In 2007, a study of 11,000 Canadians over more than a decade found that those who were overweight had the lowest chance of dying from any cause.
To date, scientists have documented these findings in patients with heart failure, heart disease, stroke, kidney disease, high blood pressure — and now diabetes.
Experts are searching for explanations. One idea is that once a chronic disease develops, the body becomes catabolic, meaning it needs higher energy and caloric reserves than usual. If patients do not have those reserves, they may become malnourished even though their weight is normal, said Dr. Gregg Fonarow, one of the directors of the preventive cardiology program at the University of California, Los Angeles.
Some researchers suspect genetics: Maybe thin people who develop diabetes, cardiovascular disease and other chronic ailments have gene variants that make them more susceptible to these illnesses and put them at greater risk once they become ill. Heart disease in thin people may represent a different illness from heart disease in heavier people, Dr. Lavie said.
It may be that doctors do not treat thin patients as aggressively as they do heavier patients — or that the yardstick itself is to blame. Most researchers assess obesity by measuring body mass index, a simple ratio of height and weight. But B.M.I. does not take into account body fat, lean muscle mass, metabolic abnormalities and other nuances of physical composition.
Perhaps, some experts say, we are not asking the right question in the first place. Maybe we are so used to framing health issues in terms of obesity that we are overlooking other potential causes of disease.
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- justin said: Might be a lifestyle thing - I’d say generally thinner people are more active, hence putting themselves in more dangerous situations.
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