Almost half of obese adults are (metabolically) healthy

[yerrag]

You won't be in the cast of Desperate Housewives, but will the star of Housewives of Cincinnati!

 

[Rinse & rePeat]

You won't be in the cast of Desperate Housewives, but will the star of Housewives of Cincinnati!

I never heard of it, but I'll take it yerrag ?

 

[yerrag]

That is the city where Jerry Springer was once mayor. He was the stand-in for Trump in MAGA.

 

[Rick K]

Like I said, when has their metrics been anything but absurd? Cholesterol, Blood Pressure, Weight, Penis Size etc. - ever made anybody feel like they're A-OK?

Wait, penises come in different sizes?

 

[Rinse & rePeat]

Wait, penises come in different sizes?

Sandy!!!?

 

[yerrag]

That is the city where Jerry Springer was once mayor. He was the stand-in for Trump in MAGA.

But also a nice place to live. And wonderful people that you remind me of. And the best ice cream - the bomb-Graeter's. And the best chili-Skyline. The show would be a hit.

 

[Rinse & rePeat]

That is the city where Jerry Springer was once mayor. He was the stand-in for Trump in MAGA.

You're funny! I have heard of Cincinnati, I just didn't hear about the show ?

 

[Rinse & rePeat]

But also a nice place to live. And wonderful people that you remind me of. And the best ice cream - the bomb-Graeter's. And the best chili-Skyline. The show would be a hit.

Awww! You are sweet! My show would be a hit! Thanks for having faith in me :)

 

[yerrag]

Wait, penises come in different sizes?

Oh wait, there was no health check ever done done on that. It was that ad that keeps popping up.

 

[Rick K]

Sandy!!!?

Maybe I will have to sand a little off of mine to be fair. Yikes!

 

[Rick K]

Oh wait, there was no health check ever done done on that. It was that ad that keeps popping up.

 

[Rinse & rePeat]

Maybe I will have to sand a little off of mine to be fair. Yikes!

Ha! That is hilarious! ?

 

[Rinse & rePeat]

Oh wait, there was no health check ever done done on that. It was that ad that keeps popping up.

So where am I to go now? ?

 

[Ben.]

I'm not buying into this. This just absolves this forum of its inability to keep people from getting overweight and/or obese in following Ray Peat's recommendations for a nutrition lifestyle centered on sugar metabolism.

If the metabolism of sugar were efficient, people would not be obese. But people here don't know how to make it efficient. It's not that hard. There is a method to the madness. Unfortunately, Ray Peat has never been obese. So he can't lead the flock to the promised land of normality in weight.

While i do not endorse or advocate being overweight/obese, i personally see alot of issues in understanding bodycompositions in our society.
The more weight someone has on his/her frame that is not muscle, increases the strain on the joints, so obviously there is a "treshhold" perhaps that one should not go over but it would also be problematic to assume that "fat" in and of itself is bad.

For example, people eating w/e food they want in big quantities and still staying extremely thin (usually comes with low muscle mass too) is not normal either.
The same goes for people that gain far to much weight altho they eat "normal" and reasonable amounts of foods.

Neither of these two positions are healthy imo. A healthy person can gain weight in fat and muscle if he/she chooses to, just as a healthy person can loose weight with a few dietary changes if it is desired. It should not be "that hard" is what i am trying to say and the baseline should be somewhere inbetween idealy.

But just because some people have a little more weight than some body standards suggest, it does not mean automaticly that the thin counterpart is healthier.
Obviously, most people blame it on genes. Now i am not saying they dont play their part, but from my own experience, the healther i was, the better i was able to build muscles/gain weight but that does not mean "more weight = more healthy". It just means w/e is troubling me, makes it hard for me to put on weight. Just as a female work collegue of mine has the most amazing, thick hair but literally blows up just thinking about a piece of food. Now obviously i can't talk her into sugar metabolism and she will go into hardcore marathon running and eating realy low amounts of food ... but trying to explain a "normal" person why this backfires and that hormones/metabolism plays are far bigger role than the evil sugar or saturated fat does... im afraid will be met with deaf ears.

What i am trying to say is, people are not simply overweight but some of them are also far to skinny. Health/metabolism is far more complex/nuanced than BMI's or fat tissue make it seem to be.

 

[yerrag]

While i do not endorse or advocate being overweight/obese, i personally see alot of issues in understanding bodycompositions in our society.
The more weight someone has on his/her frame that is not muscle, increases the strain on the joints, so obviously there is a "treshhold" perhaps that one should not go over but it would also be problematic to assume that "fat" in and of itself is bad.

For example, people eating w/e food they want in big quantities and still staying extremely thin (usually comes with low muscle mass too) is not normal either.
The same goes for people that gain far to much weight altho they eat "normal" and reasonable amounts of foods.

