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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?   

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Neither. I am underweight. I'd rather be normal weigh with good quality muscle tone, and an active lifestyle. I think that, along with eating healthy, is the ky. HOWEVER!!! I am kind of suprised that you referred to th woman who was 40% bodyfat as looking "the picture of health" because there is SUCH a drastic difference in the appearance of skinnyfat people and fit, muscular people... I feel like that was misleading a bit. :) Just my opinions, love to all! Report
Did the studies compare whether the individuals were fit or not? Because why would the unfit AND overweight people still fare better than those not overweight? I think it needs more study. However, these people ALREADY had chronic diseases. Research has shown that obesity leads to many chronic diseases, but I'm guessing that inactivity has similar links, whether you're overweight or not. So, conclusion is, if you're going to be inactive, might as well be overweight? Ugh, I don't like that. I think you're better off being active and losing weight as a result. And if you don't lose weight despite being active and having a healthy diet? Well you're probably still better off than anybody who doesn't work out at all, no matter how thin they are. Report
I'd rather be fit and filled with vitality and in the upper range of a normal weight. The article brings up a key point in that the medical community makes snap decisions based upon size regarding the health of the patient without even inquiring or considering the fitness of that individual. Then they follow the standard protocol based upon size. We need to be the voice of truth into that situation. Thank you for providing the data to have a frank conversation with our medical providers. Report
I am a little on both sides. On one hand I don't think its possbile to be under 6'6" and weigh 300 or more pounds and be very healthy.

On the other hand I don't think that the bmi is the definite rule of healthy weight. I have a son, who is SKINNY but he's taller so he's high on the hieght and weight. I have another daughter who looks chubby but is really muscular and shes borderline overweight.

I have friends who have competed in body building competitions who had 4% body fat but was overweight on the bmi.

I would like a lower weight and fit healthy. Ihave lost 20 pounds and my back and joints feel better. i would like to lose more but my body doesn't want to lol. so I'm taking it easy for now.

And even when I was "skinny" was technically 15 pounds overweight. oh joy. oh joy. let alone now. I can not be healthy at the drs. idea of "healthy weight". and thats just that. but i can lower my weight and increase the fitness. Report
I believe fitness does matter more than weight. When I think of fitness, I think of being healthy. Therefore, being healthy is far more benefical in the long run than looking at the scale. Report
This article reminds me of an incident a few years ago. I had taken my daughter and a friend of hers to the beach. The friend was very thin but never exercised, and was struggling to keep up with my slightly overweight daughter who was swimming a few times a week. Clearly my daughter was the more fit of the two.

The sad part is that this friend lives across the street from us, and I see she is not encouraged to be active at all. We live a whole 1.5 blocks from the girls' school, and they *drive* her every morning. Report
Fit. Part of size is fashion. Part is health. Either way, there's more range than our stats let us find acceptable. I want to be healthy from the inside out, and I can judge most of that as well as/better than anyone with charts and tables. Report
This is a misconception that being "thin" means a person is fit. As noted, that is not always the case. While doctors would prefer that their patients be at a healthy weight for their height, there are people who do some pretty unhealthy things to be thin. Look at how many models smoke to suppress their appetites. I'm a little surprized that there hasn't been a study to show the effects yo yo dieting has on our bodies. I'll bet yo yo dieting contributes to shortening a person's life span just like smoking or being sedentary.

Longevity really does vary from person to person. Remember Jim Fixx ? He was the father of the running movement in the United States. Ran regularly. Was the picture of perfect health. Should have lived to be 100. Died of a heart attack at 50.

I've said this before,"there really is more to good health than a number that stares at us from between our toes in the morning".

