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12 June 2009


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Christy P.

Another reason for the J-shaped curve of life expectancy and BMI (x axis) is that people dying of cancer etc tend to lose weight. Hence low remaining life expectancy at really low BMI...


Yes, I am aware of that. The idea is that if you exclude the "thin because they're sick people" from the numbers, the positive correlation between BMI and excess death is more obvious.

But let me throw this out. Some illnesses, or the medication prescribed for them, are known to cause weight gain. When the "thin because they're sick" people are excluded to show the positive correlation, do they also exclude the "fat because they're sick" people?


Let me throw out an anecdote -- in the last six years I have been at the bedside of not one but three people dying of cancer. None of them had become emaciated; all of them had become heavier during their cancer and cancer treatment. So even though it's "common sense" that "sick people get thin," I'm less inclined to believe that there isn't a counterbalancing "sick people get fat" effect.

Barbara C.

The cultural aspect is rather interesting. In one of my husband's sociology textbooks, there was an essay talking about a term in the Hispanic community for girls that had a few extra pounds that translated into "well-loved". The extra pounds were seen as a sign of coming from a good family where she was well-fed and taken care of.

Barbara C.

Oh, and I am one of those ultra-skinny people that is in terrible shape. I would love to exercise more for health, but I have two issues: 1. I already burn more calories than I am able to consume in a day (partly due to nursing), so I really have to think about if building extra muscle is worth burning more fat that I can't afford to lose.

And 2. The baby will not stay off of the board when I try to use my Wii Fit.


Barbara, likely if you exercised more you would have a bigger appetite to match, at least that's been my experience (and, I think, part of the reason why adding exercise to their routine rarely helps people lose more than a few pounds unless they make other changes as well). Why can't you eat enough calories? Most of us have no trouble adding extra in the form of high-fat healthy ingredients -- oils, nuts, dairy products, avocadoes....

Barbara C.

Well, there are several things contributing to my extreme thinness.
1. Genetically high metabolism: I totally take after my dad. In his twenties he was ordered by his priest not to fast during Lent because he was so skinny.
2. High-Octane Breast Milk: My babies usually jump from the 40th percentile to the 90th percentile within two weeks of birth. I remember pumping a bit and three out of four ounces being the fatty milk. I have an easier time when I'm not nursing.

3. When I'm stressed or really busy, I lose my appetite. Let's just say I'm stressed and busy a lot. I get a lot of "Amish" exercise.

I used to eat a lot of high-fat unhealthy foods but I started having hypoglycemic episodes. I do eat a lot of dairy: milk, yogurt, cheese. I'm not big on avocadoes, though, or nuts...unless they're in a Snickers. I've been trying to make sure I eat breakfast every morning and add an extra item to each meal, but it's really hard to stay consistent. Two stressful days seem to undue a week's worth of work.

I sometimes feel kind of guilty for even complaining about being underweight when so many people out there are killing themselves trying to get as thin as me. I think it is very telling, though, that the only time since puberty when I was not underweight was during college, which was the least stressed out time of my life (even when I was taking 18 hours, auditing 3 more, and working 30 hours).

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