Can You Be Obese and Still Be Considered Healthy

Obesity is the next major epidemiologic challenge facing today's doctors, with the annual allocation of healthcare resources for the disease exceeds $150 billion in the United States. As stated by Ryan Hurt from PubMed Central, the prevalence of obesity has risen in the United States over the past 30 years; “60% of adults are currently either obese or overweight” (“The Obesity Epidemic: Challenges, Health Initiatives, and Implications for Gastroenterologists”). Obesity is associated with a higher incidence of a number of diseases, including diabetes, cardiovascular disease, and cancer.

However, some experts believe that people can be obese and still be healthy.

These experts have indicated through many observational studies that an obese person can be considered healthy if they mentally embrace their weight, meet two clear health guidelines, and/or are very metabolically healthy. On the other hand, just as many specialists argue that healthy obesity is strictly an impossibility, and prove their claim by presenting evidence supporting the increased probability of heart disease and heart failure in obese people despite good metabolism, which clearly inhibits an obese person from being considered to be healthy.

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While supporters of healthy obesity do not blame the condition on the individual with it, some of those who deny healthy obesity suggest that unhealthy behaviors should be stigmatized in order to prevent the epidemic from increasing in prevalence.

Many people have studied how obesity is not always indicative of an unhealthy lifestyle and believe that they can lead healthier lives if they embrace their physical structure. Specifically, Mary Ray Worley’s article, “Fat and Happy: In Defense of Fat Acceptance,” unravels anti-obesity stereotypes and attempts to dispel them.

Focusing on her personal experiences as a fat woman, Worley uses illustrative language to convey her argument against fat stereotypes, saying that obesity is not directly related to a healthy lifestyle by describing the transformation of her life after she attended the National Association to Advance Fat Acceptance (NAAFA) Convention. After hiking in Yosemite, she begins to take the stairs whenever she can and starts going on frequent long hikes with her husband. As a result, she claims that she is “no longer ashamed of [her] huffing and puffing” (Worley 167). Moreover, she says that, due to her recent accomplishment of being able to hike for an entire day, she is “only beginning to discover what a marvelous gift [her body] is” (Worley 167).

Worley’s detailed depiction of her hike through Copper Falls State Park with her husband serves to prove that her opinion of her body shape is transforming in what she believes is a positive way. She is more than content with her body at this point, and eager to expand the amounts of activity it can endure. Worley reveals that she thrives in her new lifestyle, and encourages the readers to embrace the “marvelous gift[s]” that are their bodies. Instead of choosing to be ashamed of one’s weight, Worley reassures all obese people that emotionally embracing their size is the first step on the path to a full and healthy life. Contrarily, many experts argue that overeating should be stigmatized in order to reduce obesity. Greg Critser, a writer on medicine and health, claims that it's time to stigmatize the once sinful act of excessive eating. In “Too Much of a Good Thing” Crister explains that, although childhood obesity has become an epidemic, the fight against it is 'increasingly paralyzed by years of media-induced food hysteria, over-generalized and outdated nutritional wisdom,' as well as the lack of restrictions concerning food (Critser 161).

Rather than succumbing to conventional ideals, Crister strongly advises the American parents to take a stand against gluttonous actions. He puts the responsibility on them for setting these food restrictions, but does not blame them for the nation's dietary problems. Critser claims that the stigmatization of childhood obesity will dramatically decrease obesity rates throughout America. As a solution to this seemingly immovable problem, Critser believes that engagement in unhealthy behaviors like overeating can be eliminated through the stigmatization of such behaviors. He claims that “stigmatizing such behaviors [of smokers and homosexuals] proved highly effective in reducing risk and harm” in order to obtain “short-term pain for long-term gain” (Critser 161). Critser acknowledges that stigmatizing on safe sex and smoking resulted in stereotyping those individuals who engaged in those behaviors. However, he dismisses the “pain” as both minor and temporary, and concludes that a similar endeavor can be used to help decrease obesity rates. In response, Worley would insist that the campaign such as the one Critser advocates four might make the lives of obese people even more unbearable than they already are. She would use her own personal experiences as a fat person to justify the idea that, since she feels healthy and exercises regularly, she is therefore a healthy person despite her obesity. Critser, on the other hand, would most likely be persistent in with his stigmatization plan, again using the evidence from the success of stigmatized smoking and sex. While both authors have valid points, Critser is evidence is more scientific than Worley’s, therefore making his article slightly more credible from a scientific standpoint on the issue.

