Medical World Debates Risk of Being Pudgy

There is little doubt among mainstream health professionals that being truly obese is a health hazard. But what about the borderline plump? The mildly pudgy? All those people with BMIs between 25 and 29, who according to the charts are overweight?

Government health agencies often lump all degrees of overweight together, noting for instance that over 60 percent of Americans are too heavy. But more than half of these people - roughly one-third of all Americans and 800 million people worldwide - are overweight but not obese.

Riding to the mall one Saturday, Joanne Ikeda's younger sister turned to her and asked, out of nowhere, "Do you know that I am now overweight?"

From heart-sinking personal experience, millions upon millions of people can imagine exactly what led up to that admission. She had stepped on the scales and noticed a number a little north of usual. So she looked it up on a body mass index chart. And - No! - she was officially too heavy.

Not obese, not even close. But her BMI was 26, a full, leaden point above the carved-in-stone cutoff for being overweight.

Many who are overweight but not obese are like Ikeda's sister, Irene Pakel: 55 years old, 5-foot-3, weight in the mid-140s, maybe 10 pounds or so into the overweight category. Does she have a weight problem, one that might even shorten her life?

To many in the field, the answer is clear.

"Over 99 percent of experts throughout the world are convinced by overwhelming data that being overweight is a huge problem indeed for the majority of the world," says Dr. Philip James, chairman of the International Obesity Task Force in London.

But as co-director of the Center for Weight and Health at the University of California at Berkeley, Ikeda has a professional, though somewhat contrarian, opinion: Not likely.

"She's very physically fit," says Ikeda. "She goes to Curves everyday after work. To look at her, you would say, 'Here is someone who is not even slightly chubby.'"

Ikeda has a weight problem of her own. Her BMI is 33, which makes her officially obese. Does that bother her? "Not really," she said. "What matters is my metabolic fitness."

Some in the world of diet and health - and as James says, they are a minority - feel too much is made of the lower end of the BMI scale, that perhaps even the entire category called overweight causes much anxiety for nothing.

"This is so ludicrous," says Ikeda. "Why are we doing this to ourselves? I think it has a lot to do with the dieting and pharmaceutical industry and the pressure to medicate every condition."

"A completely phony category" is what University of Colorado attorney Paul Campos calls overweight. He is author of "The Obesity Myth" and argues that the real health problem is too little exercise, not too much weight.