It's time to stop demonising fat ? what matters is where it's hiding, says body MRI expert
You say it's only in recent decades that fat has been demonised. What do you mean?
For thousands of years, people who would now be considered overweight were admired. To be large was a sign of prosperity, and was associated with fertility. If you look at paintings and drawings over thousands of years, you are always going to see women with a body mass index above 25, and up to 30, who are considered beautiful. It is only in the last 30 years that we have seen a drop in BMI in such portrayals and the concept of health related to lower and lower BMIs.
Have we really got our ideas about fat so wrong?
If you stop people in the street and ask them if they are happy with their amount of fat, they will say no. If you then ask if they want to reduce it, they say yes. Ask by how much and they will say they want to reduce it completely. Getting rid of fat should not be the aim. The aim should be to have a healthy amount, but nobody thinks in those terms. We have demonised it.
Who is to blame for fat's bad press?
There is not a day that goes by without an article in a newspaper or magazine telling you how to reduce fat. Not a single article will say, look, not only is a certain amount of fat good, but it is essential for your well-being.
How should we regard our body fat then?
Not just as a dumping ground for excess energy, which is the way most people see it, but as a beautiful organ that interacts with your environment and helps maintain homeostasis within your body. Fat controls and modulates your fertility, your appetite and your mood. Your immune response will not work properly if you don't have the right amount of fat.
Is this demonising of fat harmful?
We have shown that people who diet strictly can have problems. Supermodels tend to have a lot of liver fat, which is unhealthy, although their BMI can be as low as 15 to 16. The separation between beauty and health has created its own problems. We now consider people to be beautiful if they have a very low BMI but it would be healthier to have a BMI of 24, with the right distribution of fat.
Is all fat good for you?
There is a reason why body fat is there and it is a reflection of your lifestyle. Too much fat, where it is and in what form might be bad. Excess fat in the liver is bad. Subcutaneous fat, particularly around your gluteal area, is protective.
So where excess fat ends up is important?
Absolutely. With new imaging techniques, we have discovered people with "sub-phenotypes" of fat distribution. They have normal levels of fat but with increased risk of certain diseases because of fat deposits in and around internal organs. This is what we call Tofi - thin on the outside, fat inside. This internal fat is believed to be more likely to lead to type 2 diabetes and heart disease. Other people can increase their external fat with very little effect on their internal fat.
Profile
Jimmy Bell heads the molecular imaging group at Imperial College London, where he pioneered body fat imaging using MRI. He was a speaker at last month's Cheltenham Science Festival
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