Neither of these two positions are healthy imo. A healthy person can gain weight in fat and muscle if he/she chooses to, just as a healthy person can loose weight with a few dietary changes if it is desired. It should not be "that hard" is what i am trying to say and the baseline should be somewhere inbetween idealy.

But just because some people have a little more weight than some body standards suggest, it does not mean automaticly that the thin counterpart is healthier.
Obviously, most people blame it on genes. Now i am not saying they dont play their part, but from my own experience, the healther i was, the better i was able to build muscles/gain weight but that does not mean "more weight = more healthy". It just means w/e is troubling me, makes it hard for me to put on weight. Just as a female work collegue of mine has the most amazing, thick hair but literally blows up just thinking about a piece of food. Now obviously i can't talk her into sugar metabolism and she will go into hardcore marathon running and eating realy low amounts of food ... but trying to explain a "normal" person why this backfires and that hormones/metabolism plays are far bigger role than the evil sugar or saturated fat is and im afraid will be met with deaf ears.

What i am trying to say is, people are not simply overweight but some of them are also far to skinny. Health/metabolism is far more complex/nuanced than BMI's or fat tissue make it seem to be.

There is a range that is for me reasonable to allow for normal variances. Modern medicine would tend to have a very wide range, given that is their proclivity to give people a forgiving range so that somebody that's really malnourished and somebody that's really not burning sugar nor even fat well (and even building up more fat reserves) would both pass these standards, and then everybody's happy to be called "normal" until they both develop serious conditions upon which they are thankful there is health insurance to pay for all the expenses of confinement in the ICU.

I don't think that you mean to be that forgiving. Underweight and overweight is not a sickness in themselves but symptoms of deeper issues. If one were to deny such symptoms and abide by very loose definitions of normal weight, then it just means also that people are late to recognize developing more health problems. If for example one were to say normal temperature ranges from 36 to 38 degrees, and by that definition many more people would not consider themselves possibly hypothyroid, would they be really sick or not optimally healthy without recognizing it?

If we agree that the above example is preposterous - that no one would ever have a range of temperature that far off, is it too much to think that having a very loose definition of overweight and obesity is just as preposterous? Certainly there are people who are more muscular and may tip into the overweight category, but where are they in the bell curve? If they fall off into the overweight category, would one not be able to differentiate one who is overweight and flabby from one is overweight and muscular?

In the end, nothing really falls into strictly discrete delineations and partitions. If normal range of say RBC for males is 4.2-4.9 (according to the functional medicine chart of Dr. Weatherby), and I have a value of 4.89, would I hold off on thinking there is a red flag? No. I would check other markers to see if it would confirm there is some issue building up that I need to be aware of. If one were to use a computer program to determine my state, that program would say I am fine right off the bat.

These are guides. It's an honor system. Ignore these guides at your peril if these guides are good guides. But if a guide should lead you astray and tell you your'e sick when you're really not, or that you're fine when you're really sick, ignore it then and you will be better off that way. Since we are in this forum to be free from guides such as doctors that lead us astray, then we should take it upon ourselves to discern which guides we should follow and which guides we should dispense with. It is our own health. We can't cheat. We have to be honorable to our own self. It is our own health.

Let them eat cake who wants us to follow systems that tell us to lie to ourselves about our true state of health.

By the way, this goes into the essence of why Ray holds the digital thought process that influences our thinking in contempt and prefers the analog. There is no discrete cut off point as nature is not built that way. As I explained with the RBC example, we have to think and process that information with our brain, and not with the computer. Brain is analog. The computer not.

 

[Ben.]

I don't think that you mean to be that forgiving. Underweight and overweight is not a sickness in themselves but symptoms of deeper issues. If one were to deny such symptoms and abide by very loose definitions of normal weight, then it just means also that people are late to recognize developing more health problems. If for example one were to say normal temperature ranges from 36 to 38 degrees, and by that definition many more people would not consider themselves possibly hypothyroid, would they be really sick or not optimally healthy without recognizing it?

No you are right, i did not mean to be "that" forgiving . You articulated it far better than i could. In retrospect i am kind of baffled how health issues, both in myself and in many others ,had more than just one sign to signal a "deeper" issue.

From my observation, people deny/supress these things (chronic skin conditions, gaining/loosing weight far to quickly, dandruff/oily scalp, impaired cognitive function etc.) with modern interventions such as cosmetics/supplements/medications. Alot of times, especially at younger ages, this works kind of because often times the issue resolves itself, by what mechanism idk, perhaps its realy the youthful growth factor or a unaware resolve of the original cause ....

And who could blame them? Lack of knowledge, incompetent doctors and a lack of "pain/decline in health quality" to actually get up and take responsibility of oneself. Sadly, until it is far to advanced.

