Health: More Than Just A Little Chunky

If you’re just a little overweight, there are plenty of books, magazines, videos and websites that will tell you how to lose those extra pounds. But very few emphasize the health benefits of simply maintaining your weight–even if you’re a tad on the chunky side. And there’s practically no advice for the extremely obese–folks who are at least 100 lbs. overweight and who have trouble moving, let alone exercising. Yet the number of morbidly obese Americans has quadrupled in the past 20 years or so (from 1 in 200 to 1 in 50); in contrast, the number who are merely obese (at least 30 lbs. overweight) has doubled.

That is one of the reasons there was so much interest in a study that appeared last week in the Journal of the American Medical Association (J.A.M.A.) about the health effects of carrying around all those extra pounds. Researchers looked at health data from more than 90,000 older women–some of normal weight, some obese and some morbidly obese. They found over the course of the seven-year study that for white women, being obese rather than of normal weight was linked to a 12% greater risk of dying. Women who were at least 100 lbs. overweight, however, had an 86% greater risk of dying. Other racial groups showed similar links between increasing body size and death rate.

Women who are less than 30 lbs. overweight might take comfort in the fact that their group showed no significantly greater risk of dying over the length of the investigation. (Other studies have shown similar results.) But they should know that their chances of developing heart disease did increase. “To me, that suggests that seven years was not a long-enough time for follow-up in the overweight women,” says the J.A.M.A. report’s lead author, Dr. Kathleen McTigue of the University of Pittsburgh. It may simply take longer for the fatal effects of heart disease to start showing up among overweight women.

A closer look at the numbers also revealed that obese women who suffered from diabetes, high blood pressure or high cholesterol levels were at much greater risk of dying than those who were simply obese. That finding should spur doctors to be more aggressive about diagnosing and treating those ailments in their heavier patients. It might also help extremely obese women who are considering the risks and benefits of taking such drastic steps as gastric-bypass surgery.

Studies like this one may eventually enable scientists to get a better handle on the genetic and biological factors that make it easier for some people to stay trim and predispose others to pack on the pounds. The morbidly obese will probably never get the kind of attention that is lavished on the slightly overweight. But someday they may have more effective tools to treat the complications that stem from their obesity–and, better still, to prevent them from becoming obese in the first place.