According to Wikipedia Medscape is: a web resource for physicians and other health professionals. It features peer-reviewed original medical journal articles, CME (Continuing Medical Education), a customized version of the National Library of Medicine‘s MEDLINE database, daily medical news, major conference coverage, and drug information—including a drug database (Medscape Drug Reference, or MDR) and drug interaction checker. All content in Medscape is available free of charge for professionals and consumers alike, but registration is required.

All this to establish the bonafides of what I am about to share with you, and to urge you to register to receive such interesting and informative information yourself.  We are all in this together when it comes to figuring out how the human body—our body—works best. Because this particular discussion runs so directly against the prevailing dogma, you may need to lean on something.

Obesity has been blamed globally for:

• all high blood pressure
• all bad joints
• restricted marriage opportunities
• school failure
• heart attacks
• high cholesterol
• MS (yes, MS)
• all strokes
• increased business costs
• running up insurance costs for others
• cancer
• infertility
• depression
• behavior problems
• early death

So while this list (some of which may be valid and some of which may not) is terrifying enough for ourselves, it’s really scary to think we could be exposing our children to these dangers by “allowing them” to be fat.  It has even been suggested by some that parents “allowing their children to get fat” is “child abuse” and that such children should be removed from their parental homes.

Oh and then enter Puritanism.  We heartily disapprove of anything that would suggest it’s ok to eat hedonistically; e.g. “never use food as a reward” (why ever not? Good food is a reward for being alive) “don’t equate food with love” (tell that to grandmothers everywhere!) and here on Medscape comes a discussion that might lead some to think it’s ok to eat as much as they like (heaven forbid).

The discussion I am referring to on the relationship of higher body weight and obesity to mortality was published on Medscape this week.  It was given by Dr. Henry Black, Clinical Professor of Internal Medicine at the New York University Langone Medical Center, former President of the American Society of Hypertension, and a member of the Center for the Prevention of Cardiovascular Disease at New York University.  He discussed a paper published in the Journal of the American Medical Association in January, 2013 (JAMA.  2013; 309(1):71-82), a synopsis of which is also available on Medscape (registration required).  Please look at it.

Basically, after rigorously weeding out studies that were poorly controlled for confounding factors, the authors (probably to their surprise) found that while grades 2 and 3 obesity were associated with significantly higher all-cause mortality, grade 1 obesity (BMI of 30-<35) overall was not associated with higher mortality, and overweight (BMI of 25-<30) was associated with significantly lower all-cause mortality.

Dr. Black mentions that many people may be horrified at these findings.  Horrified? you ask.  Why not relieved?  Well…the old Puritanism thing: someone might interpret this as a license to eat!

But no, Dr. Black says, “This is an attempt to be a little more rational about what we do, what we recommend, and how much we torture our patients sometimes and ourselves to try to lose weight, when in fact our weight is not necessarily causing us a problem.”

And finally, and best of all, he adds: “I think the important thing here is that we need to be very careful about what we say to patients, what we say to each other, and be a little more reasonable sometimes, because if we are pushing something that isn’t scientifically based, we are making a mistake.”