The 'Fit But Fat' Debate
Christine M. Palumbo, M.B.A, R.D.
We've heard the grim statistics time and time again: Two-thirds of Americans are overweight or obese. And it's pretty clear that if you're overweight or obese, you are at a greater risk of disease and dying. A meta-analysis of 89 studies, published in the
Yet, some overweight and obese individuals are diligent about eating a healthful diet and exercising, and have healthy cholesterol, blood sugar and blood pressure levels. This scenario raises an important question: Is it possible to be healthy and be overweight? A body of science answers that question with a resounding "No," but new research suggests that there may be a few exceptions.
What the research reveals. In a study of 855 coronary artery disease patients at
How can this be? Scientists believe a number of protective factors may come into play, including where people carry their weight (abdominal weight is more dangerous than weight carried around the hips), good physical activity levels, and following a healthy weight-reduction diet, along with normal metabolic biomarkers, such as blood pressure, blood sugar, and blood lipid levels.
Being obese often goes hand in hand with a condition called metabolic syndrome, characterized by a cluster of risk factors that include abnormal glucose, blood pressure, inflammation biomarkers and cholesterol levels, and a larger waist circumference, that can raise your risk for heart disease and diabetes. Scientists have recently created a term for obese people who do not have metabolic syndrome: "metabolically normal but obese" (MNBO).
Findings from a study published in the
Weight loss still the goal
Though these findings appear to support the idea that you can be fit but fat, scientists note that the rate of MNBO is very rare within the obese population, and the risk for mortality is still high among the obese, regardless of whether they have metabolic abnormalities. Researchers also believe that one reason the MNBO might be protected from metabolic abnormalities is that they are undergoing a successful weight loss and exercise program.
If you're overweight or obese, there's no argument that your goal should be to get fit through diet, exercise, and slow, steady weight loss. But some people face a disadvantage when trying to achieve a healthy weight: genetics. Scientists have found associations between different genetic patterns and a dramatic variance in the number of calories people of similar size require in order to maintain their body weight.
Another common problem overweight people face is yo-yo dieting--going on and off restrictive, fad diets, which often results in a higher weight than they started with. Regaining weight may be so disheartening that it can lead to giving up on a weight-loss plan altogether.
"If it were easy, everyone would be skinny," said
Reasonable weight loss goals win
Unrealistic weight loss goals are common among the overweight, which can offset success. According to a study presented at the
Foreyt reports that your chances of success increase if you set smaller weight loss goals. Even losing just five percent of your total weight reduces your risk for cardiovascular disease and cancer.
According to an analysis of dieters in the National Weight Control Registry presented at the
Be well, no matter your size. There's not enough scientific basis to support the idea that most people can enjoy vibrant health and lower disease risk while being overweight or obese. However, we do know that numbers in the "normal" range for body mass index, waist circumference, blood pressure, blood cholesterol, and blood glucose levels, as well as regular physical activity and healthful dietary patterns, are associated with lower disease risk. No matter what your size, it's vital that you strive to be healthy and fit. How?
-- Eat a mostly plant-based diet, including plenty of cooked and raw produce and whole grains. Include more plant proteins like beans, and smaller amounts of lean animal proteins and low-fat dairy products.
-- Aim for 10,000 steps daily; track them using a clip-on pedometer.
-- Get seven to eight hours of sleep each night; adequate rest has been linked to healthy weight.
-- Keep tabs on your blood pressure, blood sugar, triglyceride and cholesterol levels.
An alternative weight loss approach
Health at Every Size (HAES), a new movement aimed at promoting health for the overweight, has grown in popularity among both health care experts and their patients. HAES suggests that the negative attention focused on weight can do more harm than good.
Tips for intuitive eating
-- Learn to rely on your own intuition to aid in weight loss.
-- Rely on your internal hunger cues, such as physical hunger pangs, instead of external cues, like the clock or a TV commercial.
-- Trust your internal satiety, or fullness cues, rather than whether you've cleaned your plate or finished your food.
-- Give yourself permission to eat. Avoid food guilt and enjoy your food!
-- Eat for physical reasons, not for emotions. Consider food as fuel rather than comfort.
-- Minimize distracted eating, such as eating in front of the computer or television.
-- Visit the Health at Every Size website (http://www.haescommunity.org/) to learn more about intuitive eating.
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