Home Health and Health Care Normal Weight Obesity: Another Medical Scam?

Normal Weight Obesity: Another Medical Scam?

by Erika Nicole Kendall

So, on the facebook page for BGG2WL, someone brought up the issue of “normal weight obesity.” I know what I immediately assumed it to be, but I was pleasabtly surprised by the information that appeared in the article:

Monika Sumpter did what many women dream of — she set a goal to lose weight and dropped 50 pounds.

Despite losing all of that weight, her ratio of fat to muscle was around 25 percent, 5 percent from where she started and dangerously close to what some researchers say is an unhealthy situation.

“I was just shocked. I thought that it was a lot lower, and I thought that I was healthy,” Sumpter said.

There are others like Sumpter. As many as 30 million Americans who are considered average weight may actually have what scientists call normal weight obesity, according to a recent study by the Mayo Clinic.

The study, which followed 6,171 Americans over nine years, found 20 percent to 30 percent of people considered normal weight still have an alarmingly high percentage of body fat.

Now, when this was brought up on the FB page, it was brushed off as just being a reason for the health industry to call more people “fat.” Considering the number of weight loss drugs vying for FDA approval right now, I don’t doubt that. However, I don’t think this should be brushed off so quickly. I just think there’s more to it than that.

The article goes on:

The Mayo Clinic says that generally, women should have a body fat percentage below 30 percent, while men should have a fat to muscle ratio of less than 20 percent to 25 percent.

Sumpter, a 34-year-old mother of one, is 5 feet 8 inches tall and weighs about 140 pounds, which is in the normal weight range for her height.

However, if 42 of those pounds — or 30 percent of her weight — are made up of fat, Sumpter would actually be considered normal weight obese.

Traditionally, terms like “overweight” and “obese” and “normal” in regards to weight are applied using the body mass index (BMI), and I’ve already shared my thoughts on that. What I also said back then was that I think its useless, especially considering how the body fat percentage is a much more valuable quantifier of one’s health. A body carrying an excess of muscle functions differently than a body carrying fat, and to ignore that very real issue is to ignore the real reason we use the BMI in the first place – a means of gauging ones quality of life:

I, personally, find the body fat percentage to be far more valuable in gauging my physical wellness. The body fat percentage estimates what percentage of your body appears to be purely fat. The “average American female’s” body fat percentage is somewhere around 32%, while the typical athlete is around 22%.

The bf% is a much more valuable number because it acknowledges that those in the overweight category may simply be muscular, and those on the thinner side may still be hiding some fat that needs to be addressed. There is no cheating or hiding behind “unfairness” with the body fat percentage. A caliper or a hydrostatic test is usually used to measure bf% – I use an electrical machine at my gym – but there’s also this quick and dirty calculator that I use to keep track, and it only requires a tape measure. You’ll get two numbers – take an average between the two numbers, and you’ll have a better and much more valuable estimate. If body fat is the issue (not muscle), then getting numbers that address specifically that definitely helps. [source]

I’m not sure how to say what I’m thinking… so I’m just gonna say it. This is why the scale doesn’t matter as much as we like to make it matter. It doesn’t matter how much you weigh; if anything, it matters how much fat you are carrying. Petite women are often pedestaled as being some ideal, but… if one third of her physical makeup is pure fat, what’s ideal about that? Being cute? Not if her health is in question… and let’s be real – the lifestyle that allows one to consistently maintain 30% bodyfat is what the issue is, here, not simply the fat itself.

Speaking of which, the article goes on:

That diagnosis means a higher risk of obesity-related diseases, such diabetes, high cholesterol and heart disease, which is the No. 1 killer of women.

“Women with normal weight obesity, meaning those who have high fat and a normal weight have a two times increased risk for death or dying from heart problems or a stroke,” said Dr. Francisco Lopez Jimenez, who led the Mayo Clinic study.

A diagnosis of being “normal weight obese” means higher risk of obesity-related illnesses because…. of the lifestyle! Not the weight. Not the weight. Not the weight.

Not the weight.

A lifestyle that allows one to maintain 30% (or more) body fat means that the same lifestyle is likely to contain high sugar quantities (thus, the diabetes), too much animal products and by-products (thus, the cholesterol) and too much salt (thus, the heart disease…and many other things, I’m sure.) It is about the living, not the weight.

This is what I presumed “normal weight obese” referred to in the beginning: a person of normal weight carrying the symptoms of a lifestyle usually experienced by someone who is clinically obese. And, in many ways, I believe that’s an appropriate definition.

I’d be lying if I didn’t admit that I was curious, though. I know that there’s a slew of weight loss drugs going up for FDA approval right now, so does that have something to do with the push to have more people clinically defined as obese? I mean, more people defined as obese means more people qualifying for their insurance paying for their weight loss drugs, right?

