Everyone generally knew that overeating is bad for overall health. Everyone knew that eating high cholesterol foods made you prone to heart diseases. Everyone knew that sugar is the most dangerous substance in the world. Everyone knew that exercise is good for the overall health of an individual. Everyone knew that obesity is not healthy thus reasonable for said, people to start to pay attention to what they were eating and be active. But how many people do know that body weight and physical appearances, to a certain extent, can be much healthier than people who were described to have an ideal, healthy body weight? For example, let's take a look at the life of two best friends, John and Howard.
John and Howard are best friends since they were little kids. Despite all of their similarities in terms of passion and ambition, both of them exhibit different physical appearances; John is lean while Howard is a little bit chubby. John is a much attractive guy compared to Howard and all can be attributable on how good looking John is, with his lean figure, skinny leg and charming smile. Howard on the other hand, can't fit himself with an L shirt. He looks big, short and frustrated with the fact that he put all of his effort to lose weight but end up with being "fat". He got a good looking face though, according to his girl classmate that he is having a crush on.
He put a lot of effort, planning his diet and exercise regime so that one day, he would be "pretty" enough to be able to ask his crush out on a date. John, on the other hand, love to spend his free time, munching on fast food while watching whatever series available on Netflix, belong to Howard. He always bragged to Howard, how he doesn't even exercise but still own a good body morph, deep down, Howard was jealous. Well, he shouldn't. Which out of the two you think would live healthily? Is it John or Howard?
So, the burning question, what makes you healthy? Is having a good physical appearance means you are healthy? Is being obese means you are healthy like what have been stressed out in the obesity paradox? I believe, apart from taking care of what you are going to put into your body, being active by doing physical activities is an important determinant of how good your prognosis is. An active lifestyle is not the sole determinant for a healthy lifestyle, after all, it is a multimodal figure comprises of various factors that can affect how well you are going to be 5, 10, 15 years later. Losing weight would take a lot of time and patient but starting an exercise regiment while being obese will exert an instantaneous effect.
I would like to remind you when I was talking about an instant effect provided by exercise, I don't mean losing weight. You should read an article written by 
Oh yeah, by the way, some studies in the past indicated that an exercise is a crappy tool for losing weight. Sure, some exercise does make you shed your fats quite effectively, but after a few weeks, you will reach weight plateau; a condition whereby even with the most rigorous exercise, wouldn't result in weight loss (Source). Exercise does really exert a beneficial effect on people who stick by it but without managing other factors such as diet, sleep, mental state etc. it's impossible to live healthily. Regarding the obesity paradox, even though one study published in 2018 has found some loopholes associated with the paradox, scientist seems to understand that the sole determinant that differentiates regarding the health of people who are obese and people who are lean, is frequency of physical activities (Source). It's tricky and not completely understood why obese people were having a low mortality rate from cardiovascular diseases compared to lean people, but I'm sure with an appropriate amount of subjects, sponsors and passions, we will discover it soon, the reason.
So, back to my question, what makes you healthy? The answer is quite tricky even though the question can be perceived as a simple one. Well, based on previous studies, I would like to say that exercise is an important prognostic factor that would largely determine how healthy a population is; this excludes people who were affected by genetic diseases. Gosh, it's complicated.
Now, let's take a look at weight and how it influences longevity. People often concerned with their own weight because of appearances, like, how they look; only a few fear for all of the chronic diseases that would fall on them if they were overweight. In a certain group of people, weight has been associated with how well you are going to interact with your own social group. People seem to feel insecure about their weight but if there are a few obese people in their social group, the fear usually subsided. The only problem is when you were fat and you befriend supermodels. How insecure would you be by then? It's like some sort of a life hack. If you would like to look and feel attractive while walking in the mall with your friends, leave your supermodel friends at home or better, bring uglies.
These days, some of the obese people, may have come to you with a question "How come weight influence the duration I'm going to live? How about the obesity paradox?". It's difficult to give a satisfying answer especially when people are not really open-minded. They are bound to a specific agenda or theory and they are often blinded by their own obsession. Even though there are a few valid documentation that was published to prove the existence of the obesity paradox, some scientists were sceptical. How come being fat and obese, shielded you from chronic-related suffering and death. To be honest, I'm one of those people. Being a medical doctor, I was taught how bad obesity is and all sort of diseases that I have to memorise in order to graduate but now, we have something which is the opposite.
