De-Bunking the Myth: "Fit and Fat" is Not What You Think

Fit and fat. It sounds too good to be true. The idea is that it doesn’t matter how fat you are, after all, so long as your vital signs are healthy. The concept has been touted in a Newsweek cover story, and it’s being promoted in the book Big Fat Lies by University of Virginia professor Glenn Gaesser.

The Calorie Control Council went to obesity and fitness experts to find out the truth about "fit and fat." Is it a legitimate excuse to let your weight go? Or could it be a dangerous oversimplification of a phenomenon that applies to only a tiny percentage of Americans? The experts who were interviewed are: Nancy Clark, M.S., R.D., Director of Nutrition Services at Sports Medicine Brookline, an athletic injury clinic in Brookline, Massachusetts; Dr. Randy Claytor, Senior Program Advisor with the President’s Council on Physical Fitness and Sports in Washington, D.C.; Dr. John Foreyt, Director of the Nutrition Research Clinic at the Baylor College of Medicine in Waco, Texas; and Dr. JoAnn Manson, Associate Professor at Harvard Medical School and Co-Director of Women’s Health at Brigham and Women’s Hospital in Boston.

Here’s what they had to say:

CCC: Is it possible that someone can be fat and fit, in other words obese but without the associated health risks?

Foreyt: I find the theory puzzling. Fit and fat is really an oxymoron. Someone who exercises on a regular basis and eats right is not going to stay "obese." This concept is actually based on some limited research of people with BMIs (body mass index) over 30, who obviously were very heavy but appeared to have generally a good health status.

Claytor: It’s complicated, because what’s really important are body fat levels more so than body weight. And scientists still aren’t completely certain what an appropriate level of body fat is; it’s safer to speak in terms of range. So, yes, it is possible to have some parameters of physical fitness and still have a higher level of body fat. But to be overfat and fit, no.

CCC: Could there be a sizable portion of the population who are fit and fat?

Manson: I think that a person who is both fit and fat is a rare bird. We have an epidemic of obesity and sedentary lifestyle in the United States. About 60 percent of the population is sedentary, and the prevalence is even higher among overweight and obese people. So I think to find someone who is truly physically fit -- both aerobically and from a cardio-respiratory standpoint -- and is also truly overweight and has maintained a high level of adiposity, is fairly unusual. I think it is theoretically possible. I think it does occur. However, I think it’s a rare bird.

Foreyt: If there are any of these people, there certainly aren’t many. Athletes, for example, could have unusually high BMIs, because they are muscle bound, yet still be in great shape from a health standpoint. Of course, most of us put on fat, not muscle, as we age or gain weight.

CCC: Would you agree with the message of the "Fit and Fat" proponents, that too much emphasis is being placed on a person’s weight and body image?

Foreyt: I would agree with the advice that people shouldn’t get hung up on their weight per se. I always advise my patients to pay less attention to the scale and, instead, focus on eating healthfully and exercising regularly -- and you will eventually achieve a healthy weight you can maintain. Remember, we can’t all be skinny but we all can be healthy.

Claytor: Unfortunately, this is what the media sends us -- the idea that if you’re thinner, you’ll be more successful and happier. Not only is this not necessarily true, but the media’s image of "thinner" may not be realistic for everyone. So I would agree that people shouldn’t be so concerned with body fatness, but it’s still important for people to get some exercise and watch their caloric intake.

Clark: Yes. A lot of people will try to get thin at any cost. When I counsel people, I ask them, "At what weight do you feel good?" Also, it’s important that people are at peace with food. Healthy eating and healthy exercise contribute to healthy weight.

CCC: But even as people are being told to be less obsessed with their fat or weight, is there a danger that they’ll get the wrong idea?

Claytor: Yes, there is a very real danger that people will take away the wrong message. The idea that as long as I’m exercising, it doesn’t matter how much body fat I have, or how much I eat, nothing is going to happen to me -- that’s not right.

Manson: It’s important that people understand that both obesity and sedentary lifestyle are independent risk factors for heart disease, diabetes and several other chronic diseases. I don’t think we need to say that it’s all fitness or it’s all fatness that’s the factor. They’re both independently important.

CCC: So what’s the best advice about physical activity, diet and weight control?

Claytor: If you hold your caloric intake constant and start exercising, you should lose weight, but it takes time. People who both exercise and modify their caloric intake have a better chance of losing, and maintaining, weight.

Clark: You do want to eat healthfully, such as eating more fruits and vegetables and keeping your total fat intake to no more than 30 percent of calories. A lot of thin people eat a junk food diet -- I think they’re fooling themselves. And now that people are living longer, it’s important that their healthspan stays with their lifespan.

CCC: Some have questioned the connection between obesity and health. What’s your bottom-line on this?

Foreyt: Extensive research confirms that obesity is strongly correlated with excess morbidity and mortality. My bottom line is to focus on behaviors you can control -- what you eat and how active you are. And, most of all, enjoy life!

Clark: Be realistic. Love yourself from the inside out. You can be a great person in spite of your weight. But it’s important to have a healthy weight for health reasons.

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