If I said, “People with eating disorders worry about fat,” you’d probably ask me what rock I’d just crawled out from under. Usually, the gateway to an eating disorder is a fear of fat -- and a diet (followed by the next and the next and every other behavior meant to get rid of fat). Given that eating disorders are far more complicated than a desire for thinness, and brain and biological factors also play a role, still the more anti-obesity craziness, the more fertile ground for a latent eating disorder.
So we have to ponder the truth about obesity. Is it really the severe health crisis the public health sector has been decrying?
The jury is once again deliberating. Today, the prestigious Archives of Internal Medicine, published a surprise: Fat itself is not the culprit in heart disease, diabetes and a long list of related public health woes. In turns out that some obese individuals do not appear to have an increased risk for heart disease, while some normal-weight individuals do.
More specifically, Rachel P. Wildman, Ph.D., of the Albert Einstein College of Medicine, Bronx, N.Y., and colleagues tapped 5,440 individuals participating in the National Health and Nutritional Examination Surveys between 1999 and 2004. After assessing the volunteers’ body weight and cardiometabolic status (including high blood pressure, elevated triglycerides hyperlink and low high-density lipoprotein or “good” cholesterol), the researchers found that thinness doesn’t necessarily mean healthiness.
Nearly one fourth of normal-weight adults were metabolically abnormal, meaning they were at risk for heart problems and diabetes. Meanwhile, half of overweight adults and nearly a third of obese adults were metabolically healthy.
Digging a little deeper, the researchers found that people whose weight was normal but cardiometabolism abnormal tended to be older, less physically active and have larger waists than healthy normal-weight individuals. At the same time, obese individuals with no metabolic abnormalities were more likely to be younger, black, more physically active and have smaller waists than those with metabolic risk factors.
So, it’s not obesity, per se, that puts a person at risk for heart problems and diabetes. It’s more likely “the behavioral, hormonal or biochemical and genetic mechanisms underlying these differential metabolic responses to body sizes,” the authors write.
Indeed, the lesson for those grappling with eating disorders is that it’s not fat alone that's bad. It's also the diets, fasts and subsequent binges and overeating – not to mention our bodies’ genetics and natural make-up. The combination of who we are and what we do dictate our good or bad health. Perhaps if our society held to a balanced, realistic picture of fat, people with eating disorders wouldn’t demonize it so much. And do such drastic behaviors in the quest to get rid of it.
Note: A second study of 314 individuals, published in the same Archives issue, bore a similar finding. Norbert Stefan, M.D., and colleagues at the University of Tübingen, Germany measured body fat and sensitivity to insulin action (a protector against diabetes) and thus identified a group of obese individuals who were not resistant to insulin. The researchers dubbed them as having “metabolically-benign obesity” and went one step further to suggest that their obesity protected against insulin resistance and atherosclerosis. In seems the placement of their fat (in the liver) rather than the amount of it seemed to equate most with potential health problems.