Fit and Fat
Is it possible to be fat and fit?
It's not just a stereotype, it's a fact: Most overweight people are badly out of shape. For whatever reason, they simply don't get enough exercise. But every once in awhile, a hefty person comes along who bucks the trend.
Take Steven Blair, PhD, for example. At 5 feet 4 inches tall and 180 pounds, he doesn't fit anyone's definition of svelte. But his girth is deceptive. Blair, the director of The Cooper Institute in Dallas, runs about 30 miles a week. Most slender people would eat his dust.
And Blair isn't the only fit person masked by a fat body. Tens of thousands of people, who were all different sizes, have stepped on the treadmill at The Cooper Institute, where scientists research obesity, epidemiology, nutrition, and aging. In Blair's experience, some of the heavier people were able to walk impressive distances -- far enough to put many thin subjects to shame.
What's the best measure of health: Fitness or fatness?
As a group, overweight people suffer far more than their share of health problems. Compared with people of a healthy weight, they are more likely to have heart trouble, diabetes, stroke, and certain kinds of cancer. The Centers for Disease Control and Prevention estimates that obesity-related ailments kill about 112,000 Americans each year.
But is fat really such a big-time killer? Blair, for one, thinks the blame lies elsewhere. He summarized his thoughts in a provocative (and widely reported) statement at a meeting of the Association for the Study of Obesity some years back: "There is a misdirected obsession with weight and weight loss," he said. "The focus is all wrong. It's fitness that's the key."
His opinion may seem self-serving, but Blair has solid data to back up his views. In one noteworthy study, he and his colleagues put nearly 22,000 men (ages 30 to 83) through their paces on a treadmill. They also measured every man's weight and body fat. Eight years later, they checked to see which subjects were still alive. The results were remarkable. As reported in the American Journal of Clinical Nutrition, moderately overweight men (meaning they had more than 25 percent body fat and an average body mass index of 28) who were physically fit had half the death rate of their thin, but out-of-shape, peers.
The bottom line: Fitness matters, no matter what your size.
Why is fitness so important to good health?
Exercise has many rewards besides weight control. Even if your scale hardly budges, regular workouts can strengthen your heart, bolster your immune system, lower your blood pressure, and reduce your risk of diabetes. Exercise will also improve your mood, reduce your stress, boost your energy, and improve your sleep.
Is it still important to watch my weight?
Even Blair concedes that it's better to be lean and fit than overweight and fit. For one thing, extra weight puts stress on the joints, increasing the risk of arthritis. Fat around the midsection can also promote type 2 diabetes by hampering your body's response to insulin.
In addition, a study by the National Heart, Lung and Blood Institute found evidence that extra weight is bad for your heart: in a study of over 5,000 participants, the risk of heart failure increased with each additional point of a participant's BMI (or about 4 to 8 pounds). Men experienced a 5 percent risk increase with each additional point of BMI, while women had a 7 percent increase. In general, researchers found that the risk of heart failure was 34 percent higher for overweight individuals and 104 percent higher for people classified as "obese".
If you're overweight, you have every incentive to exercise regularly and watch your diet. In the best-case scenario, you will wind up trim and healthy. But remember: Even if the perfect body eludes you, a fit body is well within your reach.
Are some people too heavy to exercise?
Extremely overweight people often have trouble starting an exercise program because they may feel self-conscious, or they may already have physical problems that discourage them from working out. But all of these obstacles can be overcome. If you have foot problems caused or aggravated by your weight, for example, you can swim or ride a bike, instead of walking or running. You can also lift weights.
With the right approach, just about everyone can benefit from exercise - and according to new research, you don't need an extreme workout to lose weight. As reported in the Journal of the American Medical Association, women in a government study were asked to reduce their calorie intake and were then given exercise programs of varying intensity. After a year, the women who exercised moderately lost about the same amount of weight as the women who worked out more vigorously and for longer periods.
The National Institutes of Health published a valuable guide called "Active at Any Size," which lists exercises specifically for larger people. Suggested workouts include walking, dancing (while standing or sitting), swimming, and bicycling (on either a regular or recumbent bike). Regardless of which activity is best for you, everyone is encouraged to set fitness goals, start slowly, and have fun.
For a copy of the National Institute of Health's "Active at Any Size" report, contact the organization below or see it on the Internet at: http://win.niddk.nih.gov/publications/active.htm The Weight-control Information Network (WIN) National Institutes of Health 1 WIN Way, Bethesda, MD 20892-3665 Phone: 202/828-1025 or 877/946-4627
Fact Sheet: CDC Efforts to Reduce or Prevent Obesity, April 19, 2005. Centers for Disease Control and Prevention. http://www.cdc.gov/od/oc/media/pressrel/fs050419.htm
Obesity Causes Fewer Deaths Than Previously Estimated, CDC Analysis Finds, California Healthline, April 20, 2005. American Diabetes Association. CDC Casts Obesity-related Death Toll in New Light. June 2005. http://docnews.diabetesjournals.org/cgi/content/full/2/6/1-a
Lee, CD et al. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. American Journal of Clinical Nutrition. March, Vol. 69 (3): 373-380.
Active at Any Size, National Institutes of Health, March 2001.
Obesity Epidemic Increases Dramatically in the United States, Centers for Disease Control and Prevention
Kenchaiah S, et al. Obesity and the risk of heart failure. N Engl J Med, Vol. 1;347(5):305-13
Jakicic JM, et al. Effect of Exercise Duration and Intensity on Weight Loss in Overweight, Sedentary Women. JAMA, vol. 290:1323-1330.