I definitely agree that size is does not offer the whole picture; but care should be taken that it is not used as an excuse to neglect our bodies. It is our responsible to make sure that we live lives that are healthy and would protect us from all these diseases Report
I for one think they both matter. I am very healthy because all of my tests say so and I feel great but according to my BMI I am still overweight. I am trying to lose the last 10 pounds and according to my BMI I would still be classified as overweight. I know I will never get down to what the charts say and that is ok with me. For whatever reason I feel the need to lose this last 10 lbs. Report
Thanks for the reminder to think about my fitness level and ability to do activities of daily living, not simply trying to reach a number on the scale. This is encouraging. Report
I'm 5 feet tall and currently 58. I weighed 125 for 20 yrs until I moved to a place where I didnt know anybody. I gained 40 lbs due to emotional eating. It wasn't until I was forced to face my weight gain and find a gym and a trainer that I learned that I wasn't eating healthy and needed to change what I ate and that I was at an age that I needed strength training to build muscle mass and cut fat. I'm back to 122-125 lbs and much prefer this. My BP is 110/70. My cholesterol is 190. I don't have any health issues. When I was overweight, my cholesterol was 250, I couldn't get my pants over my fat hips, much less fit into a chair. I couldn't go up and down stairs without puffing. My joints ached. I never exercised before because I was thin but never realizing that I was unfit. Like I said. I'm more fit and eating healthy maintaining my weight at 122-125 lbs with a figure I'm happy with. However, I'm told that's not good enough! I'm told I should weigh 118 lbs for my height! I don't think so. That, to me, is TOO thin. Report
I don't Believe this research at all whatsoever.Both Fitness and weight do matter i think. If your obese You just don't look healthy, and chances are you probobly aren't . Fitness and weight should matter to people but unfortunatley
Some people don't want any part of Fitness, weightloss, Coupled with good nutrition. and indulgences ONCE IN A WHILE IN MODERATION to make themselves healthier Because it really is about portion control. Report
Clark, obviously everyone's goal should be fitness and a BMI under 25. This is just stressing the importance of fitness. Report
being fit and healthy weight. why does it have to be one or the other? even if you are fit, doesn't the extra weight put extra stress on your joints? being overweight has become the new normal in america. how did so many americans become overweight? Report
I am overweight and fit and healthy, with no intention to be "thin". I am mid forties and the only medication I take is sinus spray for seasonal allergies. My goal when I started Sparkpeople was to lose weight only. I've learned alot since then, and being healthy and fit is much more important. And in getting fit, I was surprised how much my body has changed, and my figure has returned. I am also toned, which I really like. I really wouldn't trade me for thin. Report
I want to be fit and I know that the thin will follow, even if it takes a couple of years. Being in my mid fifties it is easier to get in shape than it is to lose weight. Report
My administrative assistant and I were talking yesterday at work, and she was recently getting over a couple of really bad colds, leading to an enlarged spleen, and she had some kidney stones. A friend of hers had given her a lecture about eating healthy, and to just try it for one week... she is 3 days in, and the cold is gone. She never had to pay attention to what she was eating, because she was always thin - she'd eat pop tarts and other Frankenfood. She doesn't really exercise either. Unfortunately, I eat healthy, and I exercise, and don't lose weight... so there ya go! Report
I am overweight, but all my "numbers" (sugar, cholesterol, etc.) have been great--but I exercise daily. My heart ekg, ultrasound, and stress tests have all been great as well.

I have strength trained regularly for over 20 years. I will never be "thin" even if I lose weight because of all the muscle mass I built. Nor do I care to be. I think thin looks unhealthy. I think most marathon runners look emaciated to me. Never a look I would want to emulate. Report
According to online BMI calculators, I'm in the middle of the "overweight" category, yet I still completed an Ironman last year at this weight. So yes, it's definitely possible to be "fit" and "fat" at the same time. These studies are interesting, but they're comparing people with serious illness/diseases. Who knows if the overweight/obese individuals would develop the same illness if they were at a healthier weight? And let's not forget about QUALITY of life. Just because they can live longer with their diseases, that's hardly all that matters. So of course, as others have mentioned, let's just all work toward fit AND a healthy weight. :-) Report
After reading "THE SUGAR FIX" by Richard Johnson M.D., I certainly don't believe that being overweight/obese is healthy, even if you are "fit" from exercise. I'll opt for being "normal weight" and fit. Report
Although the results of this study are interesting, I worry that it may cause some people to think that they should just focus on fitness rather than on developing a good level of fitness along with striving for a healthy weight. Although there may be some validity in the study, most of the research I've encountered (along with my own family medical history) points to the fact that getting to and maintaining a healthy weight is key in warding off many types of preventable disease. That doesn't mean that we have to strive to be thin (there's a pretty big range for what's considered a healthy weight), but I don't think we should simply settle for being obese and fit. The overall risk factors and reduction in quality of life associated with obesity are just too numerous.. Report
This choice was not given, but I think that being a healthy weight and fit is the best. Report
Guess I was aware of this but it still gave me a shock. I'm very resistant to doing strength exercises but this article may just be the motivation I needed to be more assiduous about it. Thanks. Report
How about "Fit, happy, content, and possibly rich" sound? I don;t need the rich bit, but I do know I can control the others easier than have more means to do what I want. Report
I'll take fit any day. But I hope that through getting fit I'll also reach a healthy weight (not 'thin'...I don't want to be thin. I'd like to be SLIM) Report
Before starting SP and a fitness routine a year ago I would have said skinny and unfit. Now that I am more fit, stronger, much more toned and yes skinnier but not skinny, my vote is for FIT!!! Report
I definitely would aim for fit, no matter my weight.

