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The Truth About Being Fit and Fat

If someone is overweight and an avid exerciser, can they still be healthy? This is a question I ask myself whenever I see a sumo wrestler or a hefty linebacker. These athletes may be in good shape from an activity perspective; otherwise they would not be able to engage in such rigorous sports. But their bodies also clearly carry several extra pounds.

The answer to this question is not simple, but emerging research suggests that there are a proportion of people who can be fit, healthy, and overweight at the same time.

Many Factors to Consider

To this day, doctors still use body mass index (BMI) to assess weight and health risk.

While BMI is a fairly accurate representation of health for most of us, it’s far from accurate for those who are very muscular or very short. For example, someone who stands 5’7″ and weighs 165 pounds would be considered overweight by BMI standards. But if that person has a very low percentage of body fat and very high muscle mass, they’re obviously not unhealthy.

For this reason, it’s important to consider other factors along with BMI when evaluating overall health risk. Along with proper diet and adequate exercise, these include genetic predisposition to certain diseases, waist circumference (belly/abdominal fat), blood pressure, blood sugar, cholesterol levels, and smoking status, to name a few.

In fact, accumulating research has found that, if all other factors excluding BMI are kept in check, a little excess weight isn’t that problematic after all. One study, published in the Journal of the American Medical Association, looked at causes of death associated with being underweight, overweight, or obese. They specifically evaluated deaths from cardiovascular disease (CVD), cancer, and all other causes not related to cancer or the heart.

Results showed that being underweight (BMI under 18.5) was linked to higher death rates from non-cancer, non-CVD causes, and obesity (BMI of 30 or more) was associated with increased CVD deaths. However, being overweight (BMI of 25-29.9) was associated with decreased mortality from non-cancer, non-CVD causes. And, there was no link between being overweight and higher risk of death from cancer or CVD.1

A later study out of University of South Carolina yielded similar results. These researchers discovered that heavy but metabolically fit people have no greater risk of developing or dying from CVD or cancer than normal-weight people. Notice I said metabolically fit. That’s a very important distinction.

A total of 43,265 participants were followed between 1979 and 2003. In addition to completing in-depth questionnaires, they underwent a treadmill test to assess cardio-respiratory fitness, as well as measurements of height, weight, waist circumference, body fat percentage, blood pressure, cholesterol, and fasting blood glucose levels.

Forty-six percent of the obese participants were metabolically fit. They enjoyed a 38 percent lower risk of death compared to their unfit obese peers. The researchers also found no significant difference between metabolically healthy and obese people versus healthy, normal weight people. This suggests two things: Being fat and fit is far better than being fat and unfit; and obese, fit individuals have similar health prognoses as normal-weight people.2

There may be many reasons for this, but one major factor has to do with exercise’s ability to dramatically reduce chronic systemic inflammation. Obesity in the absence of physical activity is a major driver of inflammation, which increases risk of CVD, cancer, diabetes, and several other debilitating diseases. Physical activity not only burns fat and aids in weight loss, it douses inflammation, which cuts the risk of disease. Even if dramatic weight loss isn’t achieved, the internal benefits still matter a lot.

The records from weight loss studies may explain why. After about four weeks, individuals typically lose six to eight pounds. However, all of a sudden, blood glucose and insulin, high blood pressure, and inflammation markers like C-reactive protein (CRP) begin to drop rapidly. For most, this is only the start of their weight loss journey, but they’re obviously regaining their health at a much faster pace than they can lose the actual weight.

In a study in the journal Preventing Chronic Disease, 18 of 41 participants were classified as having metabolic syndrome (a collection of factors that put you at higher risk of developing heart disease or diabetes) before starting the study. After only eight weeks of weight loss and exercise, that number had decreased to 10. That is incredible for an 8-week program and obviously great news for people who carry a few extra pounds but otherwise maintain healthy lifestyles.

Take-Home Message

When it comes down to basics, weight is just one measure of health among many.

I firmly believe—as does every single other reputable researcher, scientist, and health professional—that the benefits of exercise extend to everyone, no matter weight, size, or stature. Physical activity reduces disease-causing chronic inflammation that predisposes us to countless life-threatening conditions. It also lowers blood pressure, blood glucose levels, cholesterol and triglycerides, markers of inflammation, and visceral (also called abdominal or belly) fat—all very reliable indicators of wellness.

So get out there, and get moving. Whether you lose 100 pounds or 1 pound, you’re doing your body and health a favor.

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