Overweight people live longer

Critics of the study:

Don't break out the Little Debbies quite yet. It's just another population study with an unclear correlation between behavior and mortality.

Yup, it was rambling. Perhaps I also missed the point that you were concerned about the "goal of life", rather than the goal of the study, because, well, this thread is about that study, not about the goal of life.

As to this silly "Public policy does absolutely nothing to affirmatively support anything that has helped me maintain my health", that's baloney. You received childhood vaccines. You eat food that is inspected (albeit imperfectly) for pathogenic bacteria. You eat food that is priced in large part due to farm subsidies, to both traditional and organic farmers. You are exposed to less second-hand smoke because of public health interventions. The list goes on. You're not this island of virtue making it alone.

As to this silliness about the difficulty amorphous definitions-- it's rally not hard. I gave you my one line definition of good health off the top of my head-- if your counter example is that you want to run 9.9 for 100m, well, that's a pretty silly argument. To fund any research you write your grants to support why selected condition needs further study, and what benefit it has to society. If you write a grant with a trivial aim, it won't get funded. in this case, this study was a pretty decent meta-analysis (it was an unfunded study by the way, other than the writers are employed to do this type of work) of the effects of body-mass on mortality.

Feel free to dismiss it as "a correlative association that demonstrated nothing about causality"-- if you're as well versed in research as you claim, you would know that a large meta-analysis that is done well, with appropriate sensitivity analyses and adjustment for possible confounding, is of considerable benefit. Especially when, as in this case, the dozens of included studies showed consistency, have biologic plausibility, and demonstrated a dose-effect. None of those prove causation alone, but all are part of exploring a connection.

Finally, this statement "It is political concerns that, at the highest levels, are shaping the contours of acceptable research" is again a bit paranoid. Plenty of people are funded to do high-profile research that runs counter to pharmaceutical interests. Just in my institution studies have been done demonstrating that surgery for localized prostate cancer offers no advantage to watchful waiting, and that endovascular aortic aneurysm repair offers no survival advantage over conventional open surgical repair. Not to mention any number of other studies that live and die off their relative merits in study sections where they are judged by experts, and not based on some overarching political philosophy.

Back to my grant writing-- although if you're correct, I don't have a chance in hell. Luckily for me, all the evidence suggests you're not.

I heard some of this story on NPR. Of the doctors who said being overweight was good, they tended to say it was good for older people. Why?

Well, let's say you are fat and fall down. All your fat could cushion the impact and save you from breaking a major bone. Super!

How about if you get sick, then you have a miraculous store of calories just waiting to nourish through the bad times. Brilliant!

Also, the study doesn't mention that many of the thin people were also already sick. That's what the NPR story said anyway.

Whatever. I'm worried about my quality of life not the length. The last years of your unnaturally prolonged life are the crappiest anyway. I'd rather miss them.

Oh, sorry, I didn't realize I was dealing with a crazy person. Yes, preventing kids from dying of measles, tetanus, and polio does lead to more people on the planet, which does lead to other problems. But a sane person then looks to fix the other problems-- instead of claiming that preventing people from dying is bad for health, because of overpopulation. Wowza.

I heard some of this story on NPR. Of the doctors who said being overweight was good, they tended to say it was good for older people. Why?

Well, let's say you are fat and fall down. All your fat could cushion the impact and save you from breaking a major bone. Super!

How about if you get sick, then you have a miraculous store of calories just waiting to nourish through the bad times. Brilliant!

Also, the study doesn't mention that many of the thin people were also already sick. That's what the NPR story said anyway.

Whatever. I'm worried about my quality of life not the length. The last years of your unnaturally prolonged life are the crappiest anyway. I'd rather miss them.

___________________________________________________________

Sure right

End of thread

162430 wrote:

It is easy to be "reasonably muscular" at 5'10" 150lbs. I weigh 5 lbs less than that when I am at race weight (153 lbs just now when I checked) and all women drool when they see me shirtless. I am guessing that you are just some tubby cross-fitter or something.

It is probably vomit, not drool, that is coming out of their mouths.

Ghrelin wrote:

I'm thin but reasonably muscular at 5'10", 150. At 200 pounds, there's no way I wouldn't be a fatass. I know this because my dad, who's about the same height, is fat at 180.

First off, *no one* is "reasonably muscular" at 5'10", 150lbs. Sorry. You and others at that same height/weight may have deluded yourselves to think yourselves so, and I say this having been there once myself. I remember thinking myself "reasonably muscular"....until I went into a gym and actually started lifting weights.

Your dad is not proof of anything. Lift weights, eat a lot of nutritious foods, do some amount of cardio activity, and see what happens.

dd--

You are taking things much too literally, and missing the big picture as a result. Think of my examples as representative of larger phenomena, not as discrete quanta.

"If you write a grant with a trivial aim, it won't get funded."

I will leave that one to the readers to determine for themselves. One person's "trivial" is another person's crusade.

"To fund any research you write your grants to support why selected condition needs further study, and what benefit it has to society."

