The Obesity Paradox

March 3, 2014
“Fat isn’t always bad. And exercise isn’t always good,” cardiologist Lavie writes in his introduction to this thoughtful examination of what society deems a healthy weight. That pat statement is the crux of the “obesity paradox”: overweight and even moderately obese patients often live longer and fare better than their thinner counterparts when it comes to chronic diseases, cancers, and even HIV. Lavie and Loberg examine this conundrum from multiple angles, looking at where fat cells are stored, metabolic health and muscle mass, and exercise levels. By no means are the authors about to proclaim obesity a healthy option; they are quick to acknowledge that it can be tough to determine which came first, the diabetes, or the obesity or heart disease, for example. Still, studies show that patients who focus on overall fitness rather than weight loss are healthier in the long run. Readers hoping for a free ticket to all-you-can-eat ice cream or permission to tear up their gym card will be disappointed, but those who’ve focused on numbers—whether body mass or weight—will likely find solace and sound advice here.