Often, a visit to the doctor’s office starts with a weigh-in. But is a person’s weight really a reliable indicator of overall health?

Increasingly, medical research is showing that it isn’t. Despite concerns about an obesity epidemic, there is growing evidence that our obsession about weight as a primary measure of health may be misguided.

Last week a report in The Archives of Internal Medicine compared weight and cardiovascular risk factors among a representative sample of more than 5,400 adults. The data suggest that half of overweight people and one-third of obese people are “metabolically healthy.” That means that despite their excess pounds, many overweight and obese adults have healthy levels of “good” cholesterol, blood pressure, blood glucose and other risks for heart disease.

At the same time, about one out of four slim people — those who fall into the “healthy” weight range — actually have at least two cardiovascular risk factors typically associated with obesity, the study showed.

To be sure, being overweight or obese is linked with numerous health problems, and even in the most recent research, obese people were more likely to have two or more cardiovascular risk factors than slim people. But researchers say it is the proportion of overweight and obese people who are metabolically healthy that is so surprising.

“We use ‘overweight’ almost indiscriminately sometimes,” said MaryFran Sowers, a co-author of the study and professor of epidemiology at the University of Michigan. “But there is lots of individual variation within that, and we need to be cognizant of that as we think about what our health messages should be.”

The data follow a report last fall from researchers at the Centers for Disease Control and Prevention and the National Cancer Institute showing that overweight people appear to have longer life expectancies than so-called normal weight adults.

But many people resist the notion that people who are overweight or obese can be healthy. Several prominent health researchers have criticized the findings from the C.D.C. researchers as misleading, noting that mortality statistics don’t reflect the poor quality of life and suffering obesity can cause. And on the Internet, various blog posters, including readers of the Times’s Well blog, have argued that the data are deceptive, masking the fact that far more overweight and obese people are at higher cardiovascular risk than thin people.

Part of the problem may be our skewed perception of what it means to be overweight. Typically, a person is judged to be of normal weight based on body mass index, or B.M.I., which measures weight relative to height. A normal B.M.I. ranges from 18.5 to 25. Once B.M.I. reaches 25, a person is viewed as overweight. Thirty or higher is considered obese.

“People get confused by the words and the mental image they get,” said Katherine Flegal, senior research scientist at the C.D.C.’s National Center for Health Statistics. “People may think, ‘How could it be that a person who is so huge wouldn’t have health problems?’ But people with B.M.I.’s of 25 are pretty unremarkable.”

Several studies from researchers at the Cooper Institute in Dallas have shown that fitness — determined by how a person performs on a treadmill — is a far better indicator of health than body mass index. In several studies, the researchers have shown that people who are fat but can still keep up on treadmill tests have much lower heart risk than people who are slim and unfit.

In December, a study in The Journal of the American Medical Association looked at death rates among 2,600 adults 60 and older over 12 years. Notably, death rates among the overweight, those with a B.M.I. of 25 to 30, were slightly lower than in normal weight adults. Death rates were highest among those with a B.M.I. of 35 or more.

But the most striking finding was that fitness level, regardless of body mass index, was the strongest predictor of mortality risk. Those with the lowest level of fitness, as measured on treadmill tests, were four times as likely to die during the 12-year study than those with the highest level of fitness. Even those who had just a minimal level of fitness had half the risk of dying compared with those who were least fit.

During the test, the treadmill moved at a brisk walking pace as the grade increased each minute. In the study, it didn’t take much to qualify as fit. For men, it meant staying on the treadmill at least 8 minutes; for women, 5.5 minutes. The people who fell below those levels, whether fat or thin, were at highest risk.

The results were adjusted to control for age, smoking and underlying heart problems and still showed that fitness, not weight, was most important in predicting mortality risk.

Stephen Blair, a co-author of the study and a professor at the Arnold School of Public Health at the University of South Carolina, said the lesson he took from the study was that instead of focusing only on weight loss, doctors should be talking to all patients about the value of physical activity, regardless of body size.

“Why is it such a stretch of the imagination,” he said, “to consider that someone overweight or obese might actually be healthy and fit?”

Use the comments section below to discuss this issue.

In the last of our four part Perfectibility series, join in this discussion on the myth of the perfect
queer male, body image and more. Typhoon dinner will be served; come early to be sure you get some!
Facilitated by the Peer Health Advocates.

Date: Wednesday, April 23
Time: 6:30 to 7:30pm
Room: Woodhead Lounge

In part, the article states:

The bill, approved by the lower house of Parliament, faces a Senate vote. If passed, it would take aim at any means of mass communication — including magazines and Web sites — that promote eating disorders like anorexia or bulimia with punishments of up to three years in prison and more than $70,000 in fines.

The legislation was sponsored by Valérie Boyer, a conservative lawmaker from the Bouches-du-Rhône region in the south of France, and was also backed by the government’s health minister, Roselyne Bachelot. It is one of the strongest measures proposed since the 2006 death of a Brazilian model, Ana Carolina Reston, from anorexia.

“We have noticed,” Ms. Boyer said in an interview with The Associated Press, “that the sociocultural and media environment seems to favor the emergence of troubled nutritional behavior, and that is why I think it necessary to act.” read full article…

Discussion Question: Can these influences be legislated away? What other methods could affect change? 

Visit the WesWELL website for additional information on eating disorders.

If beauty is in the eye of the beholder, then try to be beheld by a feminist.

A new study finds that women who describe themselves as feminists are more forgiving than other women when assessing the attractiveness of women who are either very underweight or very heavy.

Writing in the journal Body Image, researchers said the findings added evidence to the argument that women who considered themselves feminists might be less likely to be taken in by the notion that the most important thing for women is to be thin. That belief, especially in younger women, can lead the way to an eating disorder.

“Feminism,” the authors write, “does appear to afford women a more inclusive perception of who is physically attractive.”

For the study, the researchers, led by Viren Swami of the University of Westminster in London, showed a set of photographs to 129 women who said they were feminists and 132 who said they were not. The photographs were of 10 women, faces concealed and wearing tight gray clothing, who ranged in body mass index from emaciated to obese.

The study participants were asked to identify the thinnest and heaviest women they considered “physically attractive.” They were also asked to say which woman they thought was most attractive.

Feminists and nonfeminists tended to agree on which woman was the most attractive. But that woman was described by the researchers as somewhat underweight, suggesting that even feminists cannot fully avoid societal pressures to be thin.