depends on how many other disease risk factors you have…” and goes on to list age, family history, waist measurement, fitness (repeating the 30 minutes of walking 5 days a week) cholesterol, and  inflammation (using C-reactive protein).  Most of this is familiar, and Mahoney does not lump “overweight and obese” into one category.

Mahoney’s doctor used the Framingham Risk Score (an online version is here) which determines a 10-year risk of heart attacks, and told Mahoney she had a “very low” risk of heart attack.

She decides to lose weight anyway by increasing her exercise and changing her diet, gradually losing 7lbs in 4 months (yes, 7lbs may be still within her setpoint range).  She writes,

My back and knees feel better; my cholesterol is a bit lower. Maintenance, though, is a daily struggle, and as the scale number rises and falls, so does my mood. I recalculated my Framingham Risk Score with my new weight — still the same 1 percent risk. Just for fun, I keyed in my dream weight of 130. Maddeningly, no change.

Still, I realized something. Even if it wasn’t about my heart health or my “relative risk of mortality,” it simply feels good to weigh less. I’m happy I can walk my dogs without pain, slide into my jeans without struggle, and buy a one-piece without cringing. If that’s not quality of life, what is?

Myself?  I wholeheartedly agree that walking without pain is valuable, though I also wonder whether that’s due to weight loss alone, or if the increased exercise played a part.  The mood, jeans and bathing suit?  Is all about self-esteem and attitude.  Those are things I don’t want to rely on a scale to dictate.


Just for grins, I calculated my risk of heart attack according to the online version of the Framingham risk score calculator linked to in the article (more details on the heuristics are here). I have the same 1% risk as Mahoney.  I also found it interesting that neither version uses weight in its calculations….

8 thoughts on “Overweight Doesn’t Mean Unhealthy, But Lose Weight Anyway!

  1. I’m clinically obese.

    My blood pressure, cholesterol, triglycerides and blood glucose levels were all within a healthy range when I went to the doc’s a couple of weeks ago.

  2. I’m what they call death-looking-for-a-place-to-happen obese and my numbers are all good. I plugged in my stats to that risk calculator, and at 5′ 8″ and 375 lbs, my risk of heart attack is also 1%. So losing weight isn’t going to change my risk. As for how I feel and how I look in my clothes, I’m fine with that, so why put myself through the torture of dieting simply for aesthetic reasons? Talk about a waste of time and energy, that’s it right there.

  3. Seven pounds is so totally meaningless for ANTHING except ‘fitting into my jeans better’, which can be accomplished by buying a larger size. Nor is seven pounds enough to go from walking with pain to not walking with pain, so that may largely be her imagination. (By the way, many fat people do not have chronic pain & many thin people do, stereotyping again.) And I do love that she clings to the same idea Gaesser believes in, that waist measurement is some indicator of health.
    She totally disregards that weight loss itself is dangerous to our health & becomes moreso with age, so that by the time one reaches my age, weight loss increases mortality risks by a considerable amount. And, of course, as you mentioned, the fact that it is virtually impossible for most of us to lose a great deal of weight & even more impossible to keep it off, so many people damage their health, shorten their lives, & destroy their self-esteem & quality of life by dieting over & over again, sometimes, gods help us, until they are in their 80’s.
    Seven pounds over four months? My weight can fluctuate that much over a couple of weeks. Something tells me that this a woman who is thin to average-sized & who doesn’t even admit to herself that people over 200 pounds who don’t instantly drop dead EXIST, let alone over 300 or 400 pounds. She sounds to me like another thin person who thinks her jeans were too tight & certainly not one of us.
    As for heart attacks…I am from a family of mostly fat people, most of whom have lived well into their 80’s & 90’s, & heart attacks are scarcer than hen’s teeth. I currently have three brothers in their 70’s, two of whom are very fat (260-270 pound range); none of them has ever had a heart attack.
    I will live as long as I live on my own terms in the body I have & all these idiots who think I MUST lose weight for whatever mythical reason they can think of can kiss my fat ass!

  4. I don’t know how this factoid got into my head but it’s “Exercise improves body image even if there is no change in weight or measurements.” I think I read about a study that showed this, but I don’t know the details, or whether the exercisers had improved functionality (which might explain improved body image) or whether they just felt better maybe because exercise seems to improve mood in general.

  5. Stef, I don’t recall that myself but it makes a lot of sense. Exercise is great at reminding you of what your body can do, and may cause improvements in how you do it. Ideally these are HAPPY things :)

    Re: losing 7lbs, I agree with Patsy that it’s a small amount -Mahoney wrote that she chose that goal because it was 5% of her body weight, which is an amount researchers say is more likely to be sustainable.

    What Patsy’s comment on how 7lbs is within her normal range reminded me of how useful it can be to translate pounds into percentages when talking with average-weight friends. Saying I dropped 15lbs in 4 days with the flu sounds freaky; saying I lost 3% or so of my body weight with the flu sounds normal. Or compare “Most consumer scales can be off by 4-6lbs” to “most consumer scales are off by 1-1.5%”. Which sounds more reasonable?

  6. Good points. And if seven pounds is 5% of this woman’s starting weight, that also proves my point. She started at 140 pounds & now weighs about 133, which is quite thin, so she knows nothing about truly fat people or living in a fat body. And that crap about ‘losing 5% of your body weight improves health” has pretty much been proven to be just that…crap. It isn’t true for any of us, nor is even that much weight loss usually permanently sustainable for most of us & there is just NO WAY that a woman who weighed 140 pounds could have any health or mobility issues caused by her weight. Exercise does improve body image, I think, & most likely increasing fitness may help us to feel better, but a person of 140 pounds is not going to have trouble walking around unless she has a disability.
    Losing 5% of MY body weight would be around 10 pounds, which would change nothing except to make my jeans a bit looser & some studies indicate that a deliberate loss of even that much can cause problems for many people. I will continue to move as much as I can for my overall health & mobility, eat what I please, & allow my weight to fall where it may.
    I wonder if this woman even stopped to realize that her 5% loss of 7 pounds at 140 would only translate to ten pounds for someone she must surely see as ‘very fat’ at 200 pounds or just 20 pounds for someone who weighs 400 pounds. There is very little chance that it can make any real difference in someon’s overall health, except for the negative effects weight loss can cause, though it may indeed help to change that person’s body image & be seen pschologically as beneficial.

  7. Pingback: Health Assessments | Living ~400lbs

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