Not really, which is why I phrased how I did. The illnesses associated with obesity also occur in some at normal BMI ranges. Statistically, for populations, they increase significantly above 27 and rise more over 30 but the individuals within the groups (especially that 25 to 30 “overweight” one) are very heterogenous, varying in where they store the fat they have and how much muscle mass they have. Better to avoid the circumstance in the first place than to worry about being there.
OTOH 1: identifying and modifying behaviors in individuals that predispose to the obesity related illness at any weight - lack of fitness, poor nutrition choices with lots of low satiety and hyperpalatable choices in the personal environment, few vegetables and fruits - will help.
OTOH 2: decreasing the degree to which our society’s structure is obesiogenic will help.
Wesley Clark I know by now that you must know that I care less about sustained weight loss per se than the impact of sustained behaviors on the meaningful health outcomes. And indeed behavioral changes can improve obesity related health outcomes such as the rate of diabetes - modest weight loss achieved and maintained but dramatic decreases in the rate of progression from prediabetes to diabetes, even in those that did not lose weight but who maintained the behaviors.
Heart failure too, another obesity related illness, is decreased the more of the listed healthy habits one kept, only one of which is normal body weight.
Yes the behaviors can impact weight some, but the behaviors are not so much the means to losing and maintaining weight loss as they are the means of achieving and maintaining good health themselves. At any weight.
The good news is that the dangerous visceral fat is the first to go. Which means that if your weight (well, amount of fat) is on the way down, you’re probably largely in the clear, while if you’re on the way up, your risk of problems is much, much higher. Your absolute weight doesn’t matter too much as sub-dermal fat doesn’t cause much trouble, except perhaps strain on the joints if there’s a lot of it.
As the poets would say ‘I know that you know that I know that you know’ and so on and so on.
However as far as losing weight, for people with issues like arthritis, joint pain, sleep apnea or pinched nerves actually losing mass and pounds is a desired goal (not just losing 5% of bodyweight). Right now medicine doesn’t have much to offer them other than surgery.
Well let’s take those one at a time, and do some literature searching …
Arthritis? Seems like 5% loss (but still obese at the end) by a combination of diet and exercise (but not diet alone) significantly improves a variety of functional and pain measures.
Sleep apnea? Significant improvement with an average of 10% body weight lost but still on average a BMI of about 30 … also an achievable goal to maintain with improved nutrition and exercise.
Pinched nerves? No idea.
But overall documented evidence that fairly modest loss (5 to 10%) maintained with a good nutrition and exercise, can do more for even those conditions than you may think. Losing massive amounts is not required.
No question though that establishing the habits and avoiding the obesity before it causes a health problem or even raises the risk of one is preferable and, with some attention to systems issues, achievable.
BTW while looking those up came upon this which is pretty dang cool.
Agreed though that short of bariatric surgery there is little that will consistently achieve and maintain the 20% plus (sometime plus quite a bit) weight loss needed to become no longer obese, let alone “normal weight.”
Is there any quality research out there on the effects of weight loss surgery beyond the first year or two post-surgery?
Given the ever-increasing evidence that specific behaviors improve health regardless of weight, I’d need an awful lot of evidence that WLS works long-term to improve health outcomes overall before considering it - it sounds quite terrifying honestly.
Yeah, I kind of been wondering - what ever happened to the old feminist line “Keep Your Hands Off My Body!”? I mean if a person wants choice in their sexual lives, why cant they have it in their food choices?
I have a son. I did not constantly feed him snacks in the car. He played with toys or a book. I talked to him or we sang songs. He did not constantly eat or have a sippy cup with him. Food is not entertainment.