I’m a cynic (and a businesswoman), so clearly I believe the two are thoroughly linked. I’m also someone who doesn’t want to throw the baby out with the bathwater here, either. I do think there’s a reason to have more people defined as obese, but so long as everyone isn’t being pushed to take medications they’re unsure of and instead opts to use this push to be more cognizant of their health… I can appreciate the awareness. Telling people that are 130lbs at 32%bf that they’re “all good” is just as bizarre as telling someone who’s 190lbs at 20%bf that they “need to lose.”

I also feel like this kind of awareness would make for more tolerance of the term “fat,” because apparently more of us are “fat” than we’d like to admit. I’m just sayin’. It might even stop some of that fat-bashing we see all the time. If more doctors were aware of the issue of body fat percentage over basic scale numbers, then they might be less inclined to harbor a bias against those who are “visually obese.” There might be less fat prejudice.

More from the article:

Sumpter changed her workout routine, adding more weight-bearing exercises to build lean muscle mass instead of only doing calorie-burning cardio.

“Resistance training is the key,” said Sumpter, who is now certified as a personal trainer and works at Equinox in New York. “There are three key components to a healthy lifestyle, which is healthy eating habits, resistance training to build muscle and of course cardio to burn calories and for a healthy heart, but it’s a combination of all three.”

Today she weighs 20 pounds more than her lowest weight, but her body fat percentage is down to 14 percent.

I’ve always said I’m not an advocate for “thin.” That’s not what my weight loss was/is about, and that’s not why my site is here. I’m shooting to compete in a figure competition… clearly, “thin” ain’t my thing. My goal is to figure out how to make “fit” a part of my every day life, and if I can show one more person that “fit” should be the goal, not “thin,” then I feel like this site has done some form of good. It is suspect, to me, that these opinions are gaining attention right around when all these weight loss drugs are vying for approval… but I cannot deny the fact that they have a point. Thin and fit certainly are not the same thing (the same goes for “thin” and “healthy”), and if it takes a term like “normal weight obesity” to call our attention to that fact, then I’m all for it.

What do you think? Let’s hear it!

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JoAnna November 1, 2010 - 2:08 PM

Nice article Erika.

I know that I’ve always been “big-boned” as a child and heavier than I looked. As I child, I wasn’t overweight at all. I wore normal sized clothes, but I couldn’t walk well or do regular athletics due do a birth defect: I was born with my legs turned inward from the hips down. I wore leg braces (like Forest Gump) until I was 7 years old. One pediatrician told my mother that I was too heavy for my size until tests were run to show that I had really dense bones and strong muscles from daily physical therapy sessions.

Fast forward to now when my current doctor is amazed that my A1c, triglyceride, chlolesterol, numbers are getting better, but my weight hasn’t gone down as much as he’d like. His nurse told me “The scale doesn’t lie.” when she ran thru the temperature, blood pressure and stuff. But I’ve gone down 2 jean sizes since May! I’m wearing my bras without the extender. Even my Dr weighed me again after checking the chart because he congrajulated me on my weight loss when he first entered the room. Since he’s more concerned with my diabetes status, he told me to keep doing what I’m doing and to increase the exercise to almost soreness (muscle fatigue) but not pain. He runs marathons and does yoga, but has a barrel chest and a little belly, so there’s no pulling the wool over his eyes.
His advice was now that I’m regularly exercising: if I were in a burning building, could I walk/run down 5 flights of stairs to safety? Could I run 2-3 blocks from danger? Could I pull myself over a 6 foot wall to escape a pack of pitbulls? Do I have the stamina to tread water for 10mins? So that’s my new goal. To be able to save myself if I’m ever in one of those “Disaster Movie of the Week” situations! As we laughed, he said if I work my body to able to save itself, (and get off meds) eventually I’ll fit into a “little black dress”.

Erika November 1, 2010 - 2:37 PM

Yessssss! Shoutout to focusing on what you can do with that body, not an insignificant number!

Mia November 1, 2010 - 2:30 PM

I posted a comment on something similar to this. When I was 13-16, I was constantly told that I needed to loose weight because I was not thin. I was 5’4 at 125-130lbs and they wanted me at like 105-110 I believe, because that is what the other girls were weighing. I had never been “thin” though. However, I always had more muscle mass, something I got from my Dad. The damage was already done however, before I realized the fault in what “they” referred to as “fat”. I was never “fat”, I had clear muscle definition. I think their problem was that I carried a lot of weight in my legs, which were too very muscular, and behind. Now I am fighting to loose the 70+ pounds I gained while dieting.

Merewen November 2, 2010 - 7:41 PM

This is me to a T. Very active teenager, sports and everything, but yet considered fat. 5’4 160lbs cheerleader and soccer player. Lots of muscle and very dense bones. But because of the BMI index, Marines wouldn’t have me. Their loss.

MoreAndAgain May 21, 2011 - 3:07 PM

So, I did the body fat percentage calculator, and was I kinda upset to find that I’m at 38%. I’m not too upset because I know that, in changing my diet, it’s gone down a lot from what it was, as recently as 2 months ago. My clothes are fitting much better, and I know that’s not from losing muscle.lol. I’m literally watching the rolls on my back disappear, so I’m not going to let that 38% get me down. I just know that I’ve got a long way to go.

