Telling people being obese isn't unhealthy--not productive

[eridani]

80. Thin people mostly have Type I diabetes--being thin is one of its side effects.

Type IIs are mostly fat because of the high insulin levels resulting from insulin resistance. A smaller subset are people who are insulin resistant, but are unable to compensate by making extra insulin. This leaves them at normal weights, but with terrible blood sugar control. I am astonished that articles describing this "obesity paradox" regard it as in any way surprising. It sure isn't surprising to anyone who has a clue about the genetic basis of Type II diabetes. High insulin leves aren't good for you,l but they beat the hell out of uncontrolled blood sugars.

Here are a bunch of references.

Fat type II diabetics less insulin-dependent, less likely to develop the complications of diabetes, and less likely to die from it than type II diabetics of average weight? [Turkington, R.W. and Weidling, H.K., JAMA Vol 240, p. 833-836 (1987)]

Diabetic Pima Indian women (the human population with the largest known genetic concentration of insulin resistance) experience the lowest levels of mortality when they weigh twice the actuarial ideal. Pettitt, D.J., et al Am. J. Epidemiol. Vol 115, p. 359-366 (1982)] (Pima men with the longest life spans weigh 45% more.)

Weight cycling is more strongly correlated with Type II diabetes that staying at a stable, fat weight. (Lee, IM and Paffenbarger, RS, JAMA 1992, vol 268, p 2045-49; Blair, SN, and Paffenbarger, RS, 1994,
34th annual Conference on Cardiovascular Disease Epidemiology and Prevention; Holbrook, TL et al, 1989, Int. J. Obesity, Vol 13, 723-79.) J. Epidemiol. Vol 115, p. 359-366 (1982)] (Pima men with the longest life spans weigh 45% more.)

Fat people who eat the least are the very people who have abnormal insulin response. Comparing two groups of fat people, one of which ate less than 1500 calories a day, and the other of which ate more than 3000, it was found that very one of the former group had abnormal insulin response, and none of the latter group. The people who are most at risk genetically for developing type II diabetes are therefore those who are least likely to lose weight, and the most likely to benefit from more exercise and improvements in diet composition. This means that emphasis on promoting weight loss as the first and most important consideration is perverse, nasty and destructive.
Astrup et al International Journal of Obesity Vol 11, p 51-66 (1987)


http://www.nytimes.com/2012/09/18/health/research/more-data-suggests-fitness-matters-more-than-weight.html

In research conducted to answer that question, Dr. Carnethon discovered something even more puzzling: Diabetes patients of normal weight are twice as likely to die as those who are overweight or obese. That finding makes diabetes the latest example of a medical phenomenon that mystifies scientists. They call it the obesity paradox.

In study after study, overweight and moderately obese patients with certain chronic diseases often live longer and fare better than normal-weight patients with the same ailments. The accumulation of evidence is inspiring some experts to re-examine long-held assumptions about the association between body fat and disease.

http://www.nytimes.com/2012/10/20/health/in-study-weight-loss-did-not-prevent-heart-attacks-in-diabetics.html

A large federal study of whether diet and weight loss can prevent heart attacks and strokes in overweight and obese people with Type 2 diabetes has ended two years ahead of schedule because the intensive program did not help.

“I was surprised,” said Rena Wing, the study’s chairwoman and a professor of psychiatry and human behavior at Brown University’s medical school.

Like many, she had assumed diet and exercise would help, in part because short-term studies had found that those strategies lowered blood sugar levels, blood pressure and cholesterol levels.

But, Dr. Wing added, “You do a study because you don’t know the answer.”

http://mdn.mainichi.jp/mdnnews/news/20120105p2a00m0na006000c.html (This is only in Japanese now). Another summary article is http://www.sciencedaily.com/releases/2013/01/130107100101.htm

Team of Japanese scientists discovers insulin-resistant protein
A team of Japanese scientists has identified an insulin-resistant protein that could be a major cause of obesity and diabetes, a discovery that could help medical practitioners diagnose and treat lifestyle diseases.

The finding was released through the online version of the U.S. science magazine Cell Metabolism on Jan. 4. The state of insulin resistance is widely seen in people who are suffering from type 2 diabetes caused mainly by lifestyle related factors such as overeating, inadequate exercise and obesity.

Using a method called "comparative proteomic analysis," the team of scientists from Kobe University, Shimadzu Corp. and other groups found the insulin-resistant protein in mice after conducting detailed analysis of various kinds of protein. The analysis showed that the levels of the insulin-resistant protein in the blood of obese mice were twice to three times higher than normal. When the protein was injected into other mice, those mice that were not obese became resistant to insulin.

Moreover, those mice that were made incapable of producing the protein did not become obese even when they were fed fatty foods and showed no resistance to insulin. The same protein exists in humans and it is known to be effective in treating inflammation and injuries...