When the fat get even fatter, their risk of death
jumps, too, especially if they have an apple-shaped
waistline. So concludes a study of 90,000 women in
the United States, the first to look closely at the
alarming trend of extreme obesity, being at least
90 pounds overweight.
"People think of obesity as a single thing, but
your risk can be modified within that," said lead
researcher Dr. Kathleen McTigue of the University
of Pittsburgh. She presented the study Saturday at
a meeting of the
American Heart
Association.
The good news is that losing even 20 pounds or so
will help, she said.
For the fattest women, "it would definitely improve
your health prognosis if you can move yourself just
one weight category over," McTigue said.
About 60 percent of American adults are either
overweight or obese. The excess pounds increase the
risk of diabetes, heart disease and other ailments.
The government equates obesity with a body mass
index, or BMI, of at least 30. Someone who is 5-feet-4
would have to weigh 175 pounds to reach that threshold.
The index is calculated by dividing a person's
weight in pounds by his height in inches, squared,
and multiplying that total by 703.
Doctors typically warn that obesity increases the
risk of death twofold, mostly from heart disease.
Recent studies suggest about 4 million Americans
are extremely obese, with a BMI of at least 40. That
translates into 233 pounds for that 5-feet-4 person.
Does losing a little weight help once the obesity
threshold is crossed or does it takes radical slimming
down to make a difference?
McTigue culled data on 90,000 women enrolled in
the Women's Health Initiative Observational Study,
a major project that is examining a variety of health
issues.
She compared normal-weight women, who have a BMI
below 25, with three categories of obesity: Class
1, a BMI of 30 to 34.9; Class 2, a BMI of 35 to 39.9;
and Class 3, a BMI of 40 or higher.
Of the women studied, 3.6 percent were extremely
obese, including 3.1 percent of white women and 9.6
percent of black women.
McTigue tracked the women's health over five years.
White women with Class 1 obesity had a 19 percent
greater risk of death in that period than did normal-weight
women. The extremely obese had double the risk of
death.
For black women, "regular obesity" increased the
risk of death by 36 percent, compared with a 60 percent
increased risk for the extremely obese.
Much of that risk was due to diabetes, high blood
pressure and high cholesterol. Aggressive treatment
of those conditions is particularly important for
the very obese, McTigue said.
Also, apple-shaped women had higher health risks
than pear-shaped women, even at the same weight, she
found.
Abdominal fat long has been associated with heart
disease. Genetics are most responsible for where the
body stores fat, but McTigue's findings suggest that
apple-shaped women "need to be more careful about
your body weight than other people," she said.
The study provides the most detailed look yet at
the health risks of extreme obesity, offering crucial
information as more people move into that once-rare
category, said Catherine Loria, a nutritional epidemiologist
at the National Heart, Lung and Blood Institute.
"It tends to be a very touchy subject" for doctors
and patients to broach, she said. But, "we really
do have to make the point that there are important
health consequences that should be addressed."
___
On the Net:
American Heart Association conference:
http://www.americanheart.org/presenter.jhtml?identifier3021413
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Your Body Mass Index
