Weight loss for all new article
Date:-25-09-2023
The metabolic health of an overweight person has been demonstrated. A good fitness regimen can aid. However, this is probably only the case for a tiny percentage of those who are significantly overweight.
The correlation between being overweight and dying at an early age was studied by scientists at the CDC in the early 2000s. They were curious as to the relative risks associated with being underweight or overweight.
Their results, published in JAMA, showed some unexpected things.
Katherine Flegal, PhD, a consultant professor at Stanford University and one of the authors of the CDC study, says they were surprised to find that being overweight was connected with reduced mortality than being underweight.
What Does the Available Data Reveal About Normal Metabolic Weight Gain?
According to StatPearls, metabolism encompasses all of the bodily processes that keep the body healthy and working. Numerous studies demonstrate that metabolic disorder or malfunction raises one's chances of developing type 2 diabetes, cardiovascular disease, stroke, liver disease, and even several malignancies.
According to Johns Hopkins Medicine, the following five factors make up what is known as the metabolic syndrome and are typically considered by doctors when evaluating a patient's metabolic health:
Stress levels
Blood fats called triglycerides
HDL cholesterol ("good" cholesterol) in the blood.
Dextrose (BG)
Measurement of the waist
There are some regular trends, but also a lot of individual diversity, according to experts who have researched the connection between body weight and metabolic health.
"Many people who are obese have most or even all of these metabolic abnormalities, but some have few or none of them," says Samuel Klein, MD, professor and head of the Nutrition Obesity Research Center at Washington University in St. Louis.
Dr. Klein has done research on the concept of "metabolically healthy obesity," which he calls "ill-defined," and has had some of his findings published in 2019 in the Journal of Clinical Investigation.
He cites studies that define "medically healthy obesity" as having two or fewer of the five anomalies listed above as being indicative of metabolic syndrome. Meanwhile, other scientists have decided that even one of these deviations is too much. More than 30 distinct definitions have been identified by him in the scientific and clinical literature.
Some of the research on metabolically healthy obesity is murky, he says, because of these contradictions. "In some of these papers, people reported as having metabolically healthy obesity were not metabolically healthy, they just had fewer metabolic abnormalities," he explains.
The fact that some obese patients have no metabolic problems at all is still an important message, though. He claims that long-term observation of such individuals shows no signs of the metabolic complications associated with obesity.
The prevalence of metabolically-sound obesity.
On the other hand, Klein notes, "But this group represents a small percentage of the population who are obese."
He adds that it is difficult to provide an exact figure because it varies by age, sex, and ethnicity. His research suggests that roughly 7% of the obese population may be classified as metabolically healthy obesity when assessed using the most sensitive and rigorous testing techniques.
According to the same research, metabolically healthy obesity is more prevalent among younger people, those with a BMI of less than 35, and those who are older than 35.
Women who have a higher percentage of fat in their lower body (thigh, shin, and buttocks) but not their midsection are more likely to have this condition, he says.
Very few men are metabolically healthy obese, he says, and an increase in waist circumference and abdominal fat nearly invariably indicates metabolic problems.
The reason for this is that visceral fat, which is commonly seen in the abdomen region, is associated with an elevated risk of various chronic diseases related to chronic inflammation and high blood pressure, as reported by Harvard Medical School. Because of this, excess fat in the abdominal region is more of a warning sign than fat in the extremities.
How Do You Know if Your Metabolic Health Is Normal if You Are Overweight or Obese?
Whether or whether a very heavy person has a healthy metabolic rate is partly determined by their genes. According to Klein, "we don't understand the relationship fully, but clearly there has to be a genetic cause" for why some people are more resistant than others to the negative effects of obesity.
It's also possible that things like diet and exercise play a role. According to Klein, the metabolic risks of obesity may be mitigated in those who follow a healthy lifestyle, including eating a diet low in processed foods, exercising frequently, and getting plenty of sleep.
He qualifies this by saying, "But much of this is theoretical and not borne out by epidemiological studies."
Scientists' capacity to quantify these lifestyle characteristics is "not very good," he continues; as a result, it's hard to establish whether or not they contribute to metabolically healthy obesity. To that end, he says, "It makes sense that eating a healthy diet and exercising would improve metabolic health, but whether it leads to metabolically healthy obesity is something we can't say for certain."
How does fitness help mitigate the dangers of being overweight?
A 2014 review of the literature indicated that people with higher body mass indexes who were nonetheless physically fit (as measured by maximal oxygen uptake, or VO2 max) had death rates equivalent to those of people with normal BMIs who were similarly fit. The study indicated that both groups had lower mortality than the unfit population.
