Exploring the paradox of obesity

Exploring the paradox of obesity

How do we explain research that suggests overweight people live longer?

Martin Luther King Jr. warned that human progress is neither automatic nor inevitable, and that the same may be true of the human lifespan. In the 1800s, life expectancy was less than 40 years, but it has made “steady progress” over the past two centuries, until recently “growing at a rate of about two years per decade.” Growth in longevity “appears to be slowing or even reversing.” Thanks to the obesity epidemic, we may now be raising the first generation to live shorter lives than their parents.

“This downward trend in life expectancy will almost certainly accelerate as the current generation of children reach adulthood, having gained more weight from earlier in life than ever before.” Current trends are driven by the obesity epidemic. If left unchecked, it “could signal an impending social and economic catastrophe.” Some predict that the United States may lose two to five years or more in life expectancy in the coming decades. To put this into perspective, even if we miraculously cured all types of cancer, life expectancy in the United States would only increase by 3.5 years. In other words, reversing the obesity epidemic could save more lives than curing cancer.

The evidence that being overweight increases the risk of debilitating diseases such as diabetes is considered “incontrovertible.” However, surprisingly, there is debate regarding body weight and overall mortality. In 2013, scientists at the Centers for Disease Control and Prevention (CDC) published a meta-analysis in the Journal of the American Medical Association suggesting that being overweight is advantageous. Grades 2 and 3 obesity were associated with a shorter lifespan, including having an average height of 5 feet 6 inches and a weight of approximately 216 pounds (98 kg) or more, while those weighing approximately 185 to 215 pounds (84 kg) were associated with a shorter lifespan. Grade 1 obesity, which is ), is associated with a shorter lifespan. up to 97 kg) at that height was not. Being overweight (approximately 155-185 lbs/70-83 kg at 5’6″ height) appears to be protective compared to a “normal weight” person of 115-155 lbs (52-69 kg). Ta. Overweight people, those with a body mass index (BMI) of 25 to 30, seemed to live the longest.

Headline writers were blindsided. “Being overweight may extend your lifespan, rather than shorten it,” said one article. Another article said, “Are you afraid of dieting? Don’t worry. Fat people live longer than thin people…” “Extra pounds mean a lower chance of death.” Not surprisingly, the study sparked intense debate in the public health community. The study was called “ridiculous,” “flawed,” and “misleading.” Harvard University’s nutrition department chair loses his cool, calls the study “a real pile of garbage” and says the food industry will exploit this study in the same way the oil industry exploits the “controversy” over climate change. I was worried that he might.

But public health advocates can’t simply ignore data they find inconvenient. Science is science. But can being overweight increase your risk of life-threatening diseases and at the same time extend your lifespan? This has become known as the “obesity paradox” and my video “Is the Obesity Paradox Real?” , or is it a myth?”

The solution to this puzzle appears to lie in two main sources of bias. The first is “confusion caused by smoking.” Nicotine in cigarettes can cause weight loss. In other words, if you’re thin because of smoking, it’s no wonder that your lifespan is shortened even if your waist is thin. The failure to control for the effects of smoking in studies purporting to demonstrate the “obesity paradox” has led to the risks of obesity being “grossly underestimated”.

The second major source of bias is reverse causation. Isn’t it more likely that life-threatening illnesses lead to weight loss, rather than weight loss leading to life-threatening illnesses? Illnesses such as hidden tumors, chronic heart or lung disease, alcoholism, and depression can cause unintended weight loss for months or even years before being diagnosed. For example, being overweight is normal in the United States. In other words, people who are “abnormally” thin, or in other words, people at their ideal weight, may be taking care of themselves, but instead they are “heavy smokers, frail, elderly, and sick.” It is possible that he is in a serious condition due to weight loss due to… ”

To examine the obesity paradox once and for all, the Global BMI Mortality Collaboration was established, reviewing data on more than 10 million people from hundreds of studies in dozens of countries. This is the largest evaluation of BMI and mortality in history. To eliminate bias, researchers excluded smokers and people with known chronic illnesses, and then analyzed people who had undiagnosed illnesses and who had lost weight due to impending death. We excluded the first 5 years of follow-up to exclude patients. and? The results were clear. “This analysis showed that both overweight and obesity (all grades) were associated with increased all-cause mortality,” meaning an increased risk of dying prematurely. Therefore, “adjusting these biases would lead to resolving the obesity paradox.” In other words, the so-called obesity paradox appears to be “just a myth.”

In fact, people live longer when intentionally trying to lose weight. Bariatric surgery studies like the SOS trial have shown that weight loss reduces long-term mortality, and the same is true when study participants are randomized to lose weight through lifestyle changes. They found that losing 12 pounds through diet and exercise was associated with a 15 percent reduction in overall mortality. Now, while it’s possible to extend your lifespan through exercise alone without losing weight, weight loss through diet alone appears to have a similar longevity effect.

If you missed the previous blog posts in my series on the ABCs of Obesity, please see below.

Check out the last two videos in this series: What is the ideal BMI? What is the ideal waist size?

All of this and more is explained in detail in my book How Not to Diet, and its companion book How Not to Diet Cookbook includes my 21 tips for accelerating body fat loss. Over 100 delicious green light recipes with some tweaks included. loss.

Why do people become obese in the first place? I have a series of videos on that topic. Check out the video in the related article.

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