The Obesity Paradox: When Thinner Means Sicker and Heavier Means Healthier

211 Pages·2014·1.45 MB·English

by  Carl J. Lavie M.D.

Advance praise for The Obesity Paradox
“Everyone who struggles with weight should read this important book. Dr. Lavie
presents the science to support the truth that being overweight and even
moderately obese may correlate with better long-term health and greater
longevity—if you stay fit by making good food choices and maintain sensible
physical activity. The Obesity Paradox is a story that has not been told in such a
clear, evidence-based way. It challenges conventional wisdom and is exciting to
read.”
—Andrew Weil, MD, author of 8 Weeks to Optimum Health and Spontaneous Happiness
“This provocative, phenomenal book by Chip Lavie will enhance the long-
overdue paradigm correction, at a time when the obesity paradox is considered
taboo by the mainstream opinion leaders.”
—Kam Kalantar, MD, PhD, professor of medicine and pediatrics and epidemiology, University of
California, Los Angeles
“Chip is the rare triple threat: a great doctor, outstanding researcher, and gifted
communicator. I have heard him present many times and read all his work on the
obesity paradox, and I continue to find this topic absolutely fascinating. And no
one understands it better than Chip.”
—Timothy Church, MD, MPH, PhD, professor of preventative medicine, Pennington Biomedical
Research Center, Louisiana State University, and coauthor of Move Yourself
“Paradox . . . revealed. Much more than casual social conversation, the debate
around the ‘obesity paradox’ is critical to the health of nations. No one more than
Dr. Chip Lavie has been a constant thoughtful observer on this topic—he has
performed focused research and is an expert on the overall meaningfulness of
body mass index and the obesity paradox. Indeed, Dr. Lavie introduces a whole
new way of looking at body fat and its role in health. Once in your hands you
will be wiser, better educated, and healthier!”
—Marc A. Silver, MD, FACP, FACC, FCCP, FAHA, clinical professor of medicine, University of
Illinois at Chicago
“The Obesity Paradox is an important contribution to our understanding of one
of the most interesting and unusual observations in medicine today. This book is
highly recommended reading for all health-care workers and clinical
investigators interested in the current global epidemic of obesity. Dr. Lavie has
had extensive experience with the paradox in his research career, and his writing
is clear and concise.”
—Joe Alpert, MD, editor in chief of the American Journal of Medicine
“Dr. Lavie brings clarity to compelling cutting-edge science, fully validating the
desperately important role of modifiable lifestyle choices in rewriting your
health destiny. The Obesity Paradox offers up yet another challenge to some of
our most long-held but unfounded beliefs in the health arena, especially when it
comes to body fat. And he reinforces an often overlooked ingredient to living a
good long life despite weight: the value of fitness. The Obesity Paradox is a
must read.”
—David Perlmutter, MD, author of Grain Brain
“We are on the verge of disastrous and unprecedented health consequences as a
result of our ever-evolving lifestyle choices. The solution to our problem is
simple: above all else physical activity and fitness are essential to good health.
Yet the human race remains lost, waiting for leaders to show us the way. Carl J.
Lavie is one of those leaders. Dr. Lavie has extensively studied the importance
of a physically active lifestyle. The Obesity Paradox is the culmination of his
life’s work and a shining beacon of knowledge, showing us the way to a
healthier world.”
—Ross Arena, PhD, PT, FAHA, professor and head, Department of Physical Therapy, College of
Applied Health Sciences, University of Illinois at Chicago
“Dr. Chip Lavie is one of the leading medical researchers of cardiovascular
illness, disease prevention, and the role of fitness in managing the multitude of
risk factors associated with diminished health. The Obesity Paradox reframes the
entire discussion of obesity and what it means to be healthy. Dr. Lavie focuses
on the importance of fitness in making positive changes in the course of our
health, despite being overweight or obese. To understand the big picture, before
you try another weight-loss diet, read this book.”
—Mark A. Williams, PhD, FAACVPR, FACSM, editor in chief of the Journal of
Cardiopulmonary and Rehabilitation Prevention, professor of medicine and cardiology, Creighton
University School of Medicine
“In a society preoccupied with thinness, objectivity about how our weight relates
to our health is often lost, and subtleties overlooked. In The Obesity Paradox, Dr.
Carl Lavie masterfully explores the relationship between body weight and
health, giving us a balanced and uniquely illuminating perspective. If you want
the whole truth and real understanding, lay down your preconceptions, and pick
up The Obesity Paradox.”
—David Katz, MD, author of Disease-Proof
“Carl J. Lavie, MD, is a world-renowned expert on obesity and the heart. In this
book, Dr. Lavie describes the substantial body of evidence supporting the
presence of an obesity paradox in cardiovascular and other disease states and
then discusses the proposed mechanisms by which this phenomenon may occur.
In some respects this book represents a contrarian view of the health effects of
obesity, but one that is increasingly supported by high-quality research. This
book will be of interest not only to professionals working in the field of obesity,
but to anyone who wants to live a healthful life.”
—Martin A. Alpert, MD, professor of medicine, University of Missouri–Columbia School of
Medicine
“Dr. Chip Lavie is an outstanding clinical cardiologist who has reached a level of
achievement matched by very few scientists. One of the world’s leading
authorities on the topic of the obesity paradox, he has now used his extensive
scientific background and clinical experience to write a book for the public. I am
very excited that he has written a book on this crucial issue. We need to focus
much more on healthy lifestyles, and in particular a fit and active way of life.
For health, longevity, and function, your activity habits and physical fitness
levels are far more important than your body weight. Read this book and focus
on what is important.”
—Steven N. Blair, PED, professor, Departments of Exercise Science and Epidemiology &
Biostatistics
“In this wonderful book, Dr. Lavie displays the extraordinary talent of
articulating complex concepts regarding body size, metabolism, and wellbeing in
a manner that is sophisticated and precise, but also remarkably straightforward
and clear. He spells out issues of obesity vs. slimness that affect almost
everyone, clarifying relative benefits and risks of different body shapes, as well
as the related impact of exercise, age, disease, and other key dynamics on overall
health.”
—Daniel Forman, MD, associate physician, Brigham and Women’s Hospital, associate professor
of medicine, Harvard Medical School
“Finally, a book that sets the record straight about the leading health problem
facing our nation: obesity. As one of the world’s leading experts on preventive
medicine, Dr. Carl Lavie brings to bear the latest scientific research on what it
means to be truly ‘healthy.’ The Obesity Paradox is a product of years of
collaborative research on the myths of body fat, calling out that health is more
than just a number on a scale. The Obesity Paradox is the best book I’ve read on
the roles of fatness and fitness, and is a must read for anyone interested in good
health.”
—Richard Milani, MD, MD, FACC, FAHA, chief clinical transformation officer, Ochsner Health
System, vice chairman, Department of Cardiology
“Bad fat, good fat. In this book, Dr. Lavie uniquely melds science and art into a
fantastic exploration of heart health that shines a bright light on the most
important epidemic of our times.”
—Mandeep R. Mehra, MD, FACC, FACP, medical director, Brigham and Women’s Hospital
Heart and Vascular Center Executive Director, Center for Advanced Heart Disease, professor of
medicine, Harvard Medical School
“Dr. Lavie has devoted most of his research life to unravel different facts of
obesity—a worldwide health problem. He is one of the leading experts on the so-
called obesity paradox, the idea that fat can protect you from an early death. And
in this book the reader will be able to understand the clinical issues associated
not only to obesity but the obesity paradox. It will change the reader’s views
about fatness, offering a valuable new perspective.”
—Hector Ventura, MD, FACC, FACP, director, Cardiovascular Disease Training Program and
Education at the Ochsner Clinic Foundation, and professor of medicine at the Tulane University
School of Medicine
“In this eye-opening book, cardiologist and medical researcher Dr. Carl Lavie
shows that obesity has been unfairly blamed for a litany of health conditions,
while its health benefits remain largely unknown. Reviewing scores of scientific
studies that he and others have conducted, Lavie shows that while being heavier
may put one at risk of developing certain diseases, carrying extra weight may be
protective once illness has set in. Moreover, those who are thin but physically
inactive face a plethora of unrecognized health risks. Challenging received
wisdom with a careful review of medical research, this book is a must read for
anyone who is trying to lose weight to improve their health or longevity.”
—Abigail C. Saguy, associate professor and vice chair, UCLA Sociology, and author of What’s
Wrong with Fat?
“Two out of three Americans are overweight or obese, and many of them feel
guilty and/or fearful about these extra pounds. Dr. Lavie, a brilliant and
internationally renowned cardiologist who is one of the foremost experts on
preventive cardiology, explores the long-term health consequences of carrying
around excess fat, offering startling and counterintuitive findings. This
groundbreaking book is a must-read for anyone who is overweight or obese and
struggling to lose weight, often times through using potentially dangerous
therapies including radical gastric bypass, dangerous drugs and/or supplements,
and crash dieting leading to detrimental yo-yo weight changes. Dr. Lavie’s
insightful book has the power to change the zeitgeist about body fat—and what a
truly healthy shape looks like.”
—James O’Keefe, MD, medical director of the Charles and Barbara Duboc Cardio Health and
Wellness Center at Saint Luke’s Mid America Heart Institute, and professor of medicine at the
University of Missouri-Kansas City
“I was initially skeptical: Did we really need another book on our
overweight/obesity epidemic? But then I started reading The Obesity Paradox
and I could not put it down: It is well-written, doesn’t rely on medical jargon,
and draws from the most up-to-date and accurate medical literature. Dr. Chip
Lavie, a ‘giant’ in the fields of preventive cardiology/lifestyle medicine/cardiac
rehabilitation provides the reader with a research-based hopeful message: It’s not
doomsday to have some extra fat on you, especially if you maintain a certain
level of aerobic fitness. If you choose to read only one health-related book this
year, read this one. I plan to recommend it to all of our patients.”
—Barry A. Franklin, PhD, director, Preventive Cardiology and Cardiac Rehabilitation William
Beaumont Hospital, and professor of internal medicine at Oakland University William Beaumont
School of Medicine

