I mean HAES isn’t completely wrong. But they’re not correct either.
Fact is, you don’t KNOW how much fat will make you unhealthy. Some people with a certain fat distribution might be healthy at higher BMIs. Some might already have issues much earlier.
It literally depends on how many fat cells you have in your „storage“ fat deposits. And the rate of cell division. Because fat cells CANNOT take up unlimited amounts of fatty acids, so after a maximum is reached the excess energy/metabolites will be deposited elsewhere -> metabolically active fat deposits (abdominal fat, subcutaneous as well as around the organs i.e. probably at the omentum majus or around organs). Those fat deposits are not for storage and have high basal lipolysis rates. This causes elevated blood levels of fatty acids which causes an oversupply of energy in almost every cell type in the body. Most cells will just turn insulin resistant under such circumstances (to avoid cell damage from reactive oxygen species that are made if there isn’t enough ADP to convert to ATP in oxidative phosphorylation - the concrete mechanisms would be too complex for a simple post) however pancreatic cells cannot do that and as such get damaged. So not only are fatty acids accumulating in the bloodstream but also sugars. In high enough concentrations both of these can cause substantial damage to endothelial walls of the blood vessels resulting in plaques which may later calcify and cause vascular diseases. not to mention insulin resistance is basically Diabetes type II and if the pancreas gets damaged badly enough that’s a Type I (no intrinsic Insulin production remains).
Not only that but it’s also very hard for obese people to lose weight and do sports. Muscle fibers are also speckled with fat cells after some time and the insulin resistance inhibits uptake into the musculature during exercise leading to muscle fatigue due to lack of energy. Also they’re accustomed to higher amounts of the hormone leptin which is produced by fat deposits. Contrary to popular belief leptin does NOT make you feel satiated (that’s other hormones most likely gastrin or CCK and Insulin or sth like that) instead it is just a signal that means something like „hey we got enough energy stored! We’re fine!“.
However as soon as you start loosing fat the leptin levels fall, which is what in my opinion may also cause the ravenous hunger we experience when restricting. It’s a signal that your body is out of homeostasis (or not on what popular science calls a set point). This can cause a lot of hormonal changes, increase hunger, decrease TSH and in turn T3 levels, decreases motivation to move etc.
It also takes a while until we accustom to lower leptin levels (around 6 months I think).
This is why crash dieting doesn’t work. Why weight loss needs a change in lifestyle. Your body likes to hog energy even to morbidly obese degrees. In that regard we are still cave people who are always trying not to starve to death
We were not made for a world in which food is abundant and found in every corner store. Where we don’t need to hunt or search for food but sit in offices to earn the money to buy food.
That is the reason so many people nowadays have Diabetes Type II and stay diabetic and overweight... Obesity is on the rise. No wonder Bayer didn’t sell their Diabetes Health Care. There’s a lot of money to be made in the future.
Source: my own presentation on the topic in med school hehe
And yes underweight is also pretty dangerous and unhealthy. But as has been said, at least we KNOW we are being unhealthy and many of us try to at least dampen the harm a bit.
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