Which is Better: Fit and Fat or Skinny and Unfit?

By , SparkPeople Blogger
For many years, research has linked being overweight or obese with a variety of health problems, including diabetes, heart disease and stroke. But a new study claims that weight might not be the best predictor of overall health.

In a study from The Archives of Internal Medicine, the weight and cardiovascular risk factors of over 5,000 adults were analyzed. The results are a little surprising: Half of the overweight people and over one-third of the obese people in the study were “metabolically healthy.” This means that even though they were carrying extra pounds, it didn’t influence their cholesterol, blood pressure or other measures that indicate risk of heart disease.

Size doesn’t always equate with health. In this study, about one out of four people who fell into the “healthy” weight range had at least two cardiovascular risk factors typically associated with obesity. So maybe you shouldn’t be jealous of your thin friend who eats whatever she wants and never exercises--she might not be as healthy as you’d think.

Several studies from the Cooper Institute show that fitness level is a much better indicator of health than BMI. People who are overweight (or obese) but can still keep up on treadmill tests have much lower heart risk than people who are slim and unfit.

What does this mean for you? First, the number on the scale doesn’t tell the whole story and should not determine whether you’re a success or failure at becoming healthy. In reality that number is, well, just a number. What’s sometimes more important is whether or not you can walk up a set of stairs without being totally winded, or could easily walk the local 5K without wondering if you’ll be able to finish. I remember during my first marathon, I was passed by a woman who didn’t look like your typical athlete. She was overweight, but obviously fit enough to complete a 26.2 mile race (and made me look like I was moving in slow-motion).

There are a lot of factors to consider when it comes to overall health, so make sure you step back and look at the big picture. Research like this proves that it’s not only size that matters.

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YMWONG22 11/8/2019
Good info. Report
Good article Report
The problem is when weight is looked to for the whole story, like in most doctors offices. They always start with my weight (and a disapproving *tsk tsk*) only to drop their jaws when they take my BP and other vitals at my good health.

But more importantly, and more likely to affect us all, the new healthcare legislation promotes weight consideration over fitness. I have read several stories about companies and policies that charge a premium for being overweight now, and more saying they will. There are no exemptions for being "fat and fit" and similarly, there are no premiums for being a lightweight slug. And remember, under the new "affordable" health care act, no one is allowed to go without insurance, so there's no escape. So it is more vital than ever to spread the word that "fit comes first" in the story of good health and that fat is just chapter 2. Report
I personally think the BMI is the most useless and overrated thing out there, and truly wish the health/fitness people would drop it. I'm only about 10-15 lbs overweight, but I have high BP and osteopenia, so even though my heart is healthy and cholesterol is low, I've still got those issues. Both health issues are hereditary. Keeping my weight down helps but I'll probably be on BP meds for life (them's the breaks). Having said that, those extra lbs cause more problems than just heart/BP issues - ever wonder why knee & hip replacement surgeries are skyrocketing? Some overweight people have fewer health issues than others - and no doubt some "skinny" people have MORE health issues than others. So which is worse? I'd say they're about even. Report
I suppose it depends how 'fat' is being defined - a few pounds over the 'healthy weight' margin, or morbidly obese? A lot of people think they are fat when they are probably quite healthy for their body type. The ideal, health-wise, is to be the best weight for your body type. The best weight for my body type is nearer to the underweight margin than the overweight margin, because I have a tiny frame, so the possibility of being healthy and fat doesn't really apply to me - unless it was something random like the choice of either being thin and having a terminal illness or being fat and not having a terminal illness. In that case, obviously survival instincts would make me choose being fat! Report
Yes I am still to heavy and working on losing weight. However, my doctor printed one of these studies for me that showed that weight isn't the only factor to worry about. My cholesterol is good and my weight is improving. To me it said, do give up and keep up the good work and that I am healthier overweight than I gave myself credit for. Report
I think that we should all strive to be truly fit. I don't deny that the scale does not tell all but given how obese and overweight Americans are, I think we should all strive to lose those extra (or a lot of extra) pounds. I have struggled with weight all of my life but I want to be not just skinny but truly fit. I agree that being skinny, eating garbage, and not exercising is not the way to go. However, I think these studies might have some inherent flaws. As a scientist, I do have an additional question to ask. We all know that some people, no matter how healthy they are, have high cholesterol, whereas some people, no matter how unhealthy they are, have low cholesterol.My husband is skinny, eats whatever he wants, and never exercises but his cholesterol is low. I, on the other hand, have a family history of high cholesterol. Even when I'm eating right and exercising, I am still borderline high cholesterol. Does this study take these individual genetic differences into account? Report
Personally I think fit and at a reasonable weight is the idea. But in all honesty and speaking only for myself (and I have been more than 100 pounds above where I am now so not being judgmental), I think being obese whether fit or not is a health risk in and of itself and also just generally not the way I want to be, which is why I am TRYING to take off some regain pounds lol.

