En español | The day after Thanksgiving, a collective groan goes up as millions of Americans step on the bathroom scale. But here's a consoling thought: A few extra pounds may in fact be a good thing — plumping up a sagging face and providing protective cushioning for increasingly brittle bones.
A growing body of evidence points in this direction. In 2005, researchers at the Centers for Disease Control and Prevention looked at body mass index or BMI — an estimate of a person's body fat calculated by height and weight — and found that overweight people [with a BMI of 25 to 29.9] had less chance of dying than people with a normal BMI or a low BMI. For those over age 70 the evidence was even stronger. Says Katherine M. Flegal, CDC senior research scientist and lead author of the 2005 study, "The lower your BMI the worse your chances of survival."
"Banging on older people just because their BMI is 26 or 27 [when] some researchers say it's supposed to be under 25 is just silly," says G. David Williamson, a professor at Emory University's Rollins School of Public Health. "I don't see any evidence that function or longevity are compromised in that narrow range."
For people with osteoporosis a few extra pounds may actually be beneficial. "The more stress you put on bones, the more they grow, so someone who weighs more will have denser bones," says Timothy Church, M.D., professor at Pennington Biomedical Research Center in Baton Rouge, La. "That's an advantage as we grow older and lose one to two percent of muscle a year."
Younger or plumper?
Another plus to a little body fat is that it provides "volume replacement," filling in the wrinkles and sunken areas of the face to provide a more youthful appearance. Last year, doctors at Case Western Reserve University compared photos of identical twins ages 40 and older and found the heavier twin, with a BMI at least four points higher, looked younger than the thinner sibling, who often appeared gaunt or haggard. For twins over age 55, the twin with a BMI that was eight points higher looked younger, according to the study.
Still, some health experts are wary of giving the nod to even a few extra pounds, given that nearly 28 percent of Americans are obese, with a BMI of 30 or greater. "If you're at a low or ideal body weight, then gaining an extra five or 10 pounds may be beneficial," says Miriam E. Nelson, Tufts University professor and coauthor of The Strong Women's Guide to Total Health. "But if you're overweight or obese, or have hypertension or impaired glucose tolerance, then you don't want to gain weight." Obesity also dramatically increases the risk of diabetes, certain cancers and heart disease.
Focused on fitness
No matter what the bathroom scale says, the experts agree that a regimen of physical activity and a healthy diet cuts the risk of disease and death.
"Fitness is more important than fatness in determining mortality," says Steven N. Blair, an epidemiologist at the University of South Carolina's Arnold School of Public Health. In studies of thousands of overweight and obese adults over the last two decades, Blair has found fitness reduces the risk of stroke, heart disease and cancer. "We've seen dramatic reductions in mortality even in obese individuals who are fit," he adds.
How much exercise is necessary to join the fat-but-fit club? New federal guidelines advise 150 minutes of moderate exercise a week or 75 minutes of vigorous exercise.
Since developing type 2 diabetes about 10 years ago, James B. Smith II, 73, of Baton Rouge has battled his weight. When one of Smith's medications no longer seemed effective, his doctor raised the possibility of insulin injections. "After that I was even more motivated to get in shape," says Smith. He is enrolled in a three-times-a-week study on exercise and diabetes at Pennington Biomedical Research Center, peddling 20 minutes on an exercise bicycle and walking another 20 on a treadmill. "The other day after exercising my glucose came down 96 points — it was just amazing."
Even though he has only lost five pounds, he hopes the exercise regime will help control his diabetes. "I would love to lose 50 pounds, but it's just really hard to lose weight when you get older."
For many people, getting fit requires a mindset makeover, says personal trainer Nicki Anderson of Napierville, Ill. "You need to stop focusing on weight and start focusing on the healthy changes you're making," she says. Anderson preaches the 80/20 rule to her middle-aged, overweight clients. "Find the sweet spot where 80 percent of the time you move more and eat well," she says. "The other 20 percent is life — birthdays, holidays, anniversaries, vacations — so just enjoy it."
Church concurs that weight loss during the holidays is nigh impossible. "During the holidays, you're just trying to hold your own," he says. His advice: "Don't have crazy expectations but don't let the wheels come completely off the wagon."