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Does Fitness Matter More than Weight?

By , SparkPeople Blogger
Which is better:  being fat and fit, or thin and unfit?  The first reaction might assume that carrying excess body fat is more harmful to your health, even if you exercise regularly.  But is that true?  Opinions will differ depending on who you ask, but some of the latest research seems to contradict what we’ve typically been lead to believe.  Size is not always the best indicator of health. 
Newer research has been exploring the “obesity paradox”, a term used to explain how overweight and obese people tend to live longer with chronic illnesses than those who are a normal weight.  For example, “One study found that heavier dialysis patients had a lower chance of dying than those whose were of normal weight or underweight. Overweight patients with coronary disease fared better than those who were thinner in another study; mild to severe obesity posed no additional mortality risks. In 2007, a study of 11,000 Canadians over more than a decade found that those who were overweight had the lowest chance of dying from any cause.”
Scientists have validated these results in a variety of medical conditions, including high blood pressure, heart disease and diabetes.  Although research has yet to find a definitive reason, there are theories as to why those who are overweight and obese fare better with these chronic illnesses.  One theory is genetics (the illness presents itself differently in those who are thin versus fat.)  Another theory is that doctors don’t treat thin patients as aggressively because it’s assumed their bodies are able to deal with the disease more effectively.  Or maybe the real problem is that we are assigning blame to size, when really there are other factors causing these diseases.    
Just because someone appears to be normal weight, doesn’t mean they don’t have issues with high cholesterol, high blood pressure, heart disease, etc.  Size does not tell the whole story.  Recently, I had my body fat tested and heard the story of a woman in her late 50’s who came in for the same test.  This woman had been running 4-6 marathons per year for the past 30 years.  She looked very fit and trim on the outside, but her body fat test revealed that she was 40% fat (which should put her into the obese category.)  The reason:  she never knew that strength training was an important part of any exercise routine, so she had very little muscle.   Although she was the picture of good health on the outside, on the inside there were some very serious health concerns.
Research has shown the protective effects of cardiovascular fitness, and has led some to recommend that choosing between the two, its better maintain fitness than a normal weight.  Of course there are exceptions (those who are severely obese or underweight), but in general, the protective effects of fitness are hard to deny.  I’ve been in fitness classes and running groups with overweight individuals whose fitness level runs circles around mine.   Size is just one piece of the puzzle.
What do you think?  Would you rather be overweight and fit, or thin and unfit?