Is be­ing FAT OK?

Great Health Guide - - FRONT PAGE - Words Dr Mark McGrath De­sign Olek­san­dra Zuieva

There’s so much guilt and shame associated with be­ing fat but is it war­ranted? Is be­ing fat bad for our health? Should we be made to feel bad about be­ing fat? Does it help?


Most peo­ple as­so­ci­ate obe­sity with poor health, how­ever some ev­i­dence sug­gests per­haps that this isn’t al­ways the case. Metabolically healthy obe­sity is a phe­nom­e­non where de­spite be­ing over­weight, it’s pos­si­ble to be healthy ‘on the inside’.

In fact, for cer­tain chronic health con­di­tions, like chronic heart or kid­ney dis­ease, it seems that mildly obese peo­ple could have a bet­ter prog­no­sis than lean peo­ple with the same con­di­tion. This is known as the ‘obe­sity para­dox’. There are many the­o­ries as to why this may be the case but it is be­lieved fit­ness and mus­cle mass play a role.

Fur­ther­more, it has been found that be­ing un­fit dou­bles your over­all mor­tal­ity re­gard­less of weight, even if you are thin. Peo­ple who are obese but fit, have a sim­i­lar mor­tal­ity to fit nor­mal-weight in­di­vid­u­als. Per­haps most un­ex­pect­edly, is that over­weight or obese peo­ple who are fit, have a bet­ter long-term prog­no­sis than un­der­weight or lean pa­tients who are un­fit.


The rea­son some peo­ple carry ex­tra weight while oth­ers don’t is com­plex and not yet fully un­der­stood.

There’s no doubt re­duced phys­i­cal ac­tiv­ity and an over-abun­dance of calo­rie-dense food with lit­tle nu­tri­tional value are ma­jor con­trib­u­tors.

How­ever, we are start­ing to un­der­stand there are many fac­tors that play a role, some of which are be­yond our con­trol.

One such fac­tor is our ‘mi­cro­biome’ or the bac­te­ria that ben­e­fi­cially in­habit in our gut. Dif­fer­ences have been found in the pop­u­la­tions of in­testi­nal flora of obese peo­ple, in­clud­ing a re­duced diver­sity of bac­te­ria. It re­mains to be seen whether this is the cause or ef­fect and whether any po­ten­tial treat­ments could come from this knowl­edge.

Your ‘epi­ge­net­ics’ may also play a role. We have roughly 23,000 genes that en­code in­for­ma­tion about who we are. Epi­ge­net­ics is the study of what en­vi­ron­men­tal or other fac­tors play a role in turn­ing on or off some of those genes. Stud­ies of the Dutch famine at the end of World War ll, demon­strated that en­vi­ron­men­tal fac­tors can in­flu­ence body shape sev­eral gen­er­a­tions later.


Fad di­ets, be­ing over­whelmed with wellinten­tioned but none­the­less un­help­ful di­etary ad­vice and our so­ci­ety’s pre­oc­cu­pa­tion with un­re­al­is­tic body im­age, all con­trib­ute to un­healthy eat­ing pat­terns. This pre­oc­cu­pa­tion can re­sult in prob­lems of both the over and

un­der­weight kind. It’s im­por­tant to recog­nise as in­di­vid­u­als and as a so­ci­ety that we all live in dif­fer­ent healthy body shapes and sizes.


It’s worth com­ment­ing the ideal health po­si­tion is prob­a­bly to be lean and fit and be­ing very obese is cer­tainly associated with poor health out­comes. How­ever, given the emerg­ing ev­i­dence that fit­ness is a bet­ter in­di­ca­tor of long-term prog­no­sis than weight, per­haps tak­ing the fo­cus away from weight and ap­pear­ance and redi­rect­ing our ef­forts to­wards health and fit­ness could be a more help­ful ap­proach.

Take a kind and nur­tur­ing ap­proach to your body. Don’t feel guilty about food or re­strict what you eat, rather en­joy all foods in a

mind­ful way. Check in with your­self to see if you’re hun­gry be­fore eat­ing or per­haps eat­ing for an­other rea­son. Ex­er­cise has count­less

health ben­e­fits, the least im­por­tant of which is ‘weight loss’. Reg­u­lar move­ment of any sort is a great start.


1. Be­ing obese doesn’t nec­es­sar­ily mean your health is bad and be­ing thin doesn’t nec­es­sar­ily mean your health is good. 2. We all live in dif­fer­ent health body shapes and sizes. 3. While re­duced phys­i­cal ac­tiv­ity and nu­tri­ent poor calo­rie-dense foods are ma­jor con­trib­u­tors to obe­sity, there are many fac­tors that play a role, some of which are be­yond our con­trol. 4. Fit­ness is more im­por­tant for gen­eral health than weight.

Dr Mark McGrath is an ex­pe­ri­enced Gen­eral Prac­ti­tioner in Bris­bane, Aus­tralia and has an in­ter­est in chronic diseases, obe­sity, eat­ing dis­or­ders and ap­ply­ing psy­chol­ogy to gen­eral prac­tice medicine. Mark is pas­sion­ate about dis­pelling med­i­cal mis­in­for­ma­tion found on­line and may be con­tacted via his web­site.


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