Obesity PROTECTS you from diabetes

The findings below are the exact opposite of what is usually asserted.  And this was a pretty good study, controlled for social class, among other things.  Also found that being overweight has little or no impact on your lifespan

Body Mass Index, Diabetes, Hypertension, and Short-Term Mortality: A Population-Based Observational Study, 2000-2006

Anthony Jerant, MD and Peter Franks, MD

Abstract

Background: Published studies about the association of obesity with mortality have used body mass index (BMI) data collected more than 10 years ago, potentially limiting their current applicability, particularly given evidence of a secular decline in obesity-related mortality. The objective of this study was to examine the association between BMI and mortality in a representative, contemporary United States sample.

Methods: This was a population-based observational study of data from 50,994 adults aged 18 to 90 years who responded to the 2000 to 2005 Medical Expenditures Panel Surveys. Cox regression analyses were employed to model survival during up to 6 years of follow-up (ascertained via National Death Index linkage) by self-reported BMI category (underweight, <20 kg/m2; normal weight, 20-<25 [reference]; overweight, 25-<30; obese, 30-<35; severely obese, ?35), without and with adjustment for diabetes and hypertension. Survival by BMI category also was modeled for diabetic and hypertensive individuals. All models were adjusted for sociodemographics, smoking, and Medical Expenditures Panel Surveys response year.

Results: In analyses not adjusted for diabetes or hypertension, only severe obesity was associated with mortality (adjusted hazard ratio, 1.26; 95% confidence interval, 1.00-1.59). After adjusting for diabetes and hypertension, severe obesity was no longer associated with mortality, and milder obesity (BMI 30-<35) was associated with decreased mortality (adjusted hazard ratio, 0.81; 95% confidence interval, 0.68-0.97). There was a significant interaction between diabetes (but not hypertension) and BMI (F [4, 235] = 2.71; P = .03), such that the mortality risk of diabetes was lower among mildly and severely obese persons than among those in lower BMI categories.

Conclusions: Obesity-associated mortality risk was lower than estimated in studies employing older BMI data. Only severe obesity (but not milder obesity or overweight) was associated with increased mortality, an association accounted for by coexisting diabetes and hypertension. Mortality in diabetes was lower among obese versus normal weight individuals.

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Australia:  More official abuse of "child welfare" provisions

You can be an Aboriginal child who is badly abused and neglected by your parents and the  authorities will do nothing.  But get FAT and that is another matter.  Obesity is mostly genetic so this is punishing people for something over which they have little control.  And harassing people about it just makes it worse. People may slim down for a while but in well over 90% of the cases they will eventually put it all back on again -- and more

VICTORIAN welfare authorities have begun using extreme obesity as a reason to support children being separated from their parents - and experts predict more cases as the population gets fatter.

The Department of Human Services has cited obesity in at least two child protection court cases this year.

One case involved a pre-teenage boy who weighed 110 kilograms and the other a teenage girl whose waist circumference of 169 centimetres was greater than her height. The department would not reveal the exact number of cases.

Associate Professor John Dixon, of the Baker IDI Heart and Diabetes Institute, said he expected more such cases, but that they would not become common.

"I would not want parents out there with overweight or obese children to in any way feel that it's through their negligence that we have a growing obesity issue in children today," Associate Professor Dixon said.

"That would be very wrong indeed … This is a community problem, an Australia-wide, a global problem that we're not addressing very well at the moment.

"We shouldn't be blaming the parents for our environment. The parents and the children who are obese are really victims of the environment."

In the teenage girl's case, experts stressed to the department that her weight problem needed urgent attention.

She had gained 30 kilograms in 18 months and was described by a Children's Court magistrate as "incredibly unhealthy … To hear that her waist measurement is greater than her height is so concerning."

The court was told it would be impossible for her to reduce her weight to a healthy range within a year and a more realistic goal was to lose 15 to 20 kilograms and keep it off. Doctors had concluded that the weight gain was not genetic and had to have come from eating. [Of course it comes from eating   --but it is the genetics that causes the overeating]

The girl's mother told the court that she wanted her daughter returned home or placed in residential care. The department said foster care was not an option because there were no families available who could help with her needs.

The magistrate ordered the girl remain legally in the care of the state. She and her mother had had a breakdown in their relationship that had led to the girl not living at home.

In the case of the pre-teenage boy who weighed 110 kilograms, another magistrate ordered that he be removed from his mother's care and put into a "therapeutic setting".

The boy had been referred for medical intervention but it had no effect and he had been sitting in his room, eating and inactive.

The department said it could not work with the boy's mother until he was removed from her care.

A spokesman for the department told The Age that obesity was not of itself grounds for child protection workers to become involved with a family.

But he said "obesity may be a symptom of other issues that could place a child at risk or harm that would warrant child-protection involvement".

Some of Victoria's most obese children are referred to the Weight Management Clinic at the Royal Children's Hospital.

But The Age understands that the clinic is struggling with a lack of resources to deal with families where there are several obese children who need intervention.

Non-urgent referrals to the clinic face a wait of between nine months and a year, but the clinic warns that in some cases, the delay could be longer. A smaller clinic operates at Melton.

Associate Professor Dixon said there were many determinants of obesity in children and adolescents but parental neglect was not usually considered to be one. "Severely obese adolescents and their parents are under enormous stress and there are often other issues in the family," he said.

"It wouldn't only be obesity that would lead to a child being removed."

He said any cases where extremely obese children were removed from their families should be seen as rare.

Associate Professor Tim Gill, of Sydney University's Boden Institute of Obesity, Nutrition, Exercise and Eating, said if the only reason for removing a child from their parents was weight, it was not appropriate.

"There are a whole range of issues which drive weight gain, particularly in children," Associate Professor Gill said.

"We are going to see more children in that [extreme] weight category and in some ways, yes, it's a failure of parents, but it also reflects a failure of society - that we could create a circumstance that would allow and encourage kids to overeat and under-exercise to such an extent that they get to that weight."

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