What's Behind New Findings That It's Healthy to Be Overweight?

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Then and now, these studies provoke some controversy. For one thing, smokers often gain weight when they quit smoking – but quitting smoking is a healthy thing to do. Also, many who are terminally ill are thin and frail – but not healthy! The studies attempt to correct for these issues as much as possible.

Furthermore, as medicine advances, humans are able to live longer with chronic disease. The studies use mortality as their measure, but “not dead” does not indicate that one is healthy. Some even suggest that overweight people might enjoy lower mortality because their doctors screen them for more problems due to their high weights compared to patients with lower weights.

Deb Burgard, an eating disorders specialist, says that Flegal’s conclusions make sense, because so many Americans die of diseases that cause them to lose weight while they are ill. An elderly person who has a bit more meat on his or her bones at the beginning of the illness can tolerate the weight loss with less harm to their health.

Linda Bacon, author of Health at Every Size, points to other possible discrepancies in our understanding of obesity and health. For one thing, correlation is not causation. Just because many people with a certain disease are also fat, that does not mean that one caused the other. In her book, she points to some evidence that type II diabetes causes obesity, not the other way around.

She also questions the impact of “weight cycling” (repeatedly gaining and then losing weight) on ones’ health. She says, “weight fluctuation is strongly associated with increased risk for diabetes, hypertension, and cardiovascular diseases, independent of body weight.” As many overweight people try to lose weight – sometimes via extreme diets – could the impact of weight cycling confuse our understanding of the health impact of obesity?

Her most convincing point is that sedentary lifestyles and poor eating habits can cause both health problems and overweight or obesity. And in fact, Bacon does not encourage readers to sit back and eat endless amounts of junk. She instead counsels them to pay attention to their bodies’ signals, eating only when hungry and stopping when full. Don’t eat while doing other activities. Pay attention and enjoy your food. Eat whole foods, mostly plants. And be active – but find an activity you enjoy!

Burgard, who worked with Bacon to develop the Health at Every Size model, deals with the fallout of our fat-phobic culture. Whether for health or for beauty reasons, a huge percent of Americans now hate themselves every time they look in the mirror.

“Lots of women wake up in the morning and look in the mirror and say I feel so fat, even though fat's not a feeling,” says Burgard. “It's a code word for ‘I feel ugly, I feel vulnerable, I'm going to get rejected socially.’ In our culture, that gets connected up to fatness. And so what's fascinating about this is that when people's bodies change, it's not going to be the case that they lose their identification with that part of themselves that feels vulnerable, that feels like a loser.”

Often, she finds people with eating disorders try to lose their feelings of vulnerability by losing weight. The pounds may disappear, but the feelings remain. The person tries to lose even more weight to see if that will do the trick, but it never does.

One reason Burgard dislikes the national war on obesity is because it influences people to distrust their appetites. She says, “When people look at their body size, they have this mythology that everybody who eats ‘normally’ has a thin body and if you don't have a thin body, you must not be eating the right way. It makes you distrust your appetite. They think, ‘If you did the right thing you would be thin.’ This is the biggest myth of all.”