A new study presented at the European Association for the Study of Diabetes (EASD) meeting in Vienna suggests that some people with higher body weight may still be healthy and not at greater risk of dying early.
Researchers in Denmark looked at health records of over 85,000 people, most of them women around 66 years old. They found something surprising: People who were slightly overweight, or even moderately obese, were not more likely to die within five years compared to those with “normal” weight.
The study looked at Body Mass Index (BMI), which is a way to measure body fat based on weight and height. A BMI of 18.5 to 24.9 is considered normal, 25 to 29.9 is overweight, and 30 or above is obese.
Surprisingly, people with a BMI in the 25–35 range (overweight to moderately obese) were not more likely to die early than those at the upper end of the “normal” range (BMI 22.5–24.9). In fact, people with a BMI in the lower end of normal, or who were underweight, were more likely to die.
Underweight people had almost three times the risk of death compared to those in the upper-normal range. Even people with a BMI of 18.5–22.5 had a higher risk of death than those at 22.5–24.9.
However, people with very high BMIs—above 40—did have an increased risk of dying, more than double that of the reference group.
So why do these results go against what we’ve long believed? The researchers say some people may lose weight because of underlying health problems. So it might look like thinner people are at higher risk, but the real issue could be their illness, not their weight.
They also say it’s possible that older people with higher BMI may have protective factors that help them live longer. More research is needed to know for sure.
Experts now believe that BMI alone is not enough to judge someone’s health. Where the fat is located matters too. Fat around the belly (called visceral fat) is more dangerous than fat on the hips or thighs. Belly fat can affect how the body works and lead to serious conditions like type 2 diabetes or high blood pressure.
This means that two people with the same BMI could have very different health risks. One may have diabetes, and the other may not.
Doctors say obesity treatment should be more personal, taking into account not just weight, but fat location and other health problems.
This research shows that being “fat but fit” may be possible for some people, especially older adults. But it also reminds us that good health is about more than just the number on the scale.
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