Being overweight in middle age reduces your likelihood of gliding into your 70s without any health problems like diabetes, heart disease, or cancer. It also reduces your odds of being able to walk up a flight of stairs or get through your day without crying. Obese women have it toughest, finds a new study published today in the British Medical Journal. They're nearly 80 percent less likely to experience "healthy survival" when they reach age 70, compared with women who gained fewer than 9 pounds since age 18.

Are the researchers showing that thin women who maintain their weight over the years actually live longer? Well, no, but they do indicate that these women live better, not just avoiding chronic diseases but also sidestepping mental and physical health problems that prevent women from enjoying the leisure time of their senior years -- say, Mediterranean cruises or romps in the park with the grandkids.

What's more, the study showed that it's truly tough to be a "healthy survivor," free of any sort of chronic physical or emotional pain or health condition at age 70. Only 10 percent of the 17,000 nurses in the study were, and this group included those who didn't gain any weight as well as those who gained quite a bit. (Those who lost weight were excluded from the study because it might indicate disease.) But weight mattered; about 16 percent of the women whose weight didn't deviate by more than 9 pounds when they reached middle-age could call themselves healthy survivors, compared with 11 percent of those who gained between 9 and 22 pounds by midlife. The percentages dropped further with more weight gain; just 3 percent of healthy survivors were obese in middle age.

Certainly, body weight plays a role in long-term health, but it doesn't tell the whole story. The study also found, for example, that it makes a difference where a woman carries her fat -- whether it's mostly on her hips and thighs or around her belly. Those with a waist circumference of more than 28 inches had a lower likelihood of being a healthy survivor regardless of whether they were overweight. "We're really moving away from the idea of whole body fat and focusing on where fat is located in the body," says Carol Shively, a fat researcher at Wake Forest University School of Medicine. A large waist often indicates an excess of fat around the body's organs -- called visceral fat -- which can lead to dangerous inflammation, a process thought to be involved in heart disease, diabetes, cancer, and even depression. The kind of body fat that tends to accumulate around the hips and thighs, she says, may not be damaging to our health. Obese individuals, though, usually have plenty of both kinds.

I think the take-home message here is that you don't need to panic if you've gained a few dress sizes over the years, but you should do everything you can now to keep your weight stable or even lose some weight if your body mass index is well above the healthy range. (Here's how to assess your BMI.) Studies suggest that physical activity can play a big role in helping you maintain your weight over time. Every time I cut back on my workouts, the number on scale starts to creep up. And I don't think I've found that magic formula, having put on about 15 pounds since high school.

I asked my colleague Katherine Hobson, the On Fitness blogger, to tell me how she managed not to gain an ounce since her teens, and she tells me that she was actually 10 pounds heavier at 18. "That was my all-time high," she says. "I started running after college and now do that about three to four times a week for 30 minutes at a time, plus 40-minute swim sessions two to three times a week, and two to three strength training sessions."










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