I think there's a danger in saying it's okay to be fat as long as we're fit, though, because I do believe there is a tipping point. When it starts becoming difficult to get up and walk due to excess weight, the fitness level is going to begin dropping. Being fit should not become an excuse for why it is okay to carry around excess weight. It should be a goal in its own right, independent of weight. Report
I think I would be okay with being fit and slightly overweight. Report
I'd rather not have a chronic disease. The studies are looking first at a population with a chronic disease, then dividing it into overweight or not, and finding the overweight people do better. Report
Definitely fit. But I don't have my head in the sand about the problems that come with too much weight, especially on the joints. Report
I would rather be thin for any reason. It's easier to find clothes that fit. I might have less pain in my knees also. Report
Like so many have said, I'd choose fit AND thin, but if I can only have one, I'll take fit any time. Now that I'm getting older and losing some of my fitness, finding myself fat AND unfit, I see the imporance to fitness that I never saw before, and I'm most concerned with getting that back, regardless of my size. Report
For me being fit is the most important. The weight loss will follow. Report
i would like to be fit and thin Report
I would rather be fit than too thin. I also like to be at a lower weight, but that is no good if I am not fit enough to enjoy living. Report
i think i'm going to have to say i want to be both fit and at a healthy weight. Report
I am fit and at a weight I like, want to lose a bit this year & maintain fitness that I have been losing somewhat. For me, there is no real choice, I want to be both fit & at a weight I desire. Both are important to me. Report
I would rather be fit and thin, but I will take what the good Lord gives me as long as I am doing everything I can! I do strength training really hard two times a week, but then I incorporate it into my other fitness routines on some of the other days. You can work several different muscles in one workout. I love kickboxing and I love my Boot camp workout because it is Plyometrics, cardiovascular and strength training all in one! Report
I want to be healthier but I don't have to be thin. I'd rather get to a healthy and comfortable weight that I can maintain rather than be a yo-yo dieter. Report
This is good news for me. I weigh much more than the BMI and SP say I should, but my doctor told me to keep doing whatever it is I am doing. My numbers are good, I feel fine and have a lot of energy, I'm on SP's 10K steps/day team and do it, I ought to lift those weights more and I will, especially when the weather gets bad. Report
I would rather be fit and thin. strength training is so important as I do it 4 times a week. Report
I would like to be both. I always think of thin but unhealthy never enters my mind. I am now going to try and incorporate some strength training with my exercise. I am able to walk 3.5 miles in 60 minutes and try to get further in that hour but now I will get out my strength training videos. Report
I AM thin and unfit! I joined SP to lose about 10 pounds that I recently gained while unemployed. However, I've learned through my fitness tracking that I was extremely out of shape and had absolutely no stamina or strength! I guess I am lucky that I am finding this out in my 20s, while I still have plenty of time to improve my fitness (altho I guess it's never too late to get healthier!). Interesting to think about. Report
Fit any day. BMI is a sham anyway- most people who are classified as overweight today wouldn't have been prior to lowering the threshold around the turn of the millennium.

I'd still like to be thin, but if I can have only one of the two? Fit, please. Report
I'd rather be 'fit' that anything else. Report
Every time I visit my doctor, fully expecting to be lectured about my weight, I'm asked instead about my activity levels and how much exercise I'm getting. During my most recent visit, when I told her I was losing weight, she said that was fine, but that she'd much rather her patients be overweight and fit than thin and unfit. I hope it's not a choice between those two, though. I intend to become thin AND fit. Report
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