Friday, December 10, 2010

Moving Beyond the Waistline

Digging into the New Voices archives today, we found this great unpublished post by New Voice Takao Yamada written in summer 2009. The question at hand is timely as we head into new-year-resolution-making season.

I’m 6’2” tall. I weigh 200 pounds. I exercise 5 times a week for about 45+ minutes. I generally watch what I eat, but I cheat every now and then. All in all I lead a pretty healthy life, but by the standard BMI calculation I need to drop about ten pounds because I’m overweight.

But apparently that means that I’m going to live longer. So I got that going for me.

A June 2009 study published in the journal Obesity, found that those in the category of overweight showed 17% lower risk of dying that those in the bracket for normal weight. People who were underweight had a 73% higher risk of dying. The study accounted for any of the conflating life style impacts (smoking, age, gender, alcohol, etc.) This comes on top of studies showing that obesity was a protection against tuberculosis and other diseases suggest that what we think of as optimal weight may be incorrect.

Before this goes further, let me clarify one important point. I am not talking about obesity. I am not suggesting that obesity is not a serious problem for adults or children. I’m talking about people, like myself, who are active but above their “optimal” weight.

It seems likely that some of this is due to the fact that so much of our conception of weight related health is focused on heart problems. Heart attacks and high blood pressure are the concepts we most associate with being overweight, but perhaps in focusing too much on heart health we have lost sight of a more holistic approach to what constitutes a healthy body. It could be that activity level and metabolic health are far better markers in determining what constitutes a normal healthy body.

I’m not about to join Health at Every Size or start reading Fatshonista, but I do think it’s worthwhile to consider that we have focused too much on pure BMI without considering whether or not there are other health risks we have conflated with BMI. When we see studies that declare that higher body weights are linked clearly to “all-cause” mortality, maybe it’s an issue of the life style that often surrounds being overweight and not being overweight itself.

I'm not saying that obesity is healthy or that we shouldn't focus on healthy life style choices. I'm just suggesting we consider expanding our definition of healthy weight. This may just be an excuse for me to eat the occasional donut, but I still think these questions are worth asking.

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