Obese doesn’t mean unhealthy. Correlation isn’t causation. There are many obese people who are extremely healthy. I for one have had no health issues of any sort, have great blood panels, and am in decent physical condition but sit stubbornly at a 31BMI. The only “issue” I face is psychological, and it’s rooted in precisely this statement you made.
> There are many obese people who are extremely healthy
I don't believe that's true. There are some cases (like powerlifters) who can be at an obese BMI but still have strong cardiovascular fitness, but unless you are in that narrow category, if you are obese you do not have strong aerobic fitness. 'Decent physical condition' alone belies that you are not 'extremely' healthy. Decently healthy maybe, but certainly not extremely. Even if you are still metabolically healthy, you are at increased risk for adverse long-term outcomes (source: https://pubmed.ncbi.nlm.nih.gov/24297192/). That is more than just a psychological issue, no matter how much you try to handwave it away.
Your belief in a fact is unnecessary. The issue with these studies is they don’t control for lifestyle and diet. The notion that you can not be fat while eating a high quality low calorie diet and exercising is simply false. A valuable study in this space would be measuring the impact of diet and exercise on health outcomes while holding BMI constant, then comparing across stripes.
In studies where diet and lifestyle are controlled for, metabolically health overweight are not at greater risk.
The issue is we are pointing to fatness and not diet and exercise. It’s causing people to seek ways to get thin assuming it’ll help. But some people are thin no matter what they do, some are fat. However there’s a correlation between poor lifestyle choices and being fat and good life style choices and being thin. This skews uncontrolled studies towards fat is bad even with good metabolic health, because having a good metabolic health but maintaining it with poor inputs will have a long term bad outcome.
In one of the reference below, the conclusion is:
(i) Higher fitness should be considered a characteristic of metabolically healthy but obese phenotype. (ii) Once fitness is accounted for, the metabolically healthy but obese phenotype is a benign condition, with a better prognosis for mortality and morbidity than metabolically abnormal obese individuals.
> The notion that you can not be fat while eating a high quality low calorie diet and exercising is simply false
You actually believe this shit? If you eat a calorie deficit, you will lose weight, full stop. 'High quality low calorie diet' is gobbledygook to make you feel better. You can eat absolute shit and lose weight if you eat appropriate portions. Or do you not believe in the conservation of energy?
> metabolically healthy but obese phenotype is a benign condition, with a better prognosis for mortality and morbidity than metabolically abnormal obese individuals
so, if you compare yourself only to obese people, you're healthier if you're metabolically healthy. And that is some kind of interesting scientific conclusion? Is this a study done exclusively by fat people to make themselves feel better?
> There are many obese people who are extremely healthy
I don't think that's true. However, some people can withstand bad diets. As an example, I had a morbidly obese uncle that ate copious quantities of bacon, white bread, and processed food, yet his blood work and lipid levels were always in the healthy range, which always surprised my family (my mother managed a clinical lab and did the bloodwork for my uncle).
My uncle eventually passed away after he became crippled after a bathroom fall due to his weight. He became depressed and committed suicide (he was a physician and had access to morphine). Overweight is always a health risk, even if your bloodwork is ok.
I didn’t say morbidly obese. Likewise, check my other comments on parallel replies for several studies showing cardiovascular fitness is the predictor for metabolically healthy obese people.
This is unfortunately completely untrue. Obesity, especially severe obesity, underlies the diabetes and heart disease epidemics. However obese people, particularly in the US and Western Europe, now represent a sufficiently large lobby (no pun intended) that there is significant public messaging parroting the 'healthy at any size' propaganda.
I didn’t say there is no level at which you’re clearly unhealthy. If you are obese because of unhealthy habits or lifestyle, this will impact your overall health. Being fat alone, with a healthy eating habit and lifestyle, is not indicative of a lack of health. Eating with abandon, especially of low quality food, and not exercising is what underlies the lack of health. It happens you also get fat doing this. People with a high metabolism that stay thin no matter what they eat or do still develop heart disease and diabetes.
Healthy at any size doesn’t mean someone who is morbidly obese is healthy - the strain on their heart is significant. But that’s true for any human of large size regardless of “what” constitutes their body mass. But the correlation is the fat goes with unhealthy diet and lifestyle. But not everyone who is fat is unhealthy.
They even discuss this in the article for goodness sakes.
In another comment I provided these references:
In one of the reference below, the conclusion is:
(i) Higher fitness should be considered a characteristic of metabolically healthy but obese phenotype. (ii) Once fitness is accounted for, the metabolically healthy but obese phenotype is a benign condition, with a better prognosis for mortality and morbidity than metabolically abnormal obese individuals.
The goal of that idea is to push for being being more healthy regardless of size, not to validate that you can become obese if you want with no downsides. It's basically "being obese and having issues dieting doesn't stop you from making healthy changes in other ways".
Yes. I’m fairly active. I do two one hour swimming sessions a week, a daily Tabata HIIT, and other activities in the week. I’ve no interest in becoming an iron man competitor, but I find the maintaining of decent cardio improves my mental well being considerably. I am personally fine with my weight - when I look at the extreme athletes in my family they all have a similar body makeup, and their body fat percentage stays constant even as they add muscle. Everyone in my family live into their 90’s without onset health issues. When I do medical histories with my GP it’s short and boring.