A review published in 2021 in the journal iScience agreed with these findings, arguing that fitness, rather than body weight, is a more effective health assessment. The review's authors argued that, for obese people, getting fit is more important than losing weight.
According to Klein, "there are research data showing that being fat and fit is clearly associated with a lower risk of developing heart disease or diabetes, or dying from heart disease," whereas being thin and unfit is linked to a higher risk.
Many people who are overweight or obese will benefit from getting in shape, he says. He claims that doing aerobic and endurance exercise on a regular basis will boost metabolic health and shield you from developing metabolic illnesses.
In any case, "whether becoming more fit will make you metabolically healthy obese will vary from person to person," he says. It may improve your metabolic health, but it doesn't mean you'll be healthy overall. Furthermore, he claims that a person's chance of developing metabolic or cardiovascular disorders is reduced when he or she is both physically fit and thin.
The term "fat but fit" certainly applies to some people. But as Klein points out, it's not quite obvious that those who are overweight or obese can prevent all health issues associated to their weight by only working on getting fitter. It's possible that "weight loss may still provide additional risk reduction benefits," he says.
If you're overweight or obese, should weight loss always be your first objective?
The answer to this question is obvious for people who are overweight.
"If you're obese, even if you're metabolically healthy, it's reasonable to try to lose weight," adds Klein.
Beyond metabolic health, he claims that being overweight puts one at a higher risk of age-related mobility impairments, joint problems like arthritis, dementia (as per a study in Alzheimer's and Dementia), and certain cancers (as per a study in The New England Journal of Medicine), among others. "I think it's very rare to find a person who is obese who would not benefit from losing weight," he adds of the obese.
His views are shared by other specialists.
In his capacity as a professor of metabolism and body composition at Louisiana State University's Pennington Biomedical Research Center, Steven Heymsfield, MD, has observed that "high weight takes its toll" over time. Healthy weight loss can help people who have been obese their whole lives avoid needing new hips and knees and other functional difficulties.
A balanced diet that emphasizes natural foods and minimizes ultra-processed items is beneficial for people of all sizes. Similarly, avoiding sedentary activities and committing to a regular exercise and sleep routine are both beneficial. In his opinion, anyone who is overweight would benefit from adopting these behaviors if it resulted in weight loss.
However, the benefits of weight loss are less certain for persons who are overweight as opposed to obese. Flegal argues that trying to lose weight may not necessarily yield to health benefits, especially if the individual who is overweight is enjoying a generally healthy lifestyle. (And studies shows that excess weight in old age can actually be advantageous.)
If your doctor suggests weight loss, Klein believes it's important to raise these questions regardless of your size.
You should, he argues, "ask what the benefit of me losing weight is, or why I should do this." "If they say your triglycerides are high, your blood pressure is on the edge of being abnormal, you have a family history of diabetes, or you have prediabetes — all of those are major indications for weight loss benefits," he says.
However, if your body type is similar to that of your parents who "lived to 100 without major diseases," and you too are metabolically healthy, then lowering weight may not enhance your health, according to Klein.
Is it okay for 'fat but fit' people to use weight loss pills?
Wegovy (and the associated diabetes medicines Ozempic and Mounjaro) have garnered a lot of attention recently because to the remarkable success many people have had while using them to help them lose weight. Are they good for someone who is overweight but otherwise healthy metabolically?
Klein points out that there has been a lack of research into these medications among persons who are both fat and metabolically healthy. For this reason, determining their value will involve some speculation for the time being.
Only people with a body mass index (BMI) of 30 or more, or those with a BMI of 27 or higher who also have weight-related health concerns including high blood pressure or type 2 diabetes, are considered eligible for Wegovy under the current FDA standards.
Although these requirements "are very reasonable," says Klein, there are still cases in which a person may not gain any benefit from taking a weight loss medicine.
He begins by pointing out that body mass index (BMI) has its limitations as a diagnostic tool. Based on BMI alone, a bodybuilder or other athlete with a low percentage of fat to muscle would be considered obese. Someone like that, he explains, doesn't have to use pills to lose weight.
The FDA-approved weight loss medicines, he adds, can be quite pricey ("around $1,200 or $1,300 per month"), and insurance doesn't always pay the cost. It might not be worth it to pay that much for someone who is obese but does not have any of the diseases or risk factors associated with obesity.
But he claims these medications are harmless, calling them "very safe." To add, he suggests that those who are overweight would benefit from taking a medicine to help them lose weight because it could "improve their ability to walk and play with their children, and perhaps also lower their risks for non-metabolic diseases such as cancer."
It's not simple to draw conclusions about health from an individual's weight alone. There are too many variables to generalize.
"The decision to lose weight and the best approach to losing weight are really for the patient and their physician to discuss," Klein says.
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