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weight not a consistant indicator of health
I recently found two in-depth articles discussing how weight alone is not a good indicator of health -- although they use the term 'fat' which is offensive to me because it implies unhealthiness, but anyway I'll link them for you. Just think, in 10 years scales will probably be obsolete, and they'll do a test that actually measures your body fat compared to muscle -- won't that be nice?

Fat But Still Fit -- my.webmd.com
Fit and Fat -- yourhealthconnection.com

(I added the full texts via lj-cut in case the sites delete them)

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Fat But Still Fit? Overweight and in Shape
By Camille Mojica Rey
WebMD Feature Reviewed By Michael Smith, MD

Jan. 28, 2002 -- Looking in the mirror can be a frustrating experience for someone who is trying to live right but just can't get those last few pounds off. But which is more important -- being thin or being fit?

"You can be fit and fat," says Jody Wilkinson, MD, a researcher at the Cooper Institute for Aerobic Research in Dallas. "And it's better than being skinny and sedentary." Wilkinson and his colleagues at the Institute have produced strong evidence in support of this claim. Consider some of their findings:

* A 1995 study published in the International Journal of Obesity involving more than 25,000 men tracked over a 23-year period found that fitness level was a better predictor of heart disease than weight. In other words, overweight men weren't necessarily at high risk for heart disease if they were fit.
* A study published in the October 1999 issue of The Journal of the American Medical Association found that overweight men who exercised regularly had death rates, based on any cause, only slightly higher than those of unfit men of normal weight. (Obese men who didn't work out had death rates two to three times those of the normal weight men; thus, exercise offered substantial protection even to very heavy men.)
* A study published in a 1998 issue of the International Journal of Obesity showed that of 21,000 men, unfit men were much more likely to die of heart disease than fit men -- regardless of how much they weighed.

The Other Shoe

These findings haven't convinced everyone, though. Certainly not the federal government. In 1998, the National Heart, Lung, and Blood Institute issued the first national guidelines on obesity in adults. The government came down hard on the U.S., changing the definition of healthy weight to classify 29 million additional Americans as both overweight and unhealthy. And carrying excess pounds, federal officials say, raises a person's risk of heart disease, diabetes, and numerous other ailments.

But Wilkinson says there is a crucial flaw in most of the studies cited by the "you can't be fit and fat" crowd. He acknowledges that many overweight people are indeed at greater risk of chronic disease. But most studies that have fingered weight as a culprit in these ailments have not factored in physical fitness. Without a way to separate overweight people who are fit from those who are not, Wilkinson argues, the numbers are misleading.

Finding the Middle Ground

Gerald Fletcher, MD, a cardiologist at the Mayo Clinic in Jacksonville, Fla., agrees that a person can be both fit and fat. "But most people are not," he says. That's why he, like most doctors, continues to urge his patients to lose weight -- particularly those whose excess weight is concentrated around their abdomen, who have even borderline high blood pressure or cholesterol, and who have a family history of heart disease.

Regardless of inherited tendencies, size, or shape, doctors, including Fletcher, agree that maintaining a healthy lifestyle remains the single most important advice they can give to their patients. In addition to regular exercise, Wilkinson encourages his patients to eat healthful foods and to change unhealthy habits, such as cigarette smoking.

In addition to body mass index, the following factors are indicators of better health:

* Total cholesterol levels below 200 mg/dL
* Blood pressure below 140/85
* Blood sugar level between 80 and 120 mg/dL before meals
* The majority of body fat occurring below the waist
* The ability to jog at a light pace for 20 minutes while holding a conversation

"It makes you feel better and improves the quality of life," Wilkinson says. "That's really the bottom line."

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Fat and fit?

It's not just a stereotype, it's a fact: Most overweight people are badly out of shape. For whatever reason, they simply don't get enough exercise. But every once in awhile, a hefty person comes along who bucks the trend.

Take Steven Blair, PhD, for example. At 5 feet 4 inches tall and 180 pounds, he doesn't fit anyone's definition of svelte. But his girth is deceptive. Blair, the director of The Cooper Institute in Dallas, runs about 30 miles a week. Most slender people would eat his dust.

And Blair isn't the only fit person masked by a fat body. Tens of thousands of people, who were all different sizes, have stepped on the treadmill at The Cooper Institute, where scientists research obesity, epidemiology, nutrition, and aging. In Blair's experience, some of the heavier people were able to walk impressive distances -- far enough to put many thin subjects to shame.

What's the best measure of health: Fitness or fatness?

As a group, overweight people suffer far more than their share of health problems. Compared with people of a healthy weight, they are more likely to have heart trouble, diabetes, stroke, and certain kinds of cancer. The Centers for Disease Control and Prevention estimates that obesity-related ailments kill about 112,000 Americans each year.

