IS Being FAT OK?

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?

HAVE YOU HEARD ABOUT ‘METABOLICALLY HEALTHY OBESITY’?

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.

IS IT MY FAULT THAT I’M FAT?

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.

SHAME, GUILT AND MISINFORMATION DON’T HELP.

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.

CAN WE HAVE OUR CAKE AND EAT IT TOO?

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.

TAKE HOME POINTS:

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.