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But Extreme Underweight, Obesity Linked to Earlier Death

June 25, 2009 -- There is more evidence that people who are overweight tend to live longer than people who are underweight, normal weight, or obese.

In a newly published study, people who were underweight and those who were extremely obese died the earliest.

People who were overweight, but not obese, actually lived longer than people whose weight was considered normal, based on body mass index (BMI).

The research is not the first to suggest that those who carry a little, but not too much, extra weight tend to survive longer than people who don't.

CDC researchers found the same thing in a widely reported study published in 2005, and last month a separate group of investigators reported that overweight heart patients live longer than lean ones.

The Obesity Paradox

It is becoming known as the "obesity paradox," but this is something of a misnomer. That's because few studies have linked obesity with longer life.

Rather, the studies generally suggest that people with a BMI of 25 to 29.9 -- which is considered overweight but not obese -- have a survival advantage over people with higher or lower BMIs.

BMI, which is a measure of body fat based on a person's height and weight, is used to classify people into weight categories -- underweight, normal weight, overweight, and obese.

Based on BMI scores, a 5-foot, 5-inch adult would be considered:

  • Underweight at 110 pounds or less (BMI <18.5)
  • Normal weight at 111 to 149 pounds (BMI = 18.5-24.9)
  • Overweight at 150 to 179 pounds (BMI = 25-29.9)
  • Obese at 180 to 210 pounds (BMI = 30-34.9)
  • Extremely obese at 211 pounds or more (BMI = 35 or greater)

In the newly published study, researchers used data from an ongoing Canadian national health survey to follow more than 11,000 adults from the mid-1990s to 2007.

Compared to people who fell into the normal-weight category:

  • Those classified as underweight were 73% more likely to die.
  • Those classified as extremely obese with BMI of 35 or greater were 36% more likely to die.
  • Those classified as obese with BMI 30-34.9 had about the same risk of death.
  • Those classified as overweight with BMI 25-29.9 were 17% less likely to die.

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