Self Magazine - October 1996

Who is more fit? A five-foot-four-inch woman who weighs 120 pounds or a five-foot-four-inch woman who tips the scales at 150? Easy, right? Not so fast. What if the latter is a power walker and the former, a veritable slug? New scientific evidence suggests that the active heavier woman may be more fit than someone who wears jeans that are half her size.

Can you be fat and fit? It was one of the hottest topics at the recent meeting of the American College of Sports Medicine (ACSM). On one side of the weight debate are experts who say genetics prevents some of us from ever reaching our so-called ideal body weight, and that overweight people who are active and eat right can be healthy. Yet other researchers consider excess fat deadly and warn that America's epidemic of obesity is a major public health problem-second only to cigarette smoking as a preventable cause of premature death.

One proponent of the "fat can be fit" argument is ACSM's new president, epidemiologist Steven N. Blair, M.D., director of research for the Cooper Institute for Aerobics Research in Dallas. Dr. Blair admits that part of his reasoning is personal: Even though he's a runner who eats right, he still describes himself as "short, bald and fat." But in studies, Blair has proof that "fit and healthy bodies come in all shapes and sizes." His most recent research followed approximately 10,000 men over the course of nearly 20 years and concluded that the fit men had a lower risk of death than unfit ones, regardless of weight.

In terms of health and longevity, your fitness level is far more important than your weight," Blair writes in the forward to the newly published book Big Fat Lies, by University of Virginia exercise physiologist Glenn Gaesser, Ph.D. "If the height-weight charts say you are five pounds too heavy, or even 50 or more pounds too heavy, it is of little or no consequence healthwise-as long as you are physically fit. On the other hand, if you are a couch potato, being thin provides absolutely no assurance of good health and does nothing to increase you chances of living a long life.

At a time when one third of American adults are officially obese, such a statement causes a stir.

"It's very misleading to say there are no risks associated with excess adipose tissue," counters endocrinologist JoAnn E. Manson, M.D., codirector of women's health at Brigham and Women's Hospital/Harvard Medical School. Her research on 115,000 women in the Nurse's Health Study, reported in The New England Journal of Medicine, indicated that "even mild to moderate obesity is associated with a substantial increase in the risk of premature death. We estimate that nearly 25 percent of all deaths among nonsmoking adult women in the U.S. are attributable to obesity." Although Dr. Manson agrees that it is possible to be fat and fit, she contends "It's the very rare bird" who is active enough to be fit, yet remains overweight.

While the scientists scuffle, the rest of us are left with one commonsense consensus: A healthy diet and regular activity are ideal.