The risk for mortality increased as BMI increased in adult patients without diabetes. However, mortality risk decreased with increased BMI among patients with diabetes, data suggest.
Okay. That’s interesting. In fact, the researcher, Chandra Jackson, found it “surprising”. It’s not surprising to us: we’ve reported several times on studies that show that being fat is protective in some cases:
Anyway, the researcher comes up with a bunch of excuses why this “obesity paradox” must be:
“This finding was surprising, but it may be due to a commonly observed phenomenon in chronic disease epidemiology called ‘reverse causation’ where a person’s weight at the time of the survey can be affected by their disease if it leads to weight loss and muscle wasting during advanced stages.”
She seems to be saying that the numbers are “skewed” because fat people (who would otherwise have been in the study) got so sick, they lost weight from the (fat-caused) disease, and therefore, you don’t get to count those deaths as fattie deaths, because the sick fattie was no longer fat at the time the survey was taken. While diabetes can cause weight loss, that is generally when it isn’t being controlled, and therefore, disease-related weight loss would end once treatment begins.
So, she tries:
“This apparent obesity paradox that has been observed in the past among individuals with diabetes may actually be due to methodological limitations that can bias these types of studies. From clinical and public health points of view, achieving and maintaining a healthy weight should continue to be recommended for both those with and without diabetes.”
The reason the results show some fatties living longer is because the studies (including hers) are missing something.
How about this one (and I’m not even a researcher):
Fat people with diabetes get more focused healthcare than non-diabetic fat people. The diabetes will probably be blamed on the fat (rightly or wrongly) – but any other healthcare issues are addressed based on the patient being diabetic – not based on the patient being fat. The doctor doesn’t just look at the chart (or look at you), see “fat” and stop thinking. The prescription for every problem is not as likely to be “lose weight”.
The doctor can get past the “fat” and move on, because there is already another health issue (the diabetes) at work.
And, a fat diabetic is more likely to see their doctor regularly – better chance of catching health problems early. Truth is, most doctors don’t like fat people, fat people know this, fat people (like most people) don’t like being treated like shit and therefore, fat people avoid situations where they are going to be treated like shit if it is at all possible.
I don’t see this so much as an “obesity” paradox, as a “why can’t doctors just get over the fact that there are fat people and do their fucking job so fat people don’t have to be afraid of seeking medical attention” paradox.
Of course, the other possibility is that being fat really does help, because people don’t die of type 2 diabetes itself, they die from other health problems that are complicated or exacerbated by diabetes, including heart attacks, and other studies have shown fat people survive those better.
Either way, this fat is always bad, even when it is helpful, BS needs to stop.