As both a wellness coach and personal trainer, one thing I am NOT trying to do is help people achieve perfection in any particular area. What I am trying to do, is help people make improvements in their lifestyle habits in order to bring about a healthier quality of life. Getting everyone to be an ideal weight or getting everybody to do 45 minutes of intense aerobic exercise everyday along with 3 intense and heavy weightlifting sessions each week is not realistic for most people and quite frankly, not everyone is going to do that, even if they have the time. I try to partner with my clients in order to make changes one at a time; that is incrementally in all areas in order to bring about a general betterment in the areas of health and quality of life. It is not that difficult to make some small changes in peoples eating habits and food choices. It is also not difficult to add a small amount of exercise each day, even if we have to fit it in in increments over the course of the day. But the one area that seems like we are hitting our head against the wall is getting people to lose substantial weight. So for people like myself, until now, knowing that an obese person that is exercising correctly and consistently is overcoming his potential health problems was somewhat comforting. But now, a large study that contradicts previous research in this area is telling us that maybe it’s not so and that for good health you DO have to lose weight. Which is it and how do we put these two studies in perspective?
It was a study some years ago that began this controversy. This study, under the direction of Dr. Steven Blair of the University of South Carolina (formerly of the Cooper Clinic) showed that people who are overweight or obese but fit, have a lower mortality risk than those of normal weight but low fitness levels. The study was published in the Journal of the American Medical Association.
According to this study, those in the lowest fifth in terms of fitness had a death rate four times higher than participants ranked in the top fifth for fitness. Dr. Blair states, “Being fit provides protection against mortality in these men and women 60 and older, whether they’re normal weight, overweight, or obese.” In another study by Lee, Blair, and Jackson several years before this study, 21,925 men of all shapes and sizes were assessed and monitored for eight years. The study concluded that men who were fit and fat, actually had a lower mortality rate than men who were normal weight but unfit and sedentary. One of the authors of this study is clinically obese. However, he runs 35 miles per week. So the key here is “fit”, and not necessarily thin.
Many times, people who are overweight decide not to exercise because weight loss is too great a challenge for them. Their mistake is that they don’t realize that exercise in and of itself, is beneficial for both physical and mental health. The health benefits from a daily 30-minute walk (even if broken up into 2 or 3 segments), let alone a more balanced and intense exercise range from lowering blood pressure and cholesterol to reducing stress levels. Even a moderate effort makes a big difference. In Dr. Blair’s study, the bottom fifth in fitness was twice as likely to die as the fifth right above them.
“The “obesity paradox” is a theory that argues that obesity might improve some people’s chances of survival over illnesses such as heart failure”, said lead researcher Joshua Bell, a doctoral student in University College London’s department of epidemiology and public health.
But research tracking the health of more than 2,500 British men and women for two decades found that half the people initially considered “healthy obese” wound up sliding into poor health as years passed. “Healthy obesity is something that’s a phase rather than something that’s enduring over time,” Bell said. “It’s important to have a long-term view of healthy obesity, and to bear in mind the long-term tendencies. As long as obesity persists, health tends to decline. It does seem to be a high-risk state.” Professor Tim Crowe says that research is increasingly finding that “healthy obesity” is likely a myth. Healthy obesity may be more a phase that a person goes through on their way to poor health. Similarly, this does not mean that all thin people are healthy. Advice on following healthy lifestyle habits applies to everyone, no matter what their weight.
This study suggests that obese people will eventually develop risk factors such as high blood sugar and bad cholesterol that lead to chronic illness and death, Bell and Freeman said. “The longer one is obese, the more likely they are to induce damage,” Freeman said. “I have very seldom seen people who are obese for the long-term not have a condition that requires treatment.” Bell said these findings make the case that people who are obese should try to lose weight, even if they currently don’t have any risk factors.
No one is going to argue that the best case scenario is to have a BMI of 21-23 and be absolutely fit and functional. Neither of the authors of these studies will argue with that. But what I think we have to take away from the first study is that something is better than nothing and any positive impact is better than no positive result at all. Many of my clients over the years have lost weight, but not all of their weight. They went from no exercise and a sedentary lifestyle to activity and exercise. Their physical and mental states of health improved, and that was the greatest motivation to continue their new-found habits. For many, it has meant staying off medications or reducing dosages which also translates into less side effects to deal with. The best way of doing things is one step at a time. Changing behaviors, as I have written about in detail in other articles, is difficult at best. But if we simply try to make one modification at a time and deal with any improvement as beneficial, which it is, then eventually, we might be able to achieve a normal range of weight together with the exercise and ultimately, great health. Weight loss is important, but so are other aspects of health and losing weight in a way that it stays off is as important as the weight loss itself. It is always important to create attainable and realistic goals. But sometimes focusing on the short term goals of changing your habits and losing the next kilo are better at getting you toward your long-term goal than focusing on the long term, which can be daunting and overwhelming.
Any change you make toward better health will improve your health. My take on the situation? Concentrate on your health and stay focused–the weight loss will eventually follow and will “add hours to your day, days to your year, and years to your life.”