Pecohub Mr. A, a 53-year-old company employee, saw his workload increase after becoming a manager, reduced his exercise, and frequented evening business dinners.
One day, his health check-up results startled him: his fasting blood sugar was 130 mg/dL, exceeding the diabetes threshold of 126. His triglyceride levels were also high, and his waist circumference measured 94 cm, indicating abdominal obesity.
The doctor warned, “If you don’t lose weight now, you’ll suffer greatly from diabetes.” Mr. A’s body mass index (BMI) is 27.5. BMI is calculated by dividing weight in kilograms by the square of height in meters. A BMI of 25 or higher is considered obese.
Ms. B, a 72-year-old grandmother, was told at the hospital, “You’ve lost too much weight.” Three months after her stomach cancer surgery, she had lost 5 kg.
She struggled to walk due to lack of strength. Her recovery was slow, and her anticancer treatment was nearly postponed, but at her daughter’s urging, she began a high-protein, high-calorie diet.
She ate chicken porridge, soy milk, and steamed egg daily and combined this with rehabilitation exercises at the hospital. Two months later, she gained 3 kg, and her serum albumin levels and immune cell counts recovered. By increasing her weight, she successfully completed her anticancer treatment and returned home.
The two cases demonstrate how the significance of weight completely changes with age. For those in their 40s and 50s, when diseases begin to emerge, gaining weight is the seed of illness. However, for those in their 70s and beyond, weight gain becomes a survival asset to endure diseases. Middle-aged fatness invites illness, but in old age, a plump physique helps overcome it.
Ms. Patricia Hewitt, 77, a former UK Health Secretary, recently argued in a column for *The Times* that obesity criteria for the elderly should be revised. She recounted her experience of being hospitalized for severe dehydration during a vacation in Australia and barely recovering.
At the time, a doctor told her, “Your low weight likely made dehydration easier and your body struggled to cope.” Her weight was 50 kg then.
She said, “I was proud of maintaining a weight appropriate and slim for my height, but I was advised to gain about 10 kg.” She emphasized, “Since the elderly often lose weight due to illness, their ideal weight should be heavier than that of younger people.” She urged the inclusion of the concept of ‘buffer weight’—a reserve weight to endure illness—in public health guidelines for the elderly.
There is a term called the “obesity paradox.” It refers to the observation that slightly overweight individuals often live longer than those with normal weight.
Numerous studies on Koreans support this. Research findings such as “obese individuals experience milder strokes,” “plump dementia patients outlive thinner ones,” “ICU patients with higher BMIs have lower mortality rates,” and “the heavier one is, the smaller the myocardial infarction size and lower the risk of death, indicating a stronger heart” all attest to the necessity of reserve weight in old age.
Obesity is a major risk factor for cardiovascular diseases. However, even in conditions like coronary artery disease, chronic heart failure, peripheral artery disease, and stroke, overweight patients show lower mortality rates than those with normal weight.
This trend is more pronounced in the elderly. In other words, once a disease has developed, having an overweight physique provides a greater capacity to endure it.