HUDSON STREET PRESS
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First published by Hudson Street Press, a member of Penguin Group (USA) LLC, 2014
Copyright © 2014 by Carl J. Lavie Penguin supports copyright. Copyright fuels creativity, encourages
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Excerpts from the article “The Thin Man’s Diabetes” by Jeff O’Connell were originally published in the
April 2008 issue of Men’s Health magazine and are used with express written permission of that article’s
copyright owner, Rodale, Inc. All rights reserved.
Lavie, Carl J., author.
REGISTERED TRADEMARK—MARCA REGISTRADALIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA
The obesity paradox : when thinner means sicker and heavier means healthier / Carl J. Lavie, M.D. ; with
Kristin Loberg.
pages cm
Includes bibliographical references and index.
ISBN 978-1-59463-244-0
ISBN 978-0-69814851-2 (eBook) 1. Obesity—Health aspects. 2. Overweight persons—Health and
hygiene. 3. Human body—Composition. 4. Weight loss—Physiological aspects. I. Loberg, Kristin, author.
II. Title.
RA645.O23L38 2014
616.3'98—dc23 2013045483
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Version_1
To the pursuers of health and happiness . . . no matter how much you
weigh.
And to anyone who has felt tyrannized by matters of weight, dieted
to no avail, and searched for
the secret to longevity.