Studies: Overweight is not unhealthy? The bottom line on diabetes, heart disease, arthritis risk and more.

by James Hubbard, M.D., M.P.H.

I have read and reread the obesity articles in the August 11/25, 2008, Archives of Internal Medicine attempting to glean a take-home message. They’ve been all over the news because they surprisingly concluded that about a third of overweight and obese people are at low risk for type 2 diabetes and cardiovascular disease. As if that weren’t enough, around a quarter of those at normal weight are at high risk.

So what is it about the fat that’s different? What do we do with this data?

I think we use it as a building block for more focused investigations to better predict who is at risk and what puts them that way.

We already knew fat localized around the abdomen (apple shape) increased the risk of heart disease. These studies confirm this in everybody but the obese. Overall fat in and around the liver, detected by MRI, seemed to have the closest correlation to risk, but it’s not cost-effective or practical for everyone to have an MRI. So what do you do?

  1. Don’t use this as an excuse for being overweight. These studies looked at cardiovascular and diabetes risk factors only. Increased weight is still associated with hip and knee arthritis, sleep apnea and even increased risk of some cancers. Also, they determined risk factors only, not deaths or disabilities.
  2. Don’t assume you’re healthy just because you’re normal weight. Don’t neglect periodic physicals and lab tests.
  3. At all weights, smokers had increased risk factors and those who exercised and drank alcohol moderately had decreased risk factors.

What is your take? Is it different? I would love to hear other thoughts, insights or experiences.

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4 Responses to “Studies: Overweight is not unhealthy? The bottom line on diabetes, heart disease, arthritis risk and more.”

  1. Blake Hagen Says:

    I think you are right on. There shouldn’t be any excuses for being overweight and no excuses for not taking care of yourself by seeing doc regularly for check-ups.

    Blake Hagens last blog post..Not Exactly Brain Food

  2. Mark Salinas Says:

    Sure, SOME overweight people are going to be healthy. I have a problem with the way the mainstream media presents the study. “Conclusions: Among US adults, there is a high prevalence of clustering of cardiometabolic abnormalities among normal-weight individuals and a high prevalence of overweight and obese individuals who are metabolically healthy. Further study into the physiologic mechanisms underlying these different phenotypes and their impact on health is needed.” What I get from this is that more studies need to be initiated? Many people might think they have no need to exercise, eat “better”. I agree with the three points you present…thank you!

    Mark Salinass last blog post..The Linkster….

  3. James Hubbard, M.D., M.P.H. Says:

    Thanks Mark and Blake. I agree with both of you. There study gives no one an excuse not to exercise and eat healthy.

  4. James Hubbard’s My Family Doctor Blog » Blog Archive » Your Weight Isn’t Everything: A dietitian’s opinion on that heart-disease study Says:

    [...] note: Want more? Read Dr. Hubbard’s opinion here. addthis_pub = ‘infoswellweb’; addthis_brand = ‘My Family Doctor Mag [...]

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