Most people who are overweight or obese show unhealthy changes in metabolism. However, there is a state of being called metabolically healthy obesity, in which, Patrick J. Skerrett, the Former Executive Editor of Harvard Health, claims that overweight people can still be considered to be in good health in his article “Overweight and Healthy: the Concept of Metabolically Healthy Obesity.” People who are metabolically obese, when observed from a metabolic standpoint “look like individuals with healthy weights” (Skerrett). Skerrett argues that, in order to be considered a metabolically healthy obese person, one must have “a waist size of no more than 40 inches for a man or 35 inches for a woman normal blood pressure, cholesterol, and blood sugar normal sensitivity to insulin, and good physical fitness” (Skerrett). Skerrett goes on the explain how other traits, such as high BMI, are not always indicative of an unhealthy lifestyle.

Thus, people are more inclined to be accepting of obesity due to the chance that it does not indicate an unhealthy lifestyle. Skerrett provides reassurance that not all obese people are to be blamed for their condition because of the possibility of a healthy metabolism. However, many studies have found that metabolically healthy obesity is not a justification for healthy obesity. An expert at MedPage seemingly has evidence that metabolically healthy obesity is not so healthy after all. Jeff Minerd, a contributing writer at MedPage, provides a large, long-term study conducted by the German Center for Diabetes Research, described in his article “Metabolically Healthy Obesity? Not So Much, Study Finds.” The article adds to the growing body of evidence tipping the scales against the idea that there is such a thing as metabolically healthy obesity. Minerd summarizes the design and results of the experiment, saying that “the study on more than 90,000 women followed for 3 decades found that metabolically healthy obese women -- that is, those without diabetes, hypertension, or high cholesterol -- had a nearly 40% increase in the risk of cardiovascular disease compared with metabolically healthy women of normal weight” (Minerd). In addition, Minerd also notes that a substantial majority of the metabolically healthy obese women (84%) became metabolically unhealthy during the course of the study. This is unsurprising because low metabolic rates are obvious precursors to obesity, which often leads to heart disease.

Obesity and heart disease it is believed to cause claims hundreds of thousands of lives each year. However, WebMD’s article “Can You Be Fit and Fat?” comments on the National Institutes of Health's 1998 report, Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults along with other studies, which all suggest that just because someone is overweight, it doesn't mean he or she is not fit or healthy. The report argues that there are two requirements that one must meet in order to be considered healthy even though they are obese. These two guidelines are almost identical to the ones presented by Patrick Skerrett from Harvard Health, saying that “their waist size is less than 35 inches for women or 40 inches for men, and if they do not have two or more of the following conditions: high blood pressure, high blood sugar, [and/or] high cholesterol” (“Can You Be Fit and Fat?”). In addition, the report mentions the presence of “other risk factors,” such as smoking, that play in a role in how healthy an overweight person can be (“Can You Be Fit and Fat?”).

This National Institutes of Health study, as well as many other experts, support the idea that an obese person is still able to be healthy, should they choose to lead a healthy lifestyle. On the other side of the debate, though, author Ana Sandoiu from MedNews Today claims that new, large-scale research challenges this belief, suggesting that the so-called healthy obese person is nothing but a myth in her article “Can You Be Healthy and Have obesity? Not Really, Says Major Study.” Sandoiu contributes the comments of Dr. Rishi Caleyachetty on one of her own studies on the issue. In the study, Caleyachetty concludes that “the idea of being healthily obese is a myth. Our work shows that so-called 'metabolically healthy' obese individuals are still at higher risk of coronary heart disease, cerebrovascular disease, and heart failure than normal-weight metabolically healthy individuals” (Sandoiu). Sandoiu elaborates on Caleyachetty’s findings, providing the claim that people with obesity considered to be healthy were 49 percent “higher risk of coronary heart disease,” as well as 96 percent more likely to have a heart disease or failure (Sandoiu).

Thus, the idea of metabolically healthy obesity being legitimate is quickly dissolved by concrete studies that produced quantitative evidence. Even if an obese person is medically proven to have great metabolism, Sandoiu and Caleyachetty emphasize the impossibility of such a person to simultaneously be considered to be healthy. Both women base this claim off of the fact that an increased chance of acquiring fatal heart diseases and/or failure is a direct indicator of unhealthiness. In an answer to Sandoiu, the National Institutes of Health's report from WebMD would insist that one’s obesity cannot be proven to be a direct cause of increased potential of heart failure or disease. However, Caleyachetty’s statement in Sandoiu’s article would immediately interject, saying that while the WebMD study may have been conducted accurately, its findings were incorrectly implemented into the context of obesity.