But size is a personal issue and others are free to think what they like. Peace. Report
I don't think those who are skinny should assume they are healthy merely because of their size. At the same time, we all know that carry a lot of extra weight greatly increases our chances of a myriad of ailments. Report
If I'm being honest- I'd rather be skinny and unfit, instead of fit and fat. Even if I'm fit, I will still feel and look fat with the same problems of feeling good in clothes, not being able to wear things I'd like to because they look terrible on my fat body, etc. Report
This article makes a lot of sense!
It has always been important for me to be fit and at the healthiest weight possible. Report
I remember seeing something on tv about a guy who was put in the extra risk category by his insurer, while he was actually running marathons. That was a real eye-opener.The funny thing though: I have done close to 40 miles on my bike in one day (around 4 hours), but when I try to run I can't even make it past a minute. I wonder what that says about how fit I am. Report
An interesting article for those who think that they are "healthy" just because they are thin, or those who think they are "unhealthy" just because they are a little overweight. Sometimes the scale doesn't tell the whole story... Report
Seems like I've heard this somewhere before? De ja vu? Or do we just keep repeating ourselves? Oh well, not to worry over - that would just add stress to our lives wouldn't it? Report
Look, I have have never been over weight (probably by 1 lb! LOL) but my entire life I can't remember being healthy! I was lucky to be born that way. But the cramp I have eaten in my life (especially in my teens and twenty's) and the lack of excerise has finally started catching up with me (I would get winded going up ONE flight of stairs)! I think it is more important to be fit regardless what the scale says. Report
Since we live in a "thin" worshiping environment I am not surprised. I would rather be fit than a bag of bones! I always say, "nothing tastes better than being fit!" Report
Having the energy and stamina to do all the things I want to do is my measure of health: but it certainly is nice for my knees not to have to carry as much of me around! Report
I am considered to be obese due to my weight and height. But I am not on any medication. My doctor monitors my cholesterol and my blood pressure on a regular basis. Usually about every 3 months because both of my parents died from heart disease and my brother who is tall and thin had a heart attack at the age of 31. I am 42 and have not had any serious medical issues such as that. So being thin isn't neccesarily the healthiest thing. Report
ok must admit that when i was heavier my blood pressure and cholesterol were in a great range. now that i have dropped 70 pounds my bp is up and so are my cholesterol numbers. im looking much better on the outside but concerned for the inside. but i am healthier. Report
I have always bragged about being fit and fat. I would tell people I am overweight but i can walk up three flights ofstairs and not get winded. I do not have high blood pressure, high cholesterol or diabetes. I was content in my obesity.I knew I could lose a few pounds but I did not put my all in to it. until a few weeks ago when i was walking up the stairs and my knees gave in. Being content allowed me to get to the point where my weight is affecting me physically. It's not all about size and appearance it is for me about being healthy and active no matter what the scale or the inside of my clothes say. Report
I'd rather be fit AND trim--so greedy of me I know. This blog makes an important point--being healthy is better. Report
This article makes so much sense! Thanks for sharing. Hopefully this will help people realized that the number on the scale doesn't matter as long as you feel great and are happy! :) Report
I'm one of the larger girls amongst friends, but the 'skinny' girls eat crap, drink mountain dew and sit on their behinds most days. I know that most of them couldn't walk a mile if they had to let alone a 5k, I've trying to get a few to do a half marathon with me but they don't get past training for a mile. It does make me feel better about myself that at least I know I am not going to have a heart attack tomorrow because of my weight. I'd much rather be healthy! Report
I have to suggest that even skinny people may be at risk because although they may be able to pinch an inch, its the "fat they can not pinch" that puts you at health risks, that being the fat around vital organs... I myself am working at reduing mine because I just do NOT want to wait for a heart attack....so I am managing my foods and doing my exercise, which go hand in hand. Thank you for reading my comment, Lindie Report
Fit and Healthy is what I think most of us want to be.
Skinny or not so skinny, doesn't matter as long as you feel fit and healthy.
Happy New Year to all and may this be the year we all reach our goals no matter what they are.
How about fit and healthy and happy??? Why is fat and healthy or skinny and unhealthy the only options???? Report
I would be cautious in my interpretation of this article (which could be easily mis-cited.)

Weight does not tell the whole story... but it does tell us something.

The article cited says that "23.5% (approximately 16.3 million adults) of normal-weight adults were metabolically abnormal, whereas 51.3% (approximately 35.9 million adults) of overweight adults and 31.7% (approximately 19.5 million adults) of obese adults were metabolically healthy".

