A new study shows that “healthy lifestyle habits are associated with a significant decrease in mortality regardless of baseline body mass index”. Look, over there…it’s a great big flaming sack of “no kidding.”
Which is not to say that the study shouldn’t have been conducted, but is rather my attempt to point out the utter ridiculousness of clinging to the idea that getting our bodies to a specific height weight ratio is our best chance for being healthy, knowing the health is not guaranteed, not entirely within our control, not an obligation, and not a barometer of worthiness, in the face of overwhelming evidence that:
1. It’s not possible for most people who aren’t in the weight range to get into it
2. There are plenty of people who fit that height weight ratio who are not healthy
The study looked at the association between 4 healthy lifestyle habits and mortality in a sample of 11,761 people. The healthy habits were:
1. Eating 5 or more fruits and vegetables daily
2. exercising regularly
3. consuming alcohol in moderation
4. not smoking
As you can see on the chart, being “normal weight” is an advantage if you do not partake in any of the four habits (which is still not causal.) However, even one healthy habit cuts the risk down by about half, and subjects who did those four things and were obese have basically the same outcome as “normal weight” people who did all four habits, and a dramatically lower risk than thin people who didn’t participate in the four habits.
This study is not perfect. While 14 years is a decent study period, 12,000 people could be construed as a small sample size, and it speaks only to mortality. The study isn’t overarching proof of anything – in fact overarching proof is very rare – that’s why I waded through brain aching statistics classes.
A very smart friend of mine asked me recently if I put the studies that I tout up to the same scrutiny as the studies on weight loss that I tear apart.
The answer is that I do, but I consider something else as well: risk. I’m familiar with the idea of downside risk from business – I spent years working in business operations as a consultant and my last gig was as CEO of a multimillion dollar locally owned business so I’ve been steeped in business decision making. Downside risk is a look at worst case scenarios – you can’t just make decisions based on what will happen if your strategy succeeds – you also have to look at what could happen if it fails.
So the worst case scenario for weight loss is that I fail at weight loss multiple times and end up heavier than I started and subject to the dangers of weight cycling which include high blood pressure, high cholesterol, diabetes, depression and cardiovascular disease.
The worst case scenario of healthy habits is that I exercised, ate vegetables, drank moderately and didn’t smoke and they didn’t make me healthier.
Next we have to determine how likely it is that we will experience this worst case scenario:
The vast majority of people who attempt weight loss will fail long term according to all the studies that exist. In truth if weight loss were a business decision I would probably never get to a risk calculation since the success rate is within the margin of error and not really worth trying since weight loss doesn’t always come with health improvements – sometimes it arrives alone. But let’s finish this exercise.
Based on this and other research such as that by the Cooper Institute, Wei et. al., and others healthy habits have an excellent chance of increasing health – certainly much better than weight loss.
So my decision to focus on healthy habits rather than weight loss is based both on an analysis of the likelihood of success and an analysis of downside risk. It’s also based on common sense – there are “normal weight” people with type 2 diabetes and high cholesterol, and high blood pressure, “normal weight” people get the same health issues that fat people do and “normal weight” people die of the same things that fat people do, so being “normal weight” cannot be a sure cure or preventative.
The only analysis in which weight loss comes out ahead is about what is most profitability for the diet and pharmaceutical industries.
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