The obesity paradox: Is bigger actually better?

Masterfile

Could a spare tire or love handles actually prove beneficial, reducing your risk of dying from chronic illnesses such as diabetes and heart disease? 

A recent article in the New York Times raises some interesting questions about how body weight may affect personal health — and not just in the traditionally negative way, but in potentially protective ways too. 

While obesity is often cited as a major risk factor for a range of chronic illness and diseases, the article points out that some scientists are becoming increasingly puzzled by results that indicate it’s also occasionally associated with a reduced risk of fatality. 

For example, one researcher at Northwestern University discovered that thin people develop type 2 diabetes in significant numbers too — it’s not simply an overweight person’s affliction. More interesting: those people who have type 2 diabetes and are thinner have an increased risk of dying from the disease as compared to heavier people. 

“Diabetes patients of normal weight are twice as likely to die as those who are overweight or obese,” writes the New York Times’ Harriet Brown. 

“That finding makes diabetes the latest example of a medical phenomenon that mystifies scientists. They call it the obesity paradox,” she adds.

Thus far, writes Brown, scientists have implicated that mystifying paradox in several different diseases. Some of the conditions in which obesity was associated with a reduced risk of mortality include heart failure, heart disease, stroke, kidney disease, high blood pressure and diabetes. 

Brown also cites a 2007 Canadian study that found “those who were overweight had the lowest chance of dying from any cause.” 

While scientists debate the reasons for these findings — genetics is one explanation — one expert suggested that instead of focusing on body fat, people focus instead on overall fitness. 

“Maintaining fitness is good and maintaining low weight is good. But if you had to go off one, it looks like it’s more important to maintain your fitness than your leanness. Fitness looks a little bit more protective,” said Dr. Carl Lavie.  

What's more important to you? How thin you are or how fit you are?