Can a person be both fat and fit?

No doubt most of you are aware of a controversy ignited by former model Cheryl Tiegs who twice graced the cover of Sports Illustrated magazine years ago.  Recently, Tiegs came under scrutiny when she criticized the current model featured on the cover of the same magazine, Ashley Graham, of her curvaceous, full-figured body.

Tiegs stated, “I don’t like that we’re talking about full-figured women because it’s glamorizing them because your waist should be smaller than 35 inches.  No, I don’t think it’s healthy.  Her face is beautiful.  Beautiful.  But I don’t think it’s healthy in the long run.”

Does she have a point?  Is a person with a body mass index (BMI), placing them in the overweight (25-29.9) to obese category (30 and higher), automatically unhealthy?  Or can a person with an above average BMI still be a fit and healthy individual? 

Health at every size movement

As a health professional, we tell people all the time they need to strive to be at an ideal body weight for their height .  However, there is a movement called “Health at Every Size (HAES) offering an alternative to overly restrictive diet programs claiming that the health risks of being overweight to obese have been exaggerated in research and in the news media.  Their philosophy is a person can be at whatever weight they want as long as they are both physically and emotionally as healthy as they can be at that weight.  They feel unrealistic expectations and social stigma are often at the root of weight issues for many people.  Their focus is on healthy behaviors, not weight loss.  HAES proposes individuals should accept their body’s size and shape, no matter what the weight is, as long as they are healthy and fit. 

The approach HAES takes has gained endorsement from numerous eating disorder groups such as The Academy for Eating Disorder and the Binge Eating Disorders Association.

However, not all health professionals are embracing this new approach with open arms. 

What science tells us

So what does research have to say?  We know approximately one third of adults in the United States are obese or have a BMI of 30 or greater.  We also know obesity increases the risk of many diseases – heart disease, type 2 diabetes, hypertension, abnormal blood lipids, insulin resistance, metabolic syndrome and fatty liver disease.  Carrying around excess weight increases the risk of osteoarthritis leading to joint problems of the hips and knees in addition to higher risks of gout and gallbladder disease.

Women who carry excess weight have more difficulty in becoming pregnant, a higher risk of gestational diabetes, miscarriage, stillbirth, and complications during labor and delivery.  Overweight to obese men have worse sperm quality, lowered testosterone levels reducing fertility and the risk of erectile dysfunction.

Depending on where the excess weight is located makes a difference too.  Abdominal or belly fat does pose a higher health risk than fat distributed predominately on the hips and thighs. 

Even though being overweight to obese can increase health risks, it is estimated about 35% of obese people are “metabolically healthy” meaning they have normal blood pressure, glucose levels, and blood lipid profiles.  For the rest of the majority (65%) who don’t have normal health profiles in these areas, they are at a greater risk for health problems. 

The key is will the 35% of metabolically healthy yet obese individuals be able to maintain a healthy profile long-term?  A 2015 20-year follow-up study found that most of these individuals will over time, progress to an unhealthy state at a rate eight times greater than healthy nonobese individuals.  It appears it is more the exception than the norm to be able to remain a healthy obese person as the years go by. 

Finding a happy medium

Where does this leave us in regards to providing scientific evidence-based advice for overweight to obese individuals on knowing what is the best answer for maintaining health throughout their life?  Can a person really be healthy and fit at any size?

Here are points for all those overweight to obese to consider:

·         An obese person may be able to keep healthy for relatively long periods of time but it is still best to try to have a BMI between 18 and 25.   

·         About one-half of obese people who can maintain good health over 20 years eventually become metabolically unhealthy. 

·         Losing some weight reduces a tremendous amount of wear and tear off joints along with improving cardiovascular health.  This is particularly noticeable as a person ages and osteoarthritis sets in. 

·         Adopting a more healthy diet made up of fruits, vegetables, legumes, and whole grains can be helpful with weight loss as these foods have fiber which helps you feel fuller longer.  

·         Maintaining a consistent exercise regimen will aid in achieving a more healthy body weight and also help in increasing the likelihood of avoiding many diseases associated with obesity. 

Final thoughts

We come in all shapes and sizes and we are not meant to all look the same – thank goodness!  Genetics certainly plays a role in what our weight is but so does environment.   We can’t change our genetics but we can change our environment.    

Cheryl Tiegs and Ashley Graham have completely different body types and yet both are beautiful.  No matter what your body type is – slender, stocky, athletic – the goal is for all of us regardless of our weight, to take personal responsibility in our health habits.  This means choosing healthy foods, regular physical activity, adequate sleep, reducing stress, not smoking is what will set us up for success both mentally and physically.  When this is practiced for a lifetime, the payoff is usually getting in better shape with good to excellent health. 

If you are carrying excess weight that most likely will result in developing health problems over time, take action now to at least make the attempt to apply good health habits to your lifestyle.  Bottom line, each of us has our own unique look and when we love and care enough about ourselves to promote our health, the chips tend to fall in place getting us the body we deserve.