Friday, May 26, 2017

Obesity Can't Be Healthy

A little more than ten years ago the “fat pride movement” began to pick up momentum.  The claim, supported by some studies at the time, was that it was possible to be fat and fit, that an active overweight person was healthier than a sedentary skinny person.  This was good news for those who felt they were being discriminated against and bullied due to their body shape and size.

When I list and describe the five behavioral dimensions, responsibility always follows discipline.  The simple reason is that it’s easier to find an excuse or justification rather than doing the hard work to address a problem, whether that be quitting a bad habit, saving more for retirement or maintaining the proper weight.  Dieting is hard; lifestyle changes are challenging.  A movement that advocates acceptance over change can be both refreshing and alluring to those who are struggling.  Why do the hard work when there may be supportive medical research as well as a possibility that the rest of society can be pressured into accepting us the way we are?

Last week the main argument for fat pride was undermined by a new study.  After examining the medical record of 3.5 million people in Britain over 20 years, this yet unpublished study found that “people who were obese but who had no initial signs of heart disease, diabetes or high cholesterol were not protected from ill health in later life.”  This contradicted much of the previous research.

In the study, people who were obese but metabolically healthy, that is with factors such as blood pressure and blood sugar within recommended limits "were at higher risk of developing heart disease, strokes and heart failure than people of normal weight.”

Other factors do enter in, such as weight distribution, genes and other lifestyle choices.  A very large sample is important because some overweight people live a long time, as do some smokers.  But the advice from medical professionals remains the same:  not smoking, eating a balanced diet, exercising regularly, getting the proper amount of sleep and limiting alcohol.

Except for the impressive size of the study, this is not exactly breaking news.  A few years ago, Forbes ran an article about an earlier study concluding “for most people, healthy obesity is just a phase that will likely give way to unhealthy obesity in the future” rather than putting them in the same risk category as healthy thinner people.

Losing weight and keeping it off is hard work.  It’s easier to grasp at excuses.  People should not be bullied or harassed for being overweight; they should be supported in their quest for a better, longer life.  This is true for a couple of reasons.  First, to tolerate poor behavioral choices that result in controllable consequences is to compromise our standards.  Second, in America, like it or not, the cost of everyone’s healthcare is charged back to all of society through insurance premiums.  The healthy support the sick.  The smokers, drug abusers, obese, etc. are an economic burden on the rest.  It’s everyone’s civic responsibility to be as healthy as possible to minimize the waste in society.

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