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| health > diet & fitness > story page |         |
Fit or fat? The debate continues
January 28, 2000
By Camille Mojica Rey (WebMD) -- Looking in the mirror used to be a frustrating experience for Chantal Leon. The 24-year-old student from Bridgeport, Connecticut had been overweight for years. And even after she gave her eating and exercise habits a major overhaul -- giving up cheeseburgers and exercising faithfully several days a week -- she couldn't get her dress size any lower than a 12. These days, Leon is still a size 12. But she's no longer preoccupied with her body's proportions. When she looks in the mirror, she sees a strong, fit woman who happens to be big. "I know I'm not unhealthy," she says. Her cholesterol and blood-pressure numbers are good, and her physician has encouraged her to focus on maintaining her healthy habits rather than fretting over her weight. Leon's doctor is among a growing number of medical experts who say that a person's fitness level is far more important to health than weight is.
"You can be fit and fat," says Dr. Jody Wilkinson, a researcher at the Cooper Institute for Aerobic Research in Dallas, Texas. "And it's better than being skinny and sedentary." Wilkinson and his colleagues at the Institute have produced strong evidence in support of this claim. Consider some of their findings:
These findings haven't convinced everyone, though. Certainly not the federal government. In 1998, the National Heart, Lung, and Blood Institute issued the first national guidelines on obesity in adults. The government came down hard on the United States, changing the definition of healthy weight to classify 29 million additional Americans as both overweight and unhealthy For instance, according to these new federal health standards, Leon's body mass index of 26 means that she is officially overweight. And carrying excess pounds, federal officials say, raises a person's risk of heart disease, diabetes and numerous other ailments. But Wilkinson says there is a crucial flaw in most of the studies cited by the "you-can't-be-fit-and-fat" crowd. He acknowledges that many overweight people are indeed at greater risk of chronic disease. But most studies that have fingered weight as a culprit in these ailments have not factored in physical fitness. Without a way to separate overweight people who are fit from those who are not, Wilkinson argues, the numbers are misleading. Dr. Gerald Fletcher, a cardiologist at the Mayo Clinic in Jacksonville, Florida, agrees that a person can be both fit and fat. "But most people are not," he says. That's why he, like most doctors, continues to urge his patients to lose weight -- particularly those whose excess weight is concentrated around their abdomen, who have even borderline high blood pressure or cholesterol and who have a family history of heart disease. Regardless of inherited tendencies, size or shape, doctors, including Fletcher, agree that maintaining a healthy lifestyle remains the single most important advice they can give to their patients. In addition to regular exercise, Wilkinson encourages his patients to eat healthful foods and to change unhealthy habits, such as cigarette smoking. "It makes you feel better and improves the quality of life," Wilkinson says. "That's really the bottom line." And while Chantal Leon still would like to lose 15 pounds, the sense of panic no longer looms over her. "I'm not in a rush," she says, "I'm healthy."
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