So yes, ~25% normal weight people are metabolically unhealthy and ~30% of obese people are metabolically healthy. aka: "fit and fat" is better than "skinny and unhealthy"

However, a few words of caution:
1) Increased weight DOES increase metabolic risk. (In this study, 23% of normal weight people are unhealthy vs 70% of obese people)
2) Remember that this study was done on people over the age of 20. However, AGE was an independant risk factor. However, its very different carrying a lot of weight when you are 20yrs vs 60yrs because these risk factors (age and obesity) add up!!!
3) They ONLY studied cardiac and metabolic risk factors. Other risks associated with obesity still apply! Report
I feel being fit is way better for you than being thin, my SIL is skinny as a rail but guess what, If soemthing was coming after us, Id outrun her butt anyday of the week because Im in shape compared to her, even with me being 40 pounds overweight for my ideal BMI range. Report
This was a great read:) Report
I was so pleased when this information was recognized!! I've never believed in BMI #'s, I was told at one time that it was for doctors to make a general assessment of your weight. My BMI says I'm overweight. I'm also told I should weigh 130lbs for my height. If I weighed 130lbs, I'd look anorexic. It's just not possible. I feel body type and fitness level should be analyzed before anyone should be determined "overweight". I'm 5'6", and at my fittest, I weighed 155lbs with a bodyfat of 19% and all the charts put me in the overweight category. I think being fit is far more attractive than just skinny Report
Awesome article! And I know it to be true that you can be fit and fat! Many friends of mine will see me doing a workout and be amazed that they can not keep up, but I excersise and eat right, and the curves just want to stay. Where as they eat like birds just to be thin! Report
I'd rather be fit and fat than skinny and unhealthy... I have a friend who lives in Canada... she is 'overweight'.. but she eats right and she works out and she just had an assessment by her doctor and she's very fit!
The big benefit to her is that she no longer has to feel like she's running an uphill battle... she's living right and her body is what God gave her!
it's good that the medical industry is finally realizing that some of us just have that kind of a body type from our gene pool!
Fooey to the insurance companies and all their caluclations!
Eat right.. work out and enjoy who you are!

I would rather be fit and fat anyday!!! CURVES ARE SEXY!! Report
Super article and I think it has some truth to it. If you're working out and eating right you're going to be healthier no matter what the scale says. Most of the time the scale will go down but even when it's stuck it's good to remember that you're making healthy choices and are probably much healthier than the naturally thin folk who eat what they want and never exercise. Report
I have a friend that works out 7 days a week and eats like total garbage... She never has any veggies or whole grains. All she eats is chicken and diet pepsi... It makes me sick!! She wonders why I never get sick......well...I eat right!! Report
I folk dance. We have good dancers and not so good dancers. For the most part, the good dancers do not have weight problems, which is not so true in the not so good dancers. However, one of the most nimble of the good dancers is about 50 or 60 pounds overweight! I am always amazed when I watch her. I think poor physical condition correlates highly with being overweight, but that the correlation is no where near 100%. The heartening news about this is that if you watch your diet and exercise and all and still have difficulty losing weight you are still improving your heart, lungs, brain and immune system!! This was the conclusion of a recent UC Davis study which followed groups of women in a weight loss program. Report
I'm glad that the fad of going by BMI is slowly dying out. A lot of people used to dismiss it's errors by saying "Oh, she's an athlete" or "Oh, he's a bodybuilding". While it's typically for both to have more muscle mass, EVERYONE has muscle mass. I'm glad that people aren't trying to dismiss this formulas errors anymore and are beginning to realize that they actually are errors.

IMO, it's one less number for me to worry about, haha. Report
I have known this to be true. I'm fit but not thin, I have great blood pressure and cholesterol test results.
Hope the rest of the media catches up with this reality, but we know the diet industry fuels this myth and media promotes it. Report
This is such a wonderful article for pointing out something that is often misunderstood by people and distorted by media. It is important, especially for girls/women to know this! Media likes to link looking thin with being healthy to justify the often innacurate depictions of women (6 feet tall and below a size 2).

Many girls and young women spend tons of time hating their bodies because they are not fitting certain inches, and when these ladies work out or do fad diets, they do it for the WRONG reason. They look up to the wrong people or the right people for the wrong reasons.

I am 23 and I am just coming to love myself as fuller figured AND beautiful, not BUT beautiful. I am 197 pounds, but I have been physically active since 8th grade. Doctor's say that even tho I am pre-diabetic, I have an impressive, cholesterol level and other stuff. I think it is because I work out ALOT.I am probably the most fit of all of my freinds. But 95% of my freinds have fast metabolism and eat whatever and drink alchohol with no worries!