Dr Carl J. Lavie is one of the most renowned cardiologists from the United States who has been fascinated with this topic. He even wrote a book compiling a few theories and examples from case studies and if you really interested in this kinda paradox, you should read it. The point that I would like to emphasize here is even though some studies have proved that mortality rate for people who are overweight is low compared to a normal BMI people, it does nothing to the morbidity rate. I'm one of the people who believe in preventative medicine, and proving that overweight people who were affected by heart disease have a better chance of survival compared to normal people with cardiac problems is futile. The most important note that I'm going to take from all of the research that I've read is people who are obese (especially morbidly obese) would have a greater chance at getting a heart disease. Nevertheless, I didn't ignore the fact that the obesity paradox exists.
In the obesity paradox, the mortality behaviour reacts in a U-shape manner, if there is a graph with BMI on the X-axis and the mortality rate on the Y-axis. If you were thinking, the lowest death occurs in the normal BMI, you were wrong. The highest death occurred in people who were underweight and morbidly obese while the lowest death witnessed in the overweight categories; mind-blowing, isn't it? Let's take a look at a study which has been conducted in 2013 by David Faeh et al. that investigated the mortality rate among people who are underweight. A group of dedicated scientists have been updating the result of 31,578 people, for 32 years and among them, people who were underweight have found to have the mortality rate of 32% greater than people who have a normal BMI (Source). People have been saying that BMI can be inaccurate and that's why we need to use waist to hip ratio to certify the risk of getting cardiovascular diseases but some flaws in the BMI infrastructure has been notified and adjusted according to certain types of people e.g. athletes have their own BMI chart so it will be wise to actually believe the result produced from such studies.
There are a few reasons why the obesity paradox existed:
Let's talk about two kinds of people who have cardiac diseases. Obese people usually developed cardiac diseases as a result of an existing disease; diabetes mellitus is one of the most common causes of cardiac diseases in obese people. If obese people start to pay attention to what they eat and increase the intensity of physical exercise, even if their figure and weight didn't change much, their survival rate increase tremendously. On the other hand, people who are underweight could have been affected by cardiac diseases because of secondary factors but most of them were caused by genetics. Now, there is not so much that we can do regarding genetics, for now.
Obese people might have been shielded from death by all of the available fat that acts like an alternative energy source when they were struck by diseases. This would allow them to fight acute or chronic insults which might have been too much for skinny people. In a disease process, people usually don't have much appetite. This would hinder recovery processes as our body needs energies to fight off infection or any other external insults. So the next time, if people tell you that you were eating so much, you can say that you were preparing for future fights against foreign microinvaders or diseases.
In February 2018, Srikanthan P and Karlamangla AS have published a study which shows an increase in muscle mass will result in lower mortality rate (Source). People who are underweight have little muscle compared to obese people who, in a sense, carry weight all the time. This can be one of the reasons why people who are obese have a better shot at survival compared to people who are underweight; it is a good predictor or mortality.
So, are all people who are obese have a better chance of survival compared to normal or underweight people? Definitely not. It will depend on how you were living all this while. Some people are active but can't be too much bother with the number of calories they were taking, hence, they were fat but their mortality rate is much lower than obese people who lead sedentary lifestyles. Physical activities especially exercises are a powerful tool at your disposal to ensure you will lead a long healthy life; it would be better than living longer with a cocktail of diseases.
This is a popular type of excuses when people are inviting you to exercise but you felt lazy; do you know there is such thing as exercise allergy? It is not really you are allergic to exercises but certain allergen can affect you only when you are exercising; the condition is called an exercise-induced anaphylaxis. The tricky thing about this condition is you were not, at all, allergic to the exercise itself but to the food you've taken or allergen-related things before your exercise sessions. There are a few documented cases whereby women can't exercise during their menstrual period due to a flood of oestrogen which could have amplified their anaphylactic reaction. Obviously, this is a new territory for me, and I didn't have much information regarding it but, it's an interesting case, don't you think?
The only way of recovering from such illnesses is to avoid all of the allergens be it foods, cats etc. Don't put exercise aside! Exercise is not the culprit, the allergen only reacted in a specific time period which makes exercise looks like a jerk. Some people were having a severe reaction even by brisk walking, can you imagine that? Nevertheless, you should keep on trying to find which kind of exercise suits you best. People have been taking this thing seriously, that they lived sedentarily instead. I wouldn't professionally tell you that's a bad choice, it is a choice but personally, I just think it is plain stupid; there are more diseases would follow if you submit yourself to this path. Talk to your medical doctor to know what kind of exercise you can do and they might have some alternatives if they have all kind of information.
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