But is fat really such a big-time killer? Blair, for one, thinks the blame lies elsewhere. In July 2001, he summarized his thoughts in a provocative (and widely reported) statement at a meeting of the Association for the Study of Obesity: "There is a misdirected obsession with weight and weight loss," he said. "The focus is all wrong. It's fitness that's the key."

His opinion may seem self-serving, but Blair has solid data to back up his views. In one noteworthy study, he and his colleagues put nearly 22,000 men (ages 30 to 83) through their paces on a treadmill. They also measured every man's weight and body fat. Eight years later, they checked to see which subjects were still alive. The results were remarkable. As reported in the March 1999 issue of the American Journal of Clinical Nutrition, moderately overweight men (meaning they had more than 25 percent body fat and an average body mass index of 28) who were physically fit had half the death rate of their thin, but out-of-shape, peers.

The bottom line: Fitness matters, no matter what your size.

Why is fitness so important to good health?

Exercise has many rewards besides weight control. Even if your scale hardly budges, regular workouts can strengthen your heart, bolster your immune system, lower your blood pressure, and reduce your risk of diabetes. Exercise will also improve your mood, reduce your stress, boost your energy, and improve your sleep.

Is it still important to watch my weight?

Even Blair concedes that it's better to be lean and fit than overweight and fit. For one thing, extra weight puts stress on the joints, increasing the risk of arthritis. Fat around the midsection can also promote Type 2 diabetes by hampering your body's response to insulin.

In addition, an August 2002 study by the National Heart, Lung and Blood Institute found evidence that extra weight is bad for your heart: in a study of over 5,000 participants, the risk of heart failure increased with each additional point of a participant's BMI (or about 4 to 8 pounds). Men experienced a 5 percent risk increase with each additional point of BMI, while women had a 7 percent increase. In general, researchers found that the risk of heart failure was 34 percent higher for overweight individuals and 104 percent higher for people classified as "obese".

If you're overweight, you have every incentive to exercise regularly and watch your diet. In the best-case scenario, you will wind up trim and healthy. But remember: Even if the perfect body eludes you, a fit body is well within your reach.

Are some people too heavy to exercise?

Extremely overweight people often have trouble starting an exercise program because they may feel self-conscious, or they may already have physical problems that discourage them from working out. But all of these obstacles can be overcome. If you have foot problems caused or aggravated by your weight, for example, you can swim or ride a bike, instead of walking or running. You can also lift weights.

With the right approach, just about everyone can benefit from exercise - and according to new research, you don't need an extreme workout to lose weight. As reported in the September 10, 2003 issue of the Journal of the American Medical Association, women in a government study were asked to reduce their calorie intake and were then given exercise programs of varying intensity. After a year, the women who exercised moderately lost about the same amount of weight as the women who worked out more vigorously and for longer periods.

The National Institutes of Health published a valuable guide called "Active at Any Size," which lists exercises specifically for larger people. Suggested workouts include walking, dancing (while standing or sitting), swimming, and bicycling (on either a regular or recumbent bike). Regardless of which activity is best for you, everyone is encouraged to set fitness goals, start slowly, and have fun.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.


Further Resources
For a copy of the National Institute of Health's "Active at Any Size" report, contact the organization below or see it on the Internet at:
http://win.niddk.nih.gov/publications/active.htm
The Weight-control Information Network (WIN)
National Institutes of Health
1 WIN Way, Bethesda, MD 20892-3665
Phone: 202/828-1025 or 877/946-4627
References
Fat, fit-and healthy? Hippocrates. June, 1999.
Lee, CD et al. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. American Journal of Clinical Nutrition. March, 1999. 69 (3): 373-380.
Active at Any Size, National Institutes of Health, March 2001.
Obesity Epidemic Increases Dramatically in the United States, Centers for Disease Control and Prevention
Kenchaiah S, et al. Obesity and the risk of heart failure. N Engl J Med 2002 Aug 1;347(5):305-13
Jakicic JM, et al. Effect of Exercise Duration and Intensity on Weight Loss in Overweight, Sedentary Women. JAMA. 2003;290:1323-1330.
Fact Sheet: CDC Efforts to Reduce or Prevent Obesity, April 19, 2005. Centers for Disease Control and Prevention. http://www.cdc.gov/od/oc/media/pressrel/fs050419.htm
Obesity Causes Fewer Deaths Than Previously Estimated, CDC Analysis Finds, California Healthline, April 20, 2005.
Reviewed by Charles E. McLaughlin, MD, a sports medicine specialist who teaches at the University of California at Berkeley.
Our reviewers are members of Consumer Health Interactive's medical advisory board.
To learn more about our writers and editors, click here.
First published December 14, 2001
Last updated April 28, 2005
Copyright © 2001 Consumer Health Interactive