Wrong. You look at something that interests you, and you see how you can fit it into the terms of reference of the granting agency. You consider your audience, and make your best effort to determine what is important to them, and then you tailor your efforts accordingly, while trying to maintain some integrity, if not in that application, then in the broader trajectory of your research, and that of any group or institution with which you are involved.

If you're doing anything differently, your probability of success is greatly diminished. And if you are successful with another technique, you may rest assured that others are vastly more successful with a better technique.

And therein lies the rub: very few studies are conclusive, one way or another. Some can be pretty good as far as they go, but part of what makes a study great is an express detailing of its limits of validity. As you well know, evidence for the consideration of issues can be found in peer-reviewed papers. There is ALWAYS evidence on both sides of the table--the quality of that evidence is determined by not only the intrinsic properties of the research, but by the purpose to which it is put, that is the proposition it is used to support or refute.

Consider localized prostate surgery. Without a doubt the associated paper details outcomes and measurement protocols. As a small example of the type of thing I'm trying to get across, do any of those outcomes permit the measurement and analysis of anxiety related to the prostate condition during the patient's life, as a dimension of the "advantage" of which you speak, and if so, how was it incorporated?

I have spoken to many who have had the surgery, and even in the face of research such as that from your institution, they would have the surgery again, for peace of mind. Is their quality of life better? From their point of view, yes. Is that an advantage? From their point of view, yes. Is it worth it? THAT is the type of question that public health policy should aim to address, and of which it does a damn poor job.

There are vested interests, both political and commercial, on both sides of that particular issue, upon which I need not elaborate as they are all-too-obvious. The policy game will be played by players from pharma, AMA, insurers, gov't actuaries, etc., and their considerations will be political.

To be of any actual use, in general, a research paper would have to be read by the individual patient who is considering undergoing a procedure or a treatment, or engaging or not engaging in a particular behavior, so that they can judge for them what is in their best interest at the individual level.

As far as "food inspections" go, the vast majority of food in the USA is NOT inspected, and many suppliers, although they make some effort at compliance, do not actually comply. As a result, there is a scale of warnings and timeframes for compliance in the event of non-compliance; however, the upshot is that the vast majority of food is not inspected, and the majority of facilities are currently not in full compliance.

Plus, I buy locally from small concerns and friends, and grow as much as I can, which is a lot. I do lots of canning and preserving. It is me who inspects the food. I even do things like buy whole milk directly from producers.

And yes, I did receive vaccinations--to what end, I'm still not sure. Were they worth it? Don't tell me that THAT is a settled issue. All you need to know that it isn't, is look around at how many people are opposed to vaccinating their kids. I know the arguments on both sides, and I am still not convinced that there was any net benefit of the vaccinations, either to society at large, or to myself as an individual. I do not get flu shots every year, but I certainly do get the flu most years, including this year. Know what? It provided a great excuse to sleep for several days straight. I'm back stronger and better than ever. Plus, I was able to read some Flannery O'Connor and some Exupery, things I wouldn't normally have the time to do.

"all are part of exploring a connection"

And there lies the essence. Exploration could be, and perhaps should be, intrinsically worthwhile, because nobody can predict what will result from probing the unknown. But the question is whether or not society should support such exploration, and if so, to what extent. By "extent" I mean not only "amount", but who should do the exploring, how that exploring should be done, what the roadmap is, how it affects other social concerns.

I haven't read this paper--however, in general, studies such as this one do not progress a field of inquiry in any particular direction, in the end. They end up being part of a great swirling mass of similar, and sometimes contradictory, studies. Then they get used on various sides of an agenda, the outcome of which is often pre-determined by political (which are now commercial) considerations.

While I do not disparage researchers in the trenches, the more interesting action as far as I'm concerned takes place on 2 distinct levels: 1) at the level of policy, especially as expressed through resource allocation, and 2) at the individual level for me personally. I've got to tell you that I honestly have a better life, as far as I'm concerned, than almost anybody I know. I feel good about my life and how it has shaped up, really good--and I know only a handful of others who could honestly say the same thing. And you know what? Some of them are fat! Sure things could be better both for me personally and especially at the social level, and that is why I continue working on things, and living life in general.

There is more to come, the future is exciting, and it will not involve any health care, public or private, to the extent that I can avoid it. Even if I have the misfortune of contracting a very serious illness, I do not know that I will seek "care" from the establishment. I am absolutely serious about this. I have watched many people in various stages of care for degenerative conditions, and more than one time have been told that if they knew in advance what it was going to be like, they wouldn't have done it. In fact, more have told me this than not.

I have the benefit of their experience, however. These are not easy decisions. Not seeking "care" for anything I have had in the past has also not been easy, especially when there are others urging you to actually seek that care. Things have worked out well so far. When I was 20, people kept saying "Oh yes, but wait until you're 30." When I was 20, they kept saying "Oh yes, but wait until you're 40."

And so it goes. I'm now mid-40's, and I'm still waiting, while everybody around me is deteriorating. It's more than just luck--the best luck I ever had was being born into and spending my childhood in a society that was enduring a sustained period of domestic peace. I know that is a huge piece of luck, but it doesn't tell the whole story.

