How can fat be good?

Given the continual media assault on fatness, the average person is forgiven for asking, “How can fat be good?” And yet, study after study has shown that, among people with many chronic diseases, fatter patients do better on average. This is called the “obesity paradox”, although it’s only a paradox if you believe that fatness can’t possibly be good.

But it can be. We’ve talked about it on this blog here, here, here, and here. Even anti-fat guy Kenneth Krause admitted it. But one (admittedly large) study comes out showing that this is not the case for type 2 diabetes and the media act as if that debunks the whole idea of fat as being protective. This is especially annoying since another recent study confirms the “obesity paradox” for diabetes.

The number of studies confirming that there are some health benefits to fatness is large enough such that we should no longer be debating whether the benefits exist at all. We should be running studies trying to figure out why these benefits exist, and how they can be used to help people who aren’t fat, or fat people without any illness.

I could write a lot more about this, but as I said above, we have done already, and this shit is getting old.


6 thoughts on “How can fat be good?

  1. So much of this goes back to the 1998 change in the BMI categories. After all, twenty years ago a person who got the advantages of the ‘obesity paradox’ was more often someone in the ‘normal’ category, which is now the ‘overweight’ category. While the BMI has never been a good predictor of health because all it indicates is body size according to a convoluted and completely un-nuanced equation, there was a time when the categories did a better job of matching where the sweet spot was that did not prevent diseases, but did offer the best protection against the worst ravages of diseases and conditions.

    I know that even before 1998, there was some data in favor of the ‘obesity paradox’ but there’s a lot more since then, because now there’s an even bigger gap between the BMI charts and lived reality.

    Combine the major break from reality with two decades of hand-wringing and increasing media anger at fat people, and it’s like walking into Nazi headquarters to have a lovely chat with Hitler’s top aides about all the fine contributions to the world made by Jewish people, gypsies, and gays. It doesn’t matter that you have fact on your side; they have fear, hate, and an endless stream of propaganda on theirs and it’s nearly impossible to shift.

    • Thanks for your comment. I’m willing to believe that most researchers are well meaning (unlike the Third Reich) and feel that they are increasing the good. And if they weren’t willing to look at the data honestly, we may not have learned about this “paradox” at all. Regarding BMI, it’s obviously a problem, but the main evidence for that is in the Flegal studies showing that the lowest risk of death is among the “overweight”. The “obesity paradox”, while it may be related, is, I think, something else. (Remember, as I said in another post, it’s called the “obesity paradox”, not the “overweight paradox”.) And researchers need to try to figure out what’s causing the obesity paradox, and how to use it to help everyone.

  2. I even wonder about the connection between adiposity and the onset of Type 2 diabetes. This connection is almost sacrosanct. But why did only 6 out of 150 subjects in Allergan’s “definitive” study on Lap Band and co-morbid conditions have Type 2 diabetes? This is lower than the incidence rate in normal weight individuals. Not everything, but almost everything they tell us about adiposity (obesity) is wrong. I’d would not be surprised if someday the adiposity-diabetes connection falls like the next domino.

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