Can You Be Fat and Fit?

Can you be fat and fit (and healthy) at the same time? It’s one of those questions that seems like a bit of an oxymoron. We’ve come to accept the fact that good health is associated with low body fat percentages and lean physiques, but how true is that correlation? If you are overweight but work out consistently, is it possible for you to have good health independent of your body composition? Can you be fat and fit?

The Scientific Literature

Lucky for us, there is no shortage of evidence-based literature showing that yes – it is possible to be overweight and healthy, just as it’s possible to be lean and unhealthy. For those of you who are on a quest to lose weight for whatever reason, don’t quit exercising out of frustration from lack of results – you are still reaping the health benefits of physical activity.

In a study of 9,824 men, all-cause mortality rates were lower in individuals that had a body mass index (BMI) over 18 (including overweight and obese) as compared to individuals that were underweight. In addition, at every BMI, those who were most active had significantly lower odds of all-cause mortality [1].

When looking at the mortality rates in men with diabetes, there was an inverse relationship between fitness levels and mortality rate. In other words, the more fit you were, the lower your odds of dieing. This wouldn’t be news except for the fact that this association was independent of BMI [2].

In another study following 22,000 men, it was found that unfit, lean men had a higher risk of cardiovascular disease than fit, lean men. Again, this isn’t all that surprising, but when comparing unfit, lean men to those who were fit and obese, the lean men had a higher risk of cardiovascular disease – once again showing that it’s your fitness level, and not your body weight that is the major predictor of your health [3].

Why the Confusion?

Correlation or causation – that is the question. Is being overweight correlated with bad health, or is it the cause of it? We’ve been taught that obesity is the cause of bad health. That’s a bit like saying a car accident was the cause of an injury, when in reality, it was caused by you not paying attention. That being said, obesity is correlated with bad health. This is not because unhealthy individuals are obese, it’s because unhealthy people are not fit. As a group, obese individuals tend to be less physically active. Because of this, the correlation between obesity and bad health is strong. However, once you adjust for physical activity, it’s clear that fitness is the major deciding factor of your health.

How many overweight people do you know who are physically fit and healthy, but overweight? Take a look at the linemen on professional football (American) teams. Nearly every one of them is overweight, but many of them can run sub 5 second 40 yard dashes. I guarantee you that these 300 pound men can run faster and are more physically fit than some people half their size. They also have better health than their untrained general public counterparts [4].

This is Not an Endorsement

Even after the overwhelming evidence that mortality rates are more a function of fitness levels than body mass levels, it’s still important to keep in mind the many intangible benefits of being at a “healthy” weight. Whether these benefits come in the form of improved self-confidence, better mobility, or even just a better selection of clothes, they are still benefits up and beyond just physical health. In addition, there is more to your health than just mortality rates. Extra weight can add stress to joints and organs, and cause other debilitating problems.

You didn’t think I was going to give the OK to go ahead and disregard your body fat levels and just focus on your cardiorespiratory fitness – did you? The important thing to take away from this information is that you should never quit exercising, even if your weight loss has stalled. Not every benefit of exercise is visible from the outside. Improved physical fitness has numerous health benefits, and may even be the biggest deciding factor for good health. What do you think? Is it possible to be fat and fit (and healthy)?