Meanwhile, I can confidently COMPLETELY IGNORE this study, and others like it, as totally irrelevant to me as an individual. I might, however, have to deal with it on a policy level.

Ghrelin wrote:

Opportunity investor wrote:

You're not reasonably muscular at 5'10" 150lbs. If your body type is anything like your dad's, it's more telling that you're not reasonably muscular if your dad is fat at 180lbs.

I can bench more than my own weight, which is at least a basic level of strength. If you think the majority of people over 200 pounds are muscular and not just fat, you must be blind. Take a look around your office some time.

Where did you come up with me thinking that majority of people over 200lbs are muscular and not fat? Are you trying to be a bad politician?

Anyways, benching your own weight doesn't make you muscular. Any guy who is not ridiculously fat or really young or old can bench their own weight after about 2-3 months of gym time. It just means that you reasonably weight train.

Maybe you're one of the stronger guys on your running team, but that doesn't make you muscular.

Sprintgeezer, your posts are way too damn long.

Opportunity investor wrote:

You're not reasonably muscular at 5'10" 150lbs.

Depends on the person:

Jumbo Style wrote:

Sprintgeezer, your posts are way too damn long.

OK:

1) BMI is b.s.

2) all the best food I've ever had has been cooked by someone fat

3) Pavarotti was a pig.

Who cares? Live your life.

Sprintgeezer wrote:

I haven't read this paper--however, . . .

That's pretty much what I got out of your previous series of posts.

Emerging Market Fund wrote:

Opportunity investor wrote:

You're not reasonably muscular at 5'10" 150lbs.

Depends on the person:

http://lmgtfy.com/?q=5%27+10%22+150+lbs+images

No, it doesn't. Did you even follow your own link?

Here's the kind of genius to which studies like this subject us:

"BMI is an imperfect measure of the risk of mortality"

"for overweight people, if indicators like cholesterol “are in the abnormal range, then that weight is affecting you,” but that if indicators are normal, there’s no reason to “go on a crash diet.”"

"“Once you have higher obesity, the fat’s in the fire,”"

"“Fat per se is not as bad as we thought,”"

"extra muscle can be healthy"

"“There’s something about extra body fat when you’re older that is providing some reserve,”"

"“the best weight might depend on the situation you’re in.”"

These are all quotes from MD's and PhD's, and are all taken from the linked NYT article.

Think about the inanity of some of these comments--I mean, read them, and really THINK.

Sadly, I might have to read the paper, just to be aware of its contents.

Sprintgeezer wrote:

Jumbo Style wrote:

Sprintgeezer, your posts are way too damn long.

OK:

1) BMI is b.s.

2) all the best food I've ever had has been cooked by someone fat

3) Pavarotti was a pig.

Who cares? Live your life.

Thanks for the summary, and I agree!

"I know the arguments on both sides, and I am still not convinced that there was any net benefit of the vaccinations, either to society at large, or to myself as an individual"

Out of your very long posts, that is all I really need. If you believe that statement, you don't understand science. All the rest is a nice anecdote, and I'm glad you have the best life possible, can your food, tough out minor injuries, etc; but anyone who writes that sentence does not understand the vast medical literature and historical data behind vaccines, and shouldn't be taken seriously regarding anything remotely science-based.

Yeah this lady has agenda, this is the second time she did this. You include a bunch of old smokers and cancer patients and they really ruin the curve.

dd--

OK then, I'm not here to argue with you.

Remember, though, that "science" is a process of inquiry. There are different degress of validity, and of repeatability, to any inquiry purporting to be "scientific". I would be forever in your debt if you could point me toward a comprehensive, irrefutable demonstration that vaccines have had a net benefit for either myself as an individual, or society at large.

Of course, you cannot, because although individual studies might be valid and repeatable, the determination of ultimate benefit in the social sciences is a value judgment.

Public-health-based research is not like physics or any hard science--for instance, nothing is axiomatic. When you drill down to physical specifics, such as surgical technique and tissue regeneration, you can say something definite, but the more definitely you can say something, the narrower its applicability.

Studies like this have proliferated with the rise of data mining. Why? Because data mining has become cheap, and results are often quick, and politically spectacular. You don't have to do any actual WORK. But scientifically, they are of little to no merit.

I agree that exploration should be done for its own sake, and that society should support such exploration. However, there are many fields competing for said exploration support, and there are many factions within even the field of health care that compete with one another.

To me, this is ultimately a boring field compared to others available.

You sound like an idealistic grad student, and there is nothing wrong with that--but in time you will gain more awareness of how the game is played. Look at how more senior researchers operate, and the environment in which they do so. It's a big world out there, and lots of people are competing for a finite supply of resources. In order to be successful, you will either need to be very lucky, or change your conception of what it is you are doing, and how you fit into the bigger picture.

I was also lucky to have had good childhood nutrition--mostly from our own garden, and from local meat suppliers, I'm glad to say--which had nothing to do with the regulatory environment.