A few days ago a new study was released which indicates that of people living with type-2 diabetes, those in the overweight category live the longest. They even live longer than those in the “healthy weight” category. Newspaper articles like these (TRIGGER WARNING FOR UBIQUITOUS HEADLESS FATTY SHOT) are quick to cite this as another example of the “obesity paradox”. In case you are unfamiliar with this term, the obesity paradox refers to the fact that despite the fact scientists arbitrarily chose to name a lower weight category “healthy weight” or “normal weight”, the pesky fact remains that those of a higher weight on average live longer. And while people in the “overweight” category are more likely to contract certain diseases than those in the “healthy weight” category (such as cardiovascular disease) they are more likely to survive these diseases for a longer time. It’s vexing. Because, not only does this mess up the whole color scheme of the pretty BMI charts, it also means that we’ve been telling people to slim down to a weight that just might not be in their best interest.
One wonders how long the medical establishment is going to cling to this description of the “obesity paradox”, when the solution is so very simple. Change your labels. Change your definition of “healthy weight”. In fact stop saying “healthy weight” altogether. Because while certain weights have some advantages over others in some arenas, they are more dangerous than others. For example recent research indicates that the fattest people are the least likely to suffer from dementia at an early age.
The medical establishment and world at large are unlikely to change these labels any time soon however. The reason? Cash. Money. Cabbage. Moolah. Being able to charge over and over again for obesity treatments that don’t work is big money. Adding the word “obesity” to your research proposal increases the chances of getting funding and increases the amount of funding you are likely to get. Heck, as Harriet Brown’s excellent article in the Atlantic states–even mentioning the word “obesity” in a medical exam might mean you are able to collect more money for that patient. That’s why we classify obesity as a disease, even when expert panels in the medical establishment recommended against it.
I wonder when we are going to publicly accept the real obesity paradox. That we have a situation that occurs naturally in a certain segment of the population, that in some cases is potentially harmful and in some cases is potentially beneficial. Yet we label it a disease and focus billions of dollars towards trying (unsuccessfully) to change it, without any evidence that changing it will in fact, make people healthier, happier or live longer. That, to me, is the quintessential definition of a paradox.
Jeanette DePatie (AKA The Fat Chick)
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