The ground breaking book explains why being overweight does not necessarily mean bad, and what you need to do to be healthy at any body weight. This summary only contains the most basic information and should not be treated as a replacement of the full book. The complete book contains richer information based on scientific researches and studies. For sound health decisions, you should consult your physician.

1. A Book Summary by Stephen Siregar

2. • This summary contains only the most basic
information and should not be treated as a
replacement of the book
• The full book contains complete information
regarding the subject, based on scientific researches
and studies
• For sound health decisions, you will need to consult
your physician.

3. • American Cardiologist
• Medical Director of cardiac rehabilitation
and preventive cardiology at the John
Ochsner Heart and Vascular Institute, New
Orleans, Louisiana, USA
• Professor at the Ochsner Clinical School of
the University of Queensland, Brisbane,
Australia
• Editor-in-Chief, medical journal Progress in
Cardiovascular Diseases
• Authored and co-authored over 800 medical
textbooks and journal articles

4. • Heavy Burden: Obesity May Be Even Deadlier Than
Thought (NBC News)
• Obesity Kills More Amerians Than Previously
Thought (Science Daily)
• No More Denial: Obesity Kills (EverydayHealth.com)

6. Carl J. Lavie et al
“Obesity and
Cardiovascular
Disease: Risk Factor,
Paradox and Impact
of Weight Loss”
Journal of the
American College of
Cardiology, Vol 53,
Issue 21, May 2009

7. “Overweight and moderately obese patients with
certain chronic diseases, from heart diseases and
arthrithis to advanced cancer and even AIDS, often
live longer and fare better than normal-weighterd
patients with the same ailments.” –p. 13

8. Body Mass Index (BMI)
𝐵𝑀𝐼 =
𝑚𝑎𝑠𝑠(𝑘𝑔)
ℎ𝑒𝑖𝑔ℎ𝑡2(𝑚)

9. • Category according to World Health Organization
– BMI <15 = Very Severely Underweight
– BMI 15-16 = Severely Underweight
– BMI 16-18.5 = Underweight
– BMI 18.5-25 = Normal (Healthy) Weight
– BMI 25-30 = Overweight
– BMI 30-35 = Moderately Obese
– BMI 35-40 = Severely Obese
– BMI >40 = Very Severely Obese

10. • Increased insulin resistance
• High Blood Pressure
• Coronary Heart Disease
• Stroke
• Abnormal Blood Fats
• Atrial Fibrillation
• Cancer
• Osteoarthritis
• Sleep Apnea
• Asthma
• Kidney Disease

11. The Obesity Paradox

12. Metabolically Sound
• Normal level of blood fats
• Normal blood pressure
• Good Waist-to-Hip Ratio
• High HDL
• Low LDL
• Low fasting blood sugar
Cardiovascularly Fit
• No thickening of walls
• No hardening of blood
vessels

13. “Fat is paramount to survival. No one can have a fat-
free body and be healthy at the same time.” – p.122

14. • Body temperature regulation
• Protection and cushion of internal organs
• Energy reserve
• Protecting nerve fibers
• Forms cell membranes
• For smooth skin

15. Essential Storage Excess Visceral
Needed for normal
body function
Also acts as protective
layers against injury
Releases Fatty acids,
inflammatory
compounds and
hormones that will
cause higher bad
cholesterols,
triglycerides, blood
glucose, and blood
pressure
Located in muscle and
bone marrow
Located under skin, in
muscle and in specific
areas
Accumulated in the
belly region
Health Risk Fat

16. Excess
Visceral Fat

17. • Some essential fats can be made by the body.
• Some essential fats must be obtained from outside
source.

18. Saturated Fat Trans Fat Unsaturated Fat
The only fatty acid that
raise total blood
cholesterol and LDL
Man-made synthetic
fat, acts like saturated
fat
Improves blood
cholesterol, insulin
and blood sugar
Found in meats, whole
dairy products,
coconut or palm kernel
oil
Found in margarine,
processed food, baked
goods, fast foods, as
hydrogenated oil
Found in mostly plant
based food and oils as
poly- or mono-
unsaturated fat
Part of cell
membranes, and
function of lung, heart,
bones, liver and
immune system
Most toxic fat with
hardly any redeeming
properties
Omega-3 fatty acids
are one type of poly-
unsaturated fats
Health Risk
Dietary Fat

19. “It’s not fair to lump someone with BMI of 30 (obese)
who is metabolically healthy and from a
cardiovascularly fit standpoint in the same category as
a person with BMI of 39 who can barely climb a
staircase without getting winded. By the same token, a
fit person with a BMI of 28 (overweight) could easily
outlive a thinner individual (let’s say BMI of 22)..”
– p.188

20. The Obesity Paradox
This Photo by Unknown Author is licensed under CC BY

22. “Based on all the current science to date, I am
comfortable of saying that [BMI] 27 is the new [BMI]
23.” – p. 193

23. BMI>30
Reduce Weight
Add Exercise
Reduce Weight
Maintain Exercise
Reduce Weight
Reduce Exercise
BMI
18.5-30
Maintain Weight
Add Exercise
Maintain Weight
and Exercise
Maintain Weight
Reduce Exercise
BMI
<18.5
Add Weight
Add Exercise
Add Weight
Add Weight
Reduce Exercise
Sedentary Moderate Exercise Vigorous Exercise

24. • Obesity paradox does not endorse obesity
• Weight gain prevention should be first place
• The more weight gained beyond ideal weight, the higher the
risk for numerous chronic conditions
• If your BMI says you’re overweight or mildly obese, you don’t
need to focus on losing weight if you’re fit.

25. • Instead of obsessing on weight loss, focus on metabolic and
cardiorespiratory health
• Talk about health instead about fat

26. • In the next check-up, pay attention to:
– Haemoglobin A1c (diabetic marker)
– Fasting Blood Glucose (diabetic marker)
– C-reactive Protein (CRP) (inflammation marker)
– Lipids (heart disease risk)
• Fasting Cholesterols
• Total Cholesterol
• HDL
• LDL
• Triglycerides

27. • Reduce sugar consumption
• Maintain regular sleeping patterns
• Reduce exposure to obesogens
• Move more throughout the day

28. • Reach your goal
• Enjoy what you’re eating
• You’re body seems to agree
• Does not contradict health risk

29. • High in variety of plant foods
• Less in red meat, processed meats, and high-fat dairy
• More in white meat (chicken, fish)
• Use herbs and spices instead of salt and fats to season food

31. • Exercise helps with weight management
• Weight loss is more successful with programs that provide
meals
• Some prescription drugs help with weight loss and
maintenance

32. • Moving from below average to average fitness is enough to
reap the most health benefits
• Get exercise program that includes cardio work, strength
training and stretching
• Aim for 30-40 minutes to raise your heart rate 50% from
resting rate for most days of the week
• Add resistance training to build major muscles
• Avoid being sedentary the rest of the day

33. • If you eat properly, you
may not need to take
supplements
• Consult your physician to
determine your
supplement needs

34. Take charge of your health.
Text Copyright © 2014 by Carl J. Lavie
Photo, Figures, Charts, copyrights by their respective owners