I’m all for looking at overweight and obesity in new ways. I absolutely believe that it’s possible to be overweight and healthy. I am, however, sick of seeing claims that being overweight is protective against death. The implication being that those of us who are “healthy” weights are actually more likely to die than those who are slightly overweight.
Yet another article came out last week touting the headline: People deemed overweight may actually have a lower risk of dying than those who are healthy, study says. The fact that we’re all going to die notwithstanding there are other significant issues with such claims.
To start, I’d like to take exception to the headline itself. Who writes these things? If they had inserted weight after “healthy” it would have made quite a difference. As it’s written it implies that “healthy” and “overweight” are two discrete mutually exclusive categories. This is not the case. It’s entirely possible to be overweight and healthy. It’s entirely possible to be “healthy” weight and unhealthy.
Now that, that’s out of the way, let’s get to the bigger problems with the study results, as covered in the news article. When people are ill, especially mortally ill, they often lose weight. As a result, when looking at death rates and weight it’s incredibly difficult to tease these issues apart. Thus, claims that being overweight protecting against death are essentially meaningless and potentially detrimental. I say detrimental, because if people are dissuaded from eating healthily and exercising regularly by the suggestion that it’s healthier for them to be overweight then it’s quite likely that their health will suffer. We also know that many chronic diseases such as type 2 diabetes and hypertension can be better managed with weight loss, following a balanced diet, and incorporating regular physical activity. While it’s possible that being overweight is actually protective, it’s more likely that the apparent association between lower weight and death is a result of weight loss during illness.
The other significant problem with the claim that overweight is protective against death is that it doesn’t take into consideration quality of life. Many people who are overweight will be prescribed various medications to keep related conditions in-check. This may result in a longer lifespan than someone who’s “healthy” weight who, because of appearing to be in good health (as a result of the conflation of overall health and healthy weight) may go without similar treatment. The “healthy” weight individuals may lead shorter but higher quality lives without the side effects of medications (i.e. they may have shorter lifespans but longer healthspans).
To sum it up: yes, you can be healthy and overweight. You can also be unhealthy. Ditto for both for “healthy” weight. Regardless of your weight the best way to ensure that you lead the longest healthiest life possible is by taking care of yourself.