I have heard the term “fat, but fit” or “healthy obesity” being tossed around lately, and I wanted to shed a little bit of light on this important topic. If you have heard this, you might be thinking the same - can you be fat and fit? Today, I want to dive into what that means, and if it is actually the case.
This idea actually stems from research that was done on people who were heavy, but did not have obvious risk factors, still stayed freer of chronic disease (heart disease or cancers). These risk factors were things like:
- High Blood Pressure
- High Cholesterol
- Blood Sugar Problems
The argument was that, even if you were overweight, if you could manage these factors you could mitigate the risk of chronic disease. If I was in charge of the rules, I would like that idea - but, the fact of the matter is, that just isn’t the way this works.
Bottom Line: I know that weight can be a struggle, and it affects so many of us. While it is changeable, it is certainly not easy - it takes effort, time, and discipline. Given the lives we lead, this is not always easy to do. So, I do like the thinking that one could be heavy while still doing things to improve their health (and escape the associated risks).
What we had not really seen before was good, substantial, and verified research being done into a subject like this one. These would be studies comparing people, such as:
- Those that had weight, and had no risks
- Those that had weight, and had risks
- Those that didn’t have the weight, and had no risks
- Those that didn’t have the weight, and had risks
In order to get some really good “science” out of these studies, we needed all four of these groups to be compared against one another - rather than siloing them and studying them on their own.
A recent study compared three and a half million adults (1), and of those roughly 22% were obese. How do we figure out when to classify someone as “obese”? We define weight in terms of body mass index (BMI). While there might be some shortcoming, it remains a good tool for research and health studies. Here’s how you can read your BMI:
- Between 25 - 30: Overweight
- More than 30: Obese
Of these 3 and a half million people, 22% of them fit into that category of obese. Of that 22%, some of them had obvious risk factors (high blood sugar, blood cholesterol, and blood pressure). Many, though, did not have any of those risk factors - they were entirely without risk!
Those who were obese, but had no risk factors, were compared against the lean people. This was done in order to assess their chances of developing:
- Conditions for a heart attack
- Angina (chest pain during movement)
- Heart failure
- Peripheral vascular disease
Key Insight: Worried that this study might have been biased in some way, shape, or form? The researchers actually factored in age, gender, smoking, and socioeconomic status. The kinds of things that can push heart attack risk, completely independent of body weight.
When comparing lean people, with BMIs less than 25 and no risk factors, against the obese population with no risk factors, what the researchers saw was that there was still negative outcomes. The healthy obese populations were still:
- 2.6 times more likely to develop heart disease.
- 7% more likely to have a stroke.
- Twice as likely to have heart failure
- 11% more likely to get peripheral vascular disease.
Key Insight: With heart failure, in particular, each pound of fat that we have can contribute our heart’s inability to support our extra body weight and mass. It’s an ongoing liability for your heart, because it is always working so hard to keep blood flowing.
Having said that, the risk factors made these outcomes even more likely than simply being obese. In fact, those that had the weight and the risk factors were:
- 2.6 times more like to have heart attacks or angina
- 58% more likely to get a stroke
- 3.8 times more likely to get heart failure
- 2.2 times more likely to get peripheral vascular disease
Bottom Line: The silver lining here is that, and many studies have shown that, weight loss can influence massive changes in risk reduction for these categories. It still remains as one of the most powerful interventions one can do to improve their risks for preventable death.
The Role of Weight Loss
It cannot be stressed enough the role of weight loss in our day-to-day lives, for our bodies and for our long-term health. Even if you were obese, and you were simply to move down to the overweight category of BMI, this would still show significant drop off for your risk of having a heart attack or a stroke.
Key Insight: It has even been shown that even when you do not move away from your category (an “obese” person stays “obese”), even small amounts of weight loss can lower your risks.
What happens in weight loss is often that the first 5 - 10 pounds will be visceral fat. When you go about decreasing that amount of visceral fat, you are burning all of this fat that burns, irritates, and causes inflammation throughout your body. When you lower it by that much, it is a huge and immediate change for inflammation in your body.
Visceral fat can play a big role in:
- Reflux disease
- Sleep apnea
- Cancer risk
- Heart disease
- Gas and bloating
- Chronic pain
Bottom Line: This loss of visceral fat will often have you moving better, being in less pain, having better mental alertness, even if you have not had some sort of radical weight loss transformation. That first 5 - 10 pounds is a radical transformation, and you can definitely feel it.
Small Changes, Big Differences
So, the concept of “fat, but fit” did not really work out when we dug through the numbers and the research. But what does that mean if you are feeling this way? Well, it does mean that small changes in your diet can actually result in wholesale changes in how you feel - while, at the same time, actually decreasing your risk factors.
While you are thinking about your health, why not consider some other ways you can make big changes in your life? Consider your thyroid, for example. How much do you know about it, and its role in keeping your body feeling healthy? If you feel like it might be doing more harm than good lately, take the Thyroid Quiz (2) and learn a little bit more about your health today.
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, cure diabetes, and regain energy. Learn more about the surprising story that started his quest.