Dr Flegal included studies of general populations, not just those in hospital or with specific conditions. But her findings add new fuel to the debate over what is called the obesity paradox. Those with chronic diseases such as diabetes and heart conditions seem to show an inverse relationship between BMI and mortality—that is, being moderately overweight seems to have a protective effect.I read further because I had to know,
Just why this is true remains unclear. It may be because the overweight receive life-prolonging medical care, such as treatment for diabetes and drugs to control heart conditions. It may be that they are better equipped to endure surgery. Among those who sought angioplasty for coronary artery disease, a higher BMI was linked with a higher rate of survival. Or, as Wolfram Doehner argued in 2010, chronic illness—of any sort, not just that linked to obesity—may be a metabolically demanding state, with the overweight having more energy reserves to meet that demand.I got to the end of the article, and felt vindicated.
Relatively plump citizens may indeed pose a particular burden on the state. On the one hand, they run a higher risk than those who are less fat of developing chronic ailments such as heart disease and diabetes that require expensive treatment. On the other, corpulence may extend life, meaning such treatment may be needed for many extra years. Expanding waistlines could be making people live longer, but sicker.All that time spent working out was time spent well, indeed!