“Normal weight obese” really does say so much. I kinda getting tired of people telling me, “oh girl, you don’t need to lose weight”, and “there are women who would kill for your curves”. They probably think they’re being helpful, but I don’t need better self-esteem (I’m good in that area), I need better health. I’m gonna start telling people I’m “normal weight obese”.

Melisa June 29, 2011 - 2:44 PM

This is a fabulous article. Don’t fixate on that scale number! So many women base their self-esteem on their weight largely due to ‘society’s expectations”. I say we take our power back. Let us tell society what to expect.

Rachel August 13, 2012 - 11:08 AM

“I also feel like this kind of awareness would make for more tolerance of the term “fat,” because apparently more of us are “fat” than we’d like to admit. I’m just sayin’. ”

Yeah, people who like to look down on others’ bodies despite having sagging, wobbly flab hanging from muscle-free bones might change their tune when know they’re medically defined as obese.

I am trying to build up my muscle now and I have no patience for this culture that thinks health and beauty is all about being ‘somewhere in between’ fat and skinny, like I always have been. People seem to forget about muscle completely, if you don’t look good in a bikini that the answer must be a diet. In fact, a diet alone makes it worse because you shrink what little muscle you have.

ab January 17, 2013 - 5:05 PM

Today, I did something I have never done before. I watched an episode of biggest loser and I was thoroughly sickened.

As punishment one of the teams (BlueTeam) were made to sit in a room filled with deserts for 4 hours, the very things that got them there in the first place.

Why?. How is that teaching them about the value of food?
Many of the participants lost double digit numbers, thanks to being cardio bunnies, but how much of that new body is muscle?. What exactly are they burning off?.

jessica February 4, 2013 - 8:03 AM

amen to focusing on health and not weight!!!

christine February 4, 2013 - 9:48 AM

The scale used to rule my life..a 5 pound weight gain would basically determine if I went out or not lol..young and dumb! Now, the only time I get weighed is when i go to the doctor. I go hard in the gym 3 times a week, take the stairs, and the most important thing..I take care of myself. When I put on a size 12 pair of jeans..I knew I was on my. My doctor understands that some women will never be a walking stick, but as long as you’re healthy she’s ok with it, no matter what the numbers say

Debra Petties February 9, 2013 - 8:24 AM

Over the year & a half, I’ve lost 70lbs and I did weigh myself religiously to measure how much weight I was dropping, HOWEVER, during my journey, I embraced resistance training. While I did manage to get my body fat% down, I was more focused in getting my BMI under 30, but since reading this article, I want to first get a measure of the % of body fat that lurking in my body, then I will focus more on that number instead. Thank you for this article, it’s the light bulb that I needed.

Long Cao July 18, 2013 - 3:23 PM

People don’t understand that it is a good bodyfat% we want. Men can really do well between say 8-20%, women, 15-30 in my opinion. People have to understand that losing 20 pounds of WEIGHT in a week is easy but the weight will be water! The second you return to normal eating, it comes back on. Maybe change the name to a black girls guide to fat loss lol!

Lisa truitt October 19, 2013 - 6:54 AM

I’m just very skeptical. I tend to think that the whole obesity epidemic thing is a scam to bring in more money. I also think that the body fat thing is suspect. I have known plenty of women who were definitely 30 percent or greater who lived to be old and relatively healthy. Some of them did develop diabetes or some other thing in old age. I suspect that nutritional deficiencies have a lot more to do with developing these diseases than body fat %. For example vitamin d and magnesium deficiencies are rampant and these two nutrients are crucial to insulin sensitivity and normal metabolic function. Stress plays a crucial role as well. Are you aware that there are studies showing a longevity and disease reduction benefit for people with a higher body fat? It showed a bell curve where over a certain percent and under caused a drop in longevity and increase in morbidity. The bf percent that was protective was higher than mainstream ideas. I think there is info on this in the book health at every size.

My view is that if it comes from the mainstream medical industrial complex or their shills the ms media it is lies lies and more lies.

Joules November 3, 2013 - 6:54 PM

So… back when I worked out regularly (between two ankle injuries and mono I managed to bench myself for slightly over a year) I weighed 167, dress size 6/8. I was very proud of myself until I had my BMI checked.

At 5’5 with my stature I shouldn’t have weighed more than 141. Had I had a larger frame my max weight should have been 155. I found this odd so I went and got my BMI professionally measured.

I saw a personal trainer in a weight loss clinic who did both the tape measure and pinchers thing and used a new fangled machine that sends light electricity through your body to actually measure your fat, muscle, bones, vital organs etc etc etc.

Per his measurements and that machine I could safely lose 5 pounds before I started to get into a fat percentage not considered healthy.

And that’s the day that I stopped using scale if I’m resistance training more than three times a week.

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