Types of Obesity
It’s hard to believe that we live in such a super specialized society, that there are actually different types of obesity to characterize. Isn’t fat just fat? Well, the quick answer to that question is- not really.
Different people have different body types. Similarly, different people can become obese in unique ways. How one person stores his or her excess fat may be different from how another does. It used to be that being heavy was uniformly deleterious to ones health. It is true, given a choice, one would rather be an appropriate weight for ones height. However, recent research has shown that it is not just weight, or even Body Mass Index (BMI), that is always a reliable predictor of health and/or risk factors for developing obesity related disorders.
Several years back, researchers began to categorize three major body types of those who are obese. The categories were “pear shaped”, “apple shaped”, and a third that was a combination of the other two. Pear shaped individuals store much of their fat around their buttocks and upper thighs, with little stored in the torso, neck, arm or shoulder areas. Apple shaped individuals store much of their body fat in their torsos, arms, neck and shoulders, giving them an apple like shape. As clarification, I always assume they’re referring to Red or Golden Delicious apples as other types of apples just seem round to me. The third type was a combination of the other two. I guess they couldn’t come up with a third fruit shape that would fit.
The most notable point about these different types of obesity is that there may be a difference regarding likelihood of developing obesity related complications (i.e. cardiovascular disease, hypertension, diabetes, stroke and high cholesterol). It appears that pear shaped individuals are less likely to develop these disorders and apple shaped individuals are more likely. Why this is, no one really knows. It may not be a coincidence that pear shaped individuals tend to be women and apple shaped individuals tend to be men. Women appear to have some degree of protection from cardiovascular disease until middle age. Some believe hormones related to menstruation may offer protection. Men, on the other hand, are more likely to have symptomatic vascular disease, especially coronary artery disease. Does this mean that if you are pear shaped it’s smooth sailing while apples, such as myself, are doomed?
I think debating whether you are shaped more like a pear or more like an apple is a fruitless exercise. Until more data is available about this, play it safe. Try to eat right and exercise so that your BMI, cholesterol, blood glucose, and blood pressure are all normal to better than normal. That way, no matter which fruit you resemble, you’ll be in good shape.
Jeffrey Heit is an internist in Burlington, Massachusetts and is affiliated with Philadelphia Veterans Affairs Medical Center. He wrote for HealthCentral as a health professional for Obesity.