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At what point are you overweight? Stop—that’s a subjective
question. Over what weight? And who decides? From glossy magazine
pages to family doctors, our culture leads us to believe a slim
figure is the key to a long, healthy, and happy life. But some
experts weighing in on the fitness versus fatness debate say
shedding pounds might not be so important.
The Conventional View: Weight Matters
According to the National Institute of Health, your chances of
dying of anything from heart disease to diabetes to cancer are
substantially boosted by being overweight—an adjective that
describes more than 97 million Americans. Just lighten up and
you’ll be more likely to escape an ugly fate. A recent report
issued by the NIH ranks individuals’ vulnerability to natural
death based on their body mass index. A BMI of 19 to 25 is
pretty healthy, they say, 25 to 30 is overweight and above
30 is considered obese. (Calculate your own BMI by visiting the
Calculators page in our Nutrition section.) So roughly 28% of
Americans need to lose weight to be healthier. Sounds simple,
right?
Naysayers Claim that Fitness is Key
Not so, say critics. They suggest that just getting thin might
not make you healthier at all and that fitness is more important.
Evidence directly connecting weight with health risks is scarce,
some experts say. These same experts add that weight-loss
proponents simplify the issue by ignoring physical fitness as
a component of healthy living.
Registered Nutritionist and Rocky Mountain Chapter of the American
College of Sports Medicine board member Cindy Byfield is opposed
to what she calls the weight-loss scare tactics used by
organizations like the NIH. She says that substantial health
risks are only correlated to extremely high BMIs. “As long
as you’re active on a regular basis, you’re much healthier
than a skinny person who sits on the couch all day.”
“There’s a belief with a lot of research behind it that you
can be fitter and fatter. Thin people who do not exercise
are at a high risk of heart disease. Skinny people shouldn’t
automatically think they are healthy,” Byfield says, referring
to the findings of specialists like Steven Blair of the Cooper
Institute of Aerobic Research.
Walk Your Way to Health?
In a study of 10,000 individuals over an eight-year period,
Blair found that men and women who were in the lower 20%
fitness-wise were twice as likely to die. In another study
published this month in The New England Journal of Medicine,
73,000 middle-aged women were observed before and after
periods of regular walking exercise. Researchers found that
these women experienced a 30 to 40% reduction in health
risks when they walked vigorously for only 1.5 hours each
week. Weight is not mentioned as a factor in
the study.
People tend to think of exercise as a means to an end—to
lose weight—rather than as an end in itself, Byfield says.
People who consider themselves overweight exercise to lose
fat but then get discouraged and stop without realizing
that they feel better, they’re healthier and more energized,
even if they haven’t lost weight.
“I would tell a person that what matters is their physical
activity level,” Byfield says. “Work on behavior change,
and let your body weight fall wherever it’s genetically
programmed to fall.”
Weighing in on the Side of the NIH
But James O. Hill, Director of the Center for Human Nutrition
at the University of Colorado Health Sciences Center in Denver,
defends the NIH guidelines. Hill accuses people like Byfield
of the same shortsightedness as they do the NIH. Hill agrees
with Blair’s conclusions that fitness is an integral part
of being healthy and lowering morbidity rates among
Americans.
Hill points out that the NIH-recommended treatments also
include caloric reduction, medication, and surgery. He also
argues that the NIH guidelines play a valuable role in helping
people assess their weight condition. He believes that by
ignoring weight issues and the widely accepted NIH studies,
fitness proponents are being one-sided. Weight assessment
should be a collaborative process taking advantage of all
the tools available, Hill says.
According to Hill, the NIH categorizes people and gives them
a benchmark in assessing their health. Once they determine
their BMI, individuals need to self examine and think about
how applicable that benchmark is to them. If they feel fit
and good but are overweight, then they can determine that
themselves. Still, following the guidelines is the best place
to start, he says.
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