“Fat But Fit” Is a Myth

Being fit is still better if you exercise rather than not — but, if you’re overweight, you’ll also need to lose weight to protect your heart.

You may know an obese person who bikes daily and takes hope in the idea that he or she could be “fat but fit.” The exercise definitely benefits that person — but it doesn’t cancel out the bad effects on his or her heart of carrying too much body fat.

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Can I ignore my weight if I exercise?

Alas, no. Extra pounds and low cardio fitness both increase the risk of dying from a heart disease, and, if you have to pick one, some evidence suggests that low fitness may be the worst of the two. So, one strategy to encourage public health has been to urge people to exercise and worry less about their weight.

One study using data for nearly 530,000 working adults from Spain, however, found that overweight and obese people had more cardiovascular risk than people of normal weight who were inactive.

According to the results, if you are obese and active, you are twice as likely to have high cholesterol, four times as likely to have diabetes, and five times as likely to have high blood pressure than couch potatoes who aren’t overweight.

The findings were similar for men and women.

In the data, 42 percent of the participants had a normal weight (with a body mass index[DE4] , or BMI, of 20 to 24.9), 41 percent were overweight (with a BMI from 25 to 29.9) and 18 percent were obese (BMI of 30 or above).

Americans have a bigger weight problem than the Spain group. More than 42 percent of Americans are obese, while another 30 percent are overweight. We also have a bad record on exercise: only one in four American adults get enough.

How much does exercise help?

It was true that exercise helped in the Spanish study. The risk of high blood pressure and type 2 diabetes in participants fell as they became more active. Exercise is the key: Earlier research suggests that not exercising is worse for your health than smoking. Another large study from Great Britain, with data for more 90,200 adults, found that the more you exercise, the better off your heart is. There seems to be no upper limit on the benefits.

So exercise is necessary — and so is weight loss. Exercise doesn’t completely compensate.

Why was “fat but fit” an appealing idea?

Many people feel hopeless about losing weight. Our culture doesn’t help. Our food system favors meat, carbs, and sugar, and makes vegetables and fruit expensive. Restaurants serve oversize portions. When you live among people with obesity, obesity seems ordinary and possibly okay.

The anti-fat-shaming movement argues that pressure doesn’t help people lose and being overweight or obese isn’t actually a health problem, just your body shape. Research — and other evidence — however, makes the case that it is indeed a health problem.

What you can do

The best strategy for losing weight isn’t obvious. One book, “Lose It Forever,” by Jason Karp offers a collection of great weight loss success stories from the National Weight Control Registry, which enrolls adults who have lost at least 30 pounds and kept it off for at least a year. These successful dieters tend to weigh themselves at least weekly, exercise a lot (this includes walking), restrict their calorie intake, watch portions, and stay away from high-fat foods. They also tend to eat breakfast, which provides much needed energy for your day and can limit how much you eat the rest of the day.

Exercise is important for everyone at any weight, and maintaining a healthy weight is just as important — apparently more so. Successful dieters exercise more than ordinary Americans do, and eat less. You need to do both for optimal health.

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