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What's a Healthy Weight, Anyway? The Truth About Being Fat But Fit


Weight isn't everything. The foods you eat, how well you sleep, and the quality of your relationships all affect your health too. Still, new research suggests you can't outrun your scale when it comes to your overall well-being.

For a study published in International Journal of Epidemiology, researchers followed more than 1.3 million young men for an average of 29 years, examining the link between their weight, aerobic fitness, and risk of early death. They found that men at a healthy weight—no matter their fitness level—were 30 percent less likely to die young compared to the fit, albeit obese, men. The results suggest that the beneficial effects of fitness are blunted with increased obesity, and that in extreme obesity, fitness has little to no benefit. "Maintaining a normal weight at a young age is simply more important than being fit," says Peter Nordström, M.D., Ph.D., professor and chief physician of community medicine and rehabilitation at Umeå University in Sweden, and co-author of the study.

But what do these findings mean for you? First off, it's worth noting that the study looked at men, not women, and counted deaths from suicide and drug use (to be fair, previous research links both physical inactivity and obesity to depression and poor mental health). Nordström also notes that even though the risk of early death was higher in "fat but fit" men than in healthy weight men, the risk still wasn't all that high. (Remember that 30 percent stat? Even though the overweight and obese people did die at a 30 percent greater rate than the normal-weight, unfit people, only 3.4 percent of the study's participants died in total. So it's not like overweight guys were falling over left and right.) And previous research, including one 2014 meta-analysis of 10 separate studies concluded that overweight and obese people with high cardiorespiratory fitness have similar rates of death compared to fit people at a healthy weight. The review also concluded that unfit people have twice the risk of death, no matter their weight, compared to fit people.

"No matter what you weigh, you'll benefit from being physically active," says Timothy Church, M.D., M.P.H., Ph.D., professor of preventative medicine at Pennington Biomedical Research Center in Louisiana. "I don't care about your weight," he says. "What's your fasting blood sugar level? Blood pressure? Triglycerides level?" In terms of measuring wellbeing, these markers are more reliable than weight determining your health, agrees Linda Bacon, Ph.D., author of Health At Every Size: The Surprising Truth About Your Weight. In fact, research published in the European Heart Journal shows that when obese people keep these measures in check, their risk of dying from heart disease or cancer is no higher than for with so-called normal weights. "Weight and health aren't one and the same thing," says Bacon. "Just ask a fat football player, or a thin person who lacks sufficient access to food. It is very possible to be fat and healthy, and thin and unhealthy."

That said, people with a lot of one specific kind of fat, abdominal fat, do tend to be at a greater risk for health problems than people who carry their fat in their butt, hips, and thighs, says Church. Unlike subcutaneous fat, which hangs out just below your skin, abdominal (aka visceral) fat goes deep into your abdominal cavity, surrounding and compromising your internal organs. (Research from the University of Oxford even shows that butt, hip, and thigh fat is healthy, ridding the body of more harmful fatty acids and producing anti-inflammatory compounds that help lower the risk of heart disease and type 2 diabetes. It pays to be a pear.)

That's why a large waistlines and apple body shapes—not a high number on the scale—are an established risk factor for metabolic syndrome, a cluster of conditions that increases your risk of heart disease, type 2 diabetes, and stroke. Consider this: Healthy weight women with a waist of 35 inches or more have three times the risk of dying from heart disease compared to healthy weight women with smaller waistlines, according to Circulation research, one of the largest and longest studies on abdominal obesity. Both the American Heart Association and National Heart, Lung and Blood Institute agree that waist measurements of 35 inches and higher are a marker of an apple-shaped body type and abdominal obesity.

Whatever your weight, the simplest way to determine your individual fat-to-health connection may be to measure your waist. Luckily, if your waistline is flirting with that line, exercise is one of the best ways to reduce your levels of abdominal fat and improve your health. Who cares what the scale says?


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