Preventive Medicine


People who are overweight or obese are stigmatized in American society. They are generally regarded as lazy, gluttonous, and unhealthy, and as children are bullied and mocked. Adults look at obese people differently, too. Who, upon seeing a person weighing too much, hasn’t thought to himself, “man, that guy is really fat! How did he get that way?”

That’s a question with an elusive answer. It isn’t always overeating that causes the problem. Many prescription drugs cause weight gain, many chronic illnesses are accompanied by weight gain, and a genetic predisposition for obesity is unavoidable (if both parents are obese, you’re likely to be obese, too). Many people try diet after diet and one weight-loss program after another only to be frustrated and remain overweight. Are these people doomed to die early or does adherence to healthy lifestyle choices make a difference in longevity and quality of life? 

Healthy lifestyle habits have been recommended for decades and are accepted practice in the realm of preventive medicine. Regular exercise, high fiber diet, smoking cessation, and moderate alcohol consumption are beneficial to every person regardless of their Body Mass Index (BMI). Avoiding obesity (or at least losing weight) is another healthy lifestyle choice battled by millions. 

It was recently proven that regardless of a patient’s BMI, obese or not, healthy lifestyle choices have a significant effect on mortality risk! In other words, patients who practice healthy lifestyle habits have decreased risk of death whether they are slender or obese. In fact, “the adoption of each additional healthy habit decreased all-cause mortality between 29% to 85%.” Thus, the consumption of 5 or more fruits or vegetables per day, regular exercise more than 12 times a month, moderate alcohol consumption (1 drink/day for women, 2 drinks/d for men), and not smoking, all reduce the risk of death. Each additional lifestyle habit reduces mortality by a significant amount. 

So, whether you’re obese, overweight, or slim and trim, healthy lifestyle habits will reduce your risk of death from any cause by a significant amount. Admittedly, obesity is a risk for death by itself and puts one in a high risk category, but practicing healthy habits is still beneficial. It’s a bit technical, but “Risk Hazard,” a calculation reflecting on the risk of death, improves with each additional lifestyle habit. A lower ratio is better. See the table below:


 BMI 18-25   0                            2.18

                      1                              2.70

                      2                              2.11

                      3                              1.39

BMI 25-30   0                             3.72

                      1                               2.45

                      2                               1.63

                      3                               1.16

                      4                               1.08

BMI >30      0                              6.69

                      1                                3.26

                      2                                1.76

                      3                                1.65

                      4                                1.05

This table shows how much lifestyle habits lower one’s risk of death regardless of obesity. A BMI > 30 is obesity. With the addition of four lifestyle habits, an obese person’s hazard ratio (risk) becomes equal to that of slimmer folks (1.05 vs.1.08). In fact, it’s actually lower.

I guess the message here is if you’re overweight don’t despair. You can lower your risk of death by adopting lifestyle habits mentioned in the text. It is the wise person who practices these habits, anyway. Who knows? By following these lifestyle recommendations you’ll probably lose some weight, and that’s a good thing.

Reference: Matheson EM, King DE, Everett CJ. Healthy Lifestyle Habits and Mortality in Overweight and Obese Individuals. JABFM 2012 Jan-Feb;25(1):9-14.              

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