Overweight and Mortality

What do you have to say about the information given to me by my doctor and confirmed in a recent New York Times article that those with a little extra fat have greater longevity, so much so that the idea of "average" weight has to be recalculated?

I welcome speaking about the recent JAMA paper (Jan 2013) on overweight and all-cause mortality. First, the authors measured BMI -- which is weight for height -- it did not measure adiposity and where this fat tissue lies. We know that the more centrally located fat tissue around the mid-section is what does the most damage to our health. For example, you could be what I call "skinny fat"...thin to the eye, but with no muscle and a lot of excess in the mid-section, which is not healthy. 

Second, they did not take into account the fitness level of these individuals -- indeed, those who have a higher BMI and who are fit are much better off over those who are "thinner" and unfit (and fitter individuals typically have less of the dangerous fat around their mid-section). Finally, this article looked at mortality -- NOT MORBIDITY. Overweight and obese individuals may be under more careful watch by their physicians simply due to their body size and may be living with several health risk factors -- hypertensive, elevated lipids, etc. -- but then put on drugs so that they are kept alive long -- but not necessarily a picture of health. Just a few reasons to keep on believing that it is optimal to eat well, get fitter and stay lean.