People who are a few pounds overweight have a lower risk of early death, according to a new government analysis.(Photo: Katye Martens, USA TODAY)
Folks who are just slightly overweight but have resolved to lose
weight in the new year may give their plans second thoughts in the wake
of a controversial new federal analysis.
People who are overweight
by up to 30 or so pounds have a slightly lower risk of early death
than those at a normal weight, the government analysis finds.
review of 97 studies showed that people who are extremely obese --
roughly 60 or more pounds over a normal weight -- have a greater risk of
dying early than those who are at a normal weight.
two-thirds of people in the USA are too heavy; a third are obese, which
is roughly 35 or more pounds over a normal weight. Obesity is linked to
an increased risk of type 2 diabetes, heart disease, stroke and many
types of cancer.
Flegal and colleagues at the National Center for Health Statistics,
part of the Centers for Disease Control and Prevention, reviewed the
studies, which tracked 3 million adults from around the world. The
research looked at deaths from all reasons and people's body mass index
(BMI), a number that considers weight and height.
BMI categories included: normal weight (a BMI of 18.5 to 24.9);
overweight (BMI of 25 to 30); obese (a BMI of 30 or more); extremely
obese (a BMI of 35 or more).
Findings, published in Wednesday's Journal of the American Medical Association, show that relative to normal-weight people those who were:
- Extremely obese had a 29% increased risk of early death.
- Obese had an 18% increased risk of early death.
- Overweight had a 6% lower risk of early death.
are sometimes amazed that overweight people have a lower mortality than
normal-weight people, but a lot of the research has shown this for a
long time," says Flegal, the lead researcher on the study.
Willett, head of the department of nutrition at the Harvard School of
Public Health, says the findings are "complete rubbish" because the
methodology used in the analysis seriously underestimates "the hazards
of being overweight and obese."
"There have been two major reports
published in the last several years that used the original data from
over 60 studies to look at the risk of being overweight and obese, " he
says. "These both showed clear increases in mortality in overweight and
slightly obese people. This is also supported by dozens of studies
showing increased risks of type 2 diabetes, cardiovascular disease, many
types of cancer and many other conditions among those who are
overweight and obese."
"Thus, a vast amount of data show
clearly that there are many adverse consequences of overweight and
obesity, including greater hazards of premature death," Willett says.
shouldn't interpret the government analysis to think that it is now OK
to be overweight, says Steven Heymsfield, one of the authors on the
accompanying editorial in the journal and the executive director of the
Pennington Biomedical Research Center in Baton Rouge. "We don't really
know the ideal weight for a long life and optimal health. Science is
still working that out. But falling in the normal, healthy weight range
is still the safest place to be."
Gordon Tomaselli, immediate past
president of the American Heart Association and director of the
division of cardiology at the Johns Hopkins University School of
Medicine in Baltimore, says, "We advocate for people maintaining an
ideal body weight. Other studies consistently show that being
excessively overweight increases mortality."
Flegal says there are
numerous possible suggestions that experts have given for the lower
risk of early death among those who are overweight. "There's something
called the obesity paradox. If for example, people end up having a
surgery or (being treated) in the ICU, the heavier people may survive
better. We don't know why, but there's a lot of research that suggests
Some people have suggested that "if you are sick, there is a
lot of extra demands and stress on your body with tests and treatments,
and maybe if you have a little extra weight, you are better able to
deal with these," she says.
Others have suggested that if you are
heavier you may get screened more often by the doctor, and you may get
diagnosed earlier for different conditions, Flegal says. And there are
some suggestions that doctors are more likely to follow the right
clinical guidelines in the treatment of heavier people than
normal-weight people. So it's possible that normal-weight people are
sometimes getting less than optimal treatment, she says.
suggested that there may be some benefits to fat tissue, Flegal says.
"These are just suggestions. No one knows the answer."
advice to those resolving to lose weight in the new year: "The evidence
is pretty strong that if you are obese, there is no question you should
try and get your weight down.
"But if you are overweight, you
need to make sure you are healthy on all fronts -- blood pressure,
cholesterol and type 2 diabetes. Minimally, you want to prevent further
weight gain, and ideally you want to get down to the normal range, if
you can, particularly if you have a health risk factor," he says.