Interesting NYT article...

[jenk]

The New York Times Health section has been doing quite a few articles on obesity and weight loss recently. Being obese (or fat, or large, or whatever your preferred term is :) myself, I've been watching the research on fatness & weight loss for some time; I recommend the book Big Fat Lies as an good start on the topic. So today's article on whether obesity is in fact a symptom or a disease caught my eye.

Some excerpts:

Is obesity, [researchers] ask, a symptom or a disease?

Some strongly suspect it is a symptom. And losing weight, they say, may be suppressing the symptom but doing little or nothing for the underlying illness, just as taking aspirin for a fever may do nothing for the sickness that had fever as a symptom. Moreover, obesity experts add, not every person with the symptom of obesity necessarily has a disease that can increase that person's chances of an early death.

[Many obese people do not have high blood pressure, diabetes, or insulin resistance.]

Although there is a widespread belief that weight loss will improve health, a number of large studies have raised questions about whether that is true.

Dr. Andres explains that weight loss can improve blood sugar levels, blood pressure and cholesterol levels. "On a population basis, you can expect all of those bad things to improve," he said. "It all makes sense. If you lose weight and all these things improve, it has to be good for you." But, he added, "The only problem is that when you look at mortality rates, they don't look good."

Dr. Jules Hirsch, an obesity researcher at Rockefeller University, provided evidence from studies by others that followed thousands of people for years, keeping track of who lost weight, who kept it off, who became ill and who died. Repeatedly, investigators reported that fat people who lost weight and kept it off had more heart disease and a higher death rate than people whose weight never changed.

"It all does tend to indicate that weight loss is not associated with lower mortality but is actually associated with higher mortality," said Dr. Katherine Flegal, an epidemiologist at the National Center for Health Statistics. But, she and others noted, the limitation of the studies is that they cannot distinguish between people who lost weight because they went on diets and those who lost weight because they became ill.

[A new study is planned to focus on the mortality rates of people who undergo voluntary weight loss.]

Dr. Hirsch said that, in the meantime, he wished the message could get out that truly fat people really are different from people of normal weight. "There is some sort of extraordinary genetic and environmental mix that has programmed people to be set for greater fat storage," he said. [...]

"A reduced fat person is not a normal person," Dr. Hirsch said. "If you take two women who both weigh 130 pounds, but one used to weigh 200 pounds and one always weighed 130, they are not the same."

Some of my friends don't seem to understand why I'm not actively trying to lose weight. Well, this is part of it. I don't currently have any problems with blood sugar levels, blood pressure and cholesterol levels, which are things that weight loss helps in the short term. Meanwhile, I did a *lot* of weight yo-yoing and didn't begin to learn healthy attitudes toward food until my late 20s, so I'm not a good candidate for food restrictions. Toss in that the long-term affects of dieting are unknown, mix well, simmer for an hour.

For me, the result is: I don't see any benefit for restricting my diet right now.

And the really great thing is that I've convinced my mother to quit trying to change my mind :) The really sucky thing is that even now, at the ripe old age of 35, I'm sitting here feeling defensive about a choice I've made about my own body.