Is it better to be fit and fat, or unfit and thin?

Dear Reader,

Understanding factors that affect a person’s overall health is inherently complex, as genetics, environmental factors, cultures, and lifestyle choices all significantly contribute to well-being. With that in mind, it can be more helpful for people to focus on incorporating and maintaining healthy lifestyle behaviors, rather than being focused on being a particular weight. In regards to an average person’s overall health, research is inconclusive about whether weight or whether measures of physical fitness (such as heart and lung performance and muscular strength) has a greater impact. However, research suggests that people who are significantly overweight or obese often face a multitude of conditions that can increase their likelihood of having diabetes, heart disease, and stroke (more on this in a bit!). In cases where people may be worried about their weight affecting their health, it’s best to speak with a medical provider for ways to protect and promote their well-being. But regardless of a person’s body composition, regular physical activity can be beneficial for promoting physical, mental, and emotional well-being.

Before “weighing” in on this matter, it’s crucial to first acknowledge prevalent misconceptions surrounding ideal body type and a person’s health — especially as these ideas can contribute to harmful societal prejudices against people whose body types may not look a certain way. Each body is unique and worth being cared for and valued. There’s no “one size fits all” body type, as people are exposed to diverse factors which affect their body size, shape, and composition. More so, there’s no “perfect” body that guarantees optimal physical health. And contrary to what many people may think, weighing more or “being fat” isn’t always a sign of poor health, and weighing less or “being thin” isn’t always a marker of physical fitness. In fact, recent research shows that some body fat is necessary for survival!

Oftentimes, body mass index (BMI) is used to assess a person’s overall health and the conditions for which they may be at risk; however, the Centers for Disease Control and Prevention (CDC) suggest that while it can be a quick and useful tool, it can't be used to diagnose any conditions. As it stands, calculations and labels for BMI may be misleading as it only considers a person’s overall weight and height, not taking into account their distribution of muscle (or lean mass) to body fat. As a substitute to BMI the measure of physical fitness may take into account a person’s heart and lung performance, muscular strength, endurance, flexibility, and body composition. Though these factors aren’t as quick and easy to calculate as BMI, they can provide a deeper understanding of a person’s health.

While a person’s weight doesn’t necessarily map on to their fitness level, studies show that someone who is significantly overweight or obese bears a higher risk for high blood pressure, high blood sugar, and harmful cholesterol levels, as compared to someone who is of a lower weight. This, in turn, can increase the risk for heart disease, stroke, diabetes, and metabolic syndrome, and subsequently, premature death. While some people may opt to combat this risk through regular physical activity and a balanced diet, these efforts may be undermined if they use alcohol or other drugs on a regular basis, and remain significantly overweight.

Although having excess fat may increase the risk of various conditions, having some fat in the body is necessary. Within the body, there are different types of fat serving various functions; these fats, depending on their amount and location, can affect a person’s health. In particular, it’s worth noting where subcutaneous fat and visceral fat are stored within the body. Subcutaneous fat is usually found right under the skin, whereas visceral surrounds the internal organs. When these types of fats (particularly visceral fat) are found in excess around the stomach and waist, there may be an increased the risk for metabolic syndrome. However, if a person primarily has excess fat in the lower parts of the body, such as the thighs and hips, they may not have the same kinds and degrees of health risks.

When assessing a person’s physical fitness, it’s not enough to just consider their weight or body fat, but also take into account their lifestyle. For example, someone who doesn’t fall within the overweight BMI weight range but is a regular cigarette smoker might have less heart and lung capacity than someone who is within the overweight BMI weight range but doesn’t smoke. By the same token, a person within the overweight BMI weight range who gets more physical activity than someone in the normal BMI weight range may have a healthier heart and stronger muscles.

Ultimately, truly assessing a person’s health is far too complicated and nuanced to be determined by a number on a scale. Instead, it’s best for individuals to focus on accepting their body shape, size, and composition, and feeling as though they can do whatever they need to do to live the life they want. In cases where people have concerns about or wish to change their body composition, they may wish to speak with their health care providers and dietitians who can help provide support for any changes in lifestyle behaviors or any medical interventions that will help them get to the desired or necessary changes. Regardless of how much a person weighs, engaging in physical activity on a consistent basis has a number of health benefits beyond healthy weight maintenance. It’s suggested that adults get 150 minutes of moderate intensity or 75 minutes of vigorous intensity physical activity per week, in addition to muscle strengthening activities on two or more days in a week. For more information (and maybe a little motivation) to get and stay active, check out CDC’s Physical Activity Basics website.

Cheers to appreciating people just the “weigh” they are.