It is SO EMPOWERING to have a true understanding of health and ALSO to not think beauty is ONLY reserved for smaller frames/shapes

But is it not funny that the major motivator of losing weight in this country is to be thin (then health follows)?? I myself had that mentality. But either way, it's funny bc the larger people ended being more health consious and physically active so technically they are healthier to some degree!!

Hopefully our culure will start promiting true health on the premise of a long and health life..and not fitting into a size 2!! Report
The study actually says that weight alone may not be the BEST predictor of overall health. Weight is a part of a number of indicators that should be used to assess your status. I think the message is not to rely on one thing alone, weight, running time, blood glucose level, fat in the diet, heartrate, etc. etc etc. These articles put an emphasis on something like weight and inadvertently, or maybe purposefully, strike fear and concern in people and even worse, add to the growing discrimination against people who look overweight. Bottom line, the research may be valid, but the way the media presents it to the public, leaves much to be desired. Report
I've always felt that many of the health issues associated with obesity are really health issues caused by eating crap and/or not exercising. If you eat crap and don't exercise, you are more likely to end up obese, but there's also plenty of people who eat crap and/or don't exercise who either have the metabolism or the sense of portion control to avoid getting obese.

The eating crap and not exercising angle also ties in with studies that show that loosing just 10% of body weight for an obese person has huge benefits - to lose that 10% they're most likely eating less crap and exercising more. Report
LOVE THIS ARTICLE! one of my kid's dads and i were talking recently. He is in the Coast Guard and quite fit. We were talking about what is obese. For the chart because he is short, he is technically obese.

Just goes to show us - health is a total picture, not just height & weight.

i'd love to see more info like this. thank you. Report
It really can't be about the numbers. Remember that muscle is much heavier than fat. Many athletes by weight and size would be considered overweight but it is all muscle. If you are exercising regularly, eating healthy and have lots of energy, than consider yourself fit regardless of what you weigh. Report
And I thought that paying attention to my scale was all there is but i guess i was wrong; i'm happy to say that i work very hard and do lots of good challenges every month to keep up with my healthy body. Yes a number is just a #! And as a human being I like to see good numbers, jajaja...
This is so encouraging. Working out, eating healthier but still being considered overweight is such a downer. It's nice to know it's not all about the weight! Like they say, "It's just a number!" Report
I agree that we must be VERY careful about these findings. I believe that fat is NEVER fit. I also believe that skinny does NOT mean fit. I have an ultra thin girlfriend who can eat whatever she wants, has never worked out and pants like a dog after climbing the stairs. That being said, I will repeat that fat is never fit. You can build up your cardio endurance, strengthen muscles, increase flexibility, improve resting heart rate - all with repeated exercise and all while being fat. I have done this. I could do aerobics all around most of my friends. I could bike, I was strong. But I was fat. Yes, my blood pressure was fine, and my resting heart rate was impressive, but fat is fat. And I went to a barriatric specialist (not for surgery) but to get my total health profile. My liver was showing signs of becoming "fatty liver", I was on the borderline of diabetes, my waist measurements and abdominal fat were to the dangerous point heading towards heart disease, I could go on and on......All of this has changed since I work out now AND lost the weight. And I am only 37 years old, so none of these findings had to do with age. I guarantee any overweight person will see signs of obesity related health problems given time, and not that much time, even if they are deemed "fit". Report
This is so true. I can out bike, out walk, and out jog my husband and he is thinner than I am. Almost 40 pounds thinner. But I have been working out more than him and training myself to be more fit. It actually helps to motivate me and he loves the competition and watching me succede!!! Report
I love this entry because I've never been a "skinny" girl but I have always been in shape. I can run up 3-5 flights of stairs without getting out of breath, I normally run 5-10Ks, I've always been able to lift heavy things YET my clothes make it seem that I'm Fatty McFatty! I'm 5'5, almost 160lbs, and I wear a size 12 so I get angry that society is making me seem like I'm huge and out of shape when I could probably outrun half of those people. Report
It knew it! When I walked up and down stairs for hours with my 10 lb baby wrapped around me in December, my step mom commented on how fit I am! It's the best feeling. Even though I don't always like the looks of the bod, as long as I'm exercising, I usually feel great and that's the most important! Report
This is a great article. My doctor has told me several times that the # on the scale isn't the ultimate tale. He says he has several overweight patients that are in better physical condition than some of his skinniest patients! He was hesitant to give me a "goal weight" when I started in my local TOPS group several years ago. To go by the "government chart", my goal weight would make me look like a walking skeleton. I did reach it once & I had several people tell me I looked sick. Too thin for my build, sunken cheeks, it just didn't look good. My goal weight now is about 15-20 lbs heavier & my doctor is very happy with that. I'm OK with it too. Report