Health Conditions Hub Obesity

You Can Be Too Thin

Death risk for underweight people higher than for severely obese

The old adage goes, “You can never be too rich or too thin,” but new research proves that saying wrong. In fact, according to the study, people who are clinically underweight have an even higher risk of dying than obese folks.

We’ve focused so much on the obesity epidemic lately that we haven’t paid attention to the health of extremely thin people. But “we have [an] obligation to ensure that we avoid creating an epidemic of underweight adults and fetuses who are otherwise at the correct weight,” says Joel Ray, M.D., a physician-researcher at St. Michael’s Hospital in Toronto and the study’s lead author.

The new research reviewed 50 previous studies and analyzed people for five years or more, focusing on associations between body-mass index (BMI) and deaths related to any cause. Underweight patients (those with a BMI of 18.5 or less) had a 1.8 times greater risk of dying than patients with a normal BMI (between 18.5 and 25.9).

Obese patients (BMI between 30 and 34.9) face a 1.2 greater risk of dying than those with a normal BMI. Too-thin folks even had a higher risk of death than severely obese patients (those with a BMI of 35 or more), who faced a 1.3 times greater risk.

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“BMI reflects not only body fat, but also muscle mass,” Dr. Ray said in a release. “If we want to continue to use BMI in health care and public health initiatives, we must realize that a robust and healthy individual is someone who has a reasonable amount of body fat and also sufficient bone and muscle. If our focus is more on the ills of excess body fat, then we need to replace BMI with a proper measure, like waist circumference.”

Factors linked to a higher risk for being underweight included poverty, malnourishment, drug or alcohol use, smoking and mental health issues.

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