These are guides. It's an honor system. Ignore these guides at your peril if these guides are good guides. But if a guide should lead you astray and tell you your'e sick when you're really not, or that you're fine when you're really sick, ignore it then and you will be better off that way. Since we are in this forum to be free from guides such as doctors that lead us astray, then we should take it upon ourselves to discern which guides we should follow and which guides we should dispense with. It is our own health. We can't cheat. We have to be honorable to our own self. It is our own health.

Let them eat cake who wants us to follow systems that tell us to lie to ourselves about our true state of health.

By the way, this goes into the essence of why Ray holds the digital thought process that influences our thinking in contempt and prefers the analog. There is no discrete cut off point as nature is not built that way. As I explained with the RBC example, we have to think and process that information with our brain, and not with the computer. Brain is analog. The computer not.

Beautifully said, thanks for the thoughtfull response.

 

[milkboi]

This would mean a large part of the population is healthy, which seems unlikely, doesn't it?

 

[PxD]

A seemingly contradictory title, but only to people who are not aware of the so-called "obesity paradox". As I have mentioned in the past, usage of the word "paradox" usually implies a very inconvenient truth that threatens the profits of one or more branches of mainstream medicine. In this case of the obesity "paradox", it is very embarrassing to doctors that, on average, their recommendations for weight loss at all costs (restrictive dieting, exercise, drugs, and even surgery) result in patients with much higher risk of both getting and dying from a condition such as cancer, IBD, multiple sclerosis, infectious disease, etc. Even in cases of acute trauma such as accidents or being victims of violent crime (e.g. getting shot/stabbed) the obese usually have a much better chance of survival compared to their lean, "healthy" peers who follow religiously the latest and greatest recommendations from their licensed nutritionist, doctor, coach, etc. The new study below now quantifies the obesity paradox on a national level and suggests that 40%+ of obese people are in fact metabolically healthy and without increased risk of chronic diseases. In fact, the authors of the study are proposing a new medical term - metabolically healthy obesity (MHO) - that can be used to properly "diagnose" such people (and hopefully tame a bit the overzealous advocates of leanness). So, the next time your doctor admonishes you on your "excessive" weight/gluttony, you may want to show him/her the study below.

An Empirically Derived Definition of Metabolically Healthy Obesity Based on Risk of Mortality

There Is Such a Thing as "Healthy Obesity," New Study Says

Almost half of the people who meet the standards for obesity can still be considered "metabolically healthy," according to a new study.

bestlifeonline.com

"...But a new study published on May 7 in the JAMA Network Open has revealed that not all obese people have the same risk of serious health issues. In fact, they found that 40 percent of obese people in the U.S. were not at a higher risk of cardiovascular disease or death. In fact, the study found that people with a body mass index (BMI) of 30 or more, which is considered obese, were found to be "metabolically healthy" if they had three things in particular."

"...The scientists behind the new study looked at 386,420 individuals and they found that obese people with normal blood pressure levels, a relatively low waist-to-hip ratio (WHR), and no existing type 2 diabetes were not an increased risk of heart disease or death, leading them to define people who meet these metrics as having "metabolically healthy obesity (MHO)."

If you have a normal waist to hip ratio, say 35 inches and 38 inches for a man, you we’re never obese to begin with. You may have a BMI over 30, but it will be due to muscle mass, not fat mass, as indicated by the waist to hip ratio. What they’re doing here is classifying well-muscled people as overweight, and then claiming that three specific factors can mean those people are healthy despite being “overweight”.

 

[Rinse & rePeat]

I agree with you PxD! The point of this post was more about the kind of fat people are carrying around. If you have a smaller waist to hip ratio you are healthier than a skinny person. It is protective. Round shapes are the unhealthy ones.

 

[Mito]

“At adipose tissue, the problem with fatness isn't the amount of fat. It's that we've reached the point where we can't get any fatter. Well, we can, but we can no longer do so while maintaining a healthy organizational structure within adipose tissue that allows blood, oxygen, and nutrients to get to where they need to go. Surprisingly, some of the things that enable proper expansion, and thus protect our metabolic health, are things that we usually think of as “bad,” such as inflammation. In fact, the pro-inflammatory changes in the gut microbiome in response to an obesogenic diet provide information to adipose tissue that it needs to prepare for healthy expansion. And adipose expansion is most protective at the site of the “bad” body fat: visceral fat in the abdomen.

At liver, the problem is fat gets trapped in the liver, flattening out everything in the cell and hogging the space needed for glycogen storage, and this can happen even in a lean person.”

021: When Fat People Can’t Get Fat Enough and Lean People Get Fat in All the Wrong Places

Mastering Nutrition Episode 21

chrismasterjohnphd.com