Shifting the focus from size to exercise
The verdict is in: it is possible to be fat and fit. And it might be better for your health than being skinny and sedentary.
It should be no surprise to anyone that wolfing down a greasy beef burger and chips a few times a week won’t do you any good. It should be equally unsurprising that regular physical activity, be it walking or surfing or doing star jumps in your lounge room, will help to keep you healthy.
What might not be so well known is that the way a person looks isn’t always a good measure of how fit they are. Being overweight or obese doesn’t mean you’re unhealthy.
Take Mimi Valerio, the ultra-marathon runner who pushes the stereotype of what an athlete should look like. Or Erica Schenk, the plus-sized model who got tongues wagging when she appeared on the cover of Women’s Running magazine.
An increasing body of scientific research (more info here, here, here, here, here and here) shows it’s better to be fat and fit than skinny and sedentary.
That’s why Dr Evelyn Parr, an exercise and nutrition scientist at ACU’s Mary MacKillop Institute for Health Research, says it’s time we shifted our focus.
“It frustrates me that as a society we put so much emphasis on somebody’s size and weight, because in many cases it’s genetic — some individuals are always going to be slimmer than others — but our aerobic fitness is something we can control, modify and improve, by staying active,” she said.
“The body is a lot more powerful than just how it looks, and I’d rather be the person who can walk up four flights of stairs at the airport when the escalator is broken than the slim, tanned model on the billboard somewhere.”
Why exercise is good for you
Whether you’re a Slim Jim or a Fat Matt, if you’re physically fit, you lessen your chance of suffering chronic disease or premature death. It can effectively nullify some of the health risks associated with being overweight or obese.
And it comes down to exercise.
Regular aerobic and strength-promoting physical activity improves heart and lung function, fortifies your bones and muscles and changes the way your body processes oxygen.
“When somebody exercises and stresses the heart in a good way, that causes adaptations which puts them at a lesser risk of chronic disease — it’s like a pill that can help with diabetes, high cholesterol, high blood pressure, depression, dementia and many other diseases that develop over time,” Dr Parr said.
“Exercise strengthens the blood vessels and helps reduce the build up of cholesterol and plaque within those vessels, it pumps oxygen around the body and allows it to use the glucose and fat we consume … our muscle needs that energy more because we’re being more active.”
Not to mention the benefit that those who exercise regularly know from experience: it makes us feel good.
So why are we still focused on ‘fatness’ over ‘fitness’?
If physical fitness is more important to our health and wellbeing than size or weight, why aren’t we hearing about it?
Harriet Brown, author of the book Body of Truth, argues one reason may be that “researchers, like the rest of us, are still entrenched in the ‘fat will kill you’ mindset”.
“Pretty much all the research on weight loss involves some kind of change in lifestyle, often in the form of exercise, but researchers tend to attribute better health or lower mortality only to the weight lost,” says Brown.
“They fail to explore the idea that it might be the exercise (and the better fitness that results) that makes the difference, rather than the weight itself.”
Dr Parr said many of us still don’t understand the effect that being physically active can have on the body.
“Even though people can appreciate the idea that exercise is good for you, until you’ve actually experienced the incredible benefits, the feeling of wellbeing it can give you, it’s hard to fully understand the effect it can have,” she said.
Despite all the stated benefits, physical activity is still the most prevalent chronic disease risk factor in Australia, with almost nine out of 10 Australians not meeting the Department of Health’s national exercise guidelines.
And as Dr Parr pointed out, exercise is still not taught as a treatment in many Australian medical schools, with some courses spending as little as 12 hours on physical activity in a six-year degree.
Is ‘fat but fit’ a myth?
It’s important to point out that not everybody agrees you can be obese and healthy at the same time.
Just last year, this article from the UK ran with a headline of “Fat but fit is a big fat myth”.
Based largely on research from the University of Birmingham, the article quoted Dr Mike Knapton from the British Heart Foundation as saying that “just being overweight puts you at increased risk of heart attack and stroke”.
Dr Parr conceded there various risks associated with being overweight, and excess body fat can be harmful.
“There are still negative effects to having high amounts of visceral fat —the fat around organs like the pancreas, liver and intestines — and I'm not going to deny there are disease states that are affected by excess body fat,” she said.
“But I think the emphasis on ‘fatness’ is driving people in our society to be overly conscious about their size, about how much they weigh and how they look, and the research shows they’d be much better off focusing on how fit they are and how they feel, because when it comes down to it, if you get fit, you will see improvements to your health no matter who you are.”
What about diet?
So if our focus is on fitness rather than fatness, does that mean we still need to watch what we eat?
There is no doubt that eating nutritious food is hugely important to health and wellbeing. But nutrition is complicated. Dieting for weight loss rarely succeeds in the long term, and food choices that work well for one person won’t necessarily work for another.
“Nutritional science is such a difficult field, and getting an accurate understanding of how one individual’s body will process a certain type of food is very hard,” Dr Parr said.
“Energy restriction is fine in some circumstances, but it’s unlikely that anyone is going to adhere to that long term … and we need to take into account that a lot of diets can affect a person’s relationship with food in a negative way.”
Meanwhile, research has found that being physically fit can help with maintaining weight loss. Analysis of The Biggest Loser participants in the US showed the ones who maintained their weight loss six years later were those who successfully increased their physical activity from pre-show levels, even when their energy intake was the same as those who regained their weight.
“When we’re dieting and reducing our energy intake and starving some of those tissues, it works really effectively to begin with and we lose lots of weight, and then our body adapts and it makes it harder to keep the weight off,” Dr Parr said.
“With exercise, it’s one of the driving factors of our metabolic rate, and if you exercise regularly, it’s that stimulus that is constantly there, it keeps our muscle needing energy, keeping that energy turnover so that it’s not being stored and we’re not regaining the weight we’ve lost.”
Turning the spotlight from size to exercise
If you’re feeling a little bamboozled, join the queue. The world of fitness, nutrition and health is complex.
One thing we know for sure is that regular exercise is good for you. It’s a crucial aspect to maintaining your health.
It might not be easy, but it might save your life.
“I would want everybody to be focusing on their fitness rather than ‘fatness’ but our increasingly sedentary and aesthetically-minded society doesn’t push us to that,” Dr Parr said.
“The challenge for each individual is to find ways to make exercise or physical activity enjoyable, because for people who don’t enjoy exercise, it’s extremely hard to do it regularly.”
So if you’re still reading, it’s time to get moving. Throw a Frisbee to a friend. Do 10 push-ups every time you accidentally say the F-word. Go for a walk, or a surf … or just stay home, put on your favourite trackies and brush up on those star jumps.
Dr Evelyn Parr’s research focuses on reducing obesity through and nutritional interventions. She is interested in enabling the best prescription of exercise to individuals with a previous history of not exercising.