There has been a lot of literature in the last 14 years about the positive effects of exercise, even in people who are overweight. Sighting many of these studies, I often encourage people who are having problems dropping weight by explaining to them how much they are improving their health and well-being by exercising, even if overweight. I often talk of how sometimes, people have a faster-than-normal metabolism, so almost no matter what they eat, they stay thin and close to what is considered a normal weight. Are they healthy? Not really. Is someone with an above 25 Body Mass Index (BMI) or even a 30 BMI but who does aerobics 5 times a week, muscle building two or three times a week healthy? Maybe! Is the exerciser better off than the thin, sedentary, over-eater? Almost certainly.
Overweight and still healthy?
An intense debate has emerged in the last few years among obesity researchers, asking the question, “Can people be overweight but still be healthy?” Is the number on the scale the only thing that counts, or should we take other factors into consideration? Scientists are now dueling over the relative importance of “fatness vs. fitness” when it comes to determining the health of an overweight individual.
A small but vocal group of researchers have been challenging conventional wisdom. They argue that not only is it possible to be both fat and fit, but fitness is actually a more significant measure of health than body weight. The first major fatness versus fitness study was conducted by researchers at the Cooper Institute, a nonprofit fitness organization in Dallas. In a study of 22,000 men ages 30–83, the researchers measured subjects’ body composition (the proportion of fat to muscle) and put them through treadmill tests. They concluded if you are fit, being overweight doesn’t increase mortality risk.
Dr. Steven N. Blair, who headed the Cooper Institute at that time, and has now continued his research at the University of South Carolina, defends the role of fitness as a major determinant of health regardless of one’s weight. “We’ve studied this from many perspectives in women and in men and we get the same answer: It’s not the obesity—it’s the fitness,” Blair said. “Fitness can substantially reduce, if not eliminate, the high risk of being obese.” (Please note that Dr. Blair himself exercises every day but is overweight.) Blair’s most famous study was called the Aerobics Center Longitudinal Study (ACLS) and the findings were astounding. It showed that obese men who were moderately/highly fit had less than half the risk of dying than the normal-weight men who were unfit. In plain English, an obese man who was fit cut his risk of dying of any cause, at any time by half!
Results of studies done by Mary Fran Sowers and Judith Wylie, obesity researchers at the University of Michigan, showed that thin, unfit people can develop heart-related problems that fat but fit people often do not. Kelly Brownell, Director of the Yale Center for Eating and Weight Disorders, concluded in a 2003 study that heavy people that are fit have a lower risk of heart disease than thin people who are unfit.
Does weight matter?
However, others are concerned that sending this message will be misunderstood, giving overweight and obese individuals the message that weight doesn’t matter; an excuse to accept the extra pounds as unimportant and not to be worried about diet as long as they exercise.
“Being overweight has a clear association with important health problems, and even modest weight loss has important health benefits,” said Walter Willett, an expert on nutrition and health at the Harvard School of Public Health. “To tell people it doesn’t matter is really misleading. It does make a difference. It makes a huge difference.”
The Nurses’ Health Study, which since 1976, has been looking at the lifestyle habits and mortality rates of approximately 238,000 nurses, found that being a little active and a little fat wasn’t such a bad combination. But physical activity didn’t completely eliminate the risks that were associated with being overweight or obese. In fact, when the nurses were grouped by how active they were, the heavier nurses were more likely to have died than the lighter ones at every activity level.
Despite the differences in these studies, they all suggest that physical activity will offset some of the effects of excess weight, if it’s just a few extra pounds. No one is debating that there is a marked difference in disease rates in the obese vs. the overweight. When assessing overall health risk, we need to look at many factors, not just the number on the scale.
Those of you who read my columns already know that the way to weight loss is NOT to go on a diet (you will just go on the diet and then go off the diet). Diet’s focus on the deprivation side of the equation and the willpower will eventually run out. Learn how to eat—how much, how often, and learn good eating habits. Most of all learn to eat less and at the same time enjoy your food more. And you also know that exercise, moderate intensity exercise can do you a lot of good. One doesn’t have to spend hours in the gym and run for miles and miles in order to reap the benefits. Walk briskly daily for 35 minutes and do some muscle building twice a week and you will see tremendous improvement in your health both from the point of view of your vital measurements (blood tests, blood pressure and resting pulse) and you will feel better, become more functional in daily tasks and feel better emotionally.
Exercise is important and weight loss is important. We need both. But remember that if you are one of the many who have a hard time losing all of your weight, whatever you lose is beneficial and if you do indeed emphasize exercise as the key to your health that may just be the most important thing you do for your health and longevity.
Weight loss is a must! Exercise is a must! And together they will “add hours to your day, days to your year, and years to your life.”