If you want to be fit, you have to be slim. That’s the black and white message most of us have taken on board over the last few years, and it works the other way round too. According to popular opinion, if you’re fat you can’t also be fit, and that’s especially true for men.
It’s fair to say that many scientists now consider that message too simplistic. There are certainly risks associated with excess weight and advantages to being slender, but that’s not the whole truth. Some experts now suggest that fitness can be as important as fatness when it comes to health.
The problem with BMI
The one thing that many men have come to realise is that Body Mass Index (BMI) is not necessarily the last word on weight. Doctors calculate BMI by dividing your weight in kilograms by the square of your height in metres. A BMI of more than 25 is considered overweight, while a figure of 30 plus is obese.
But though BMI might be a useful tool, it has a major drawback. Muscle weighs more than fat, and men carrying a lot of muscle are often portrayed as overweight by the BMI scale. If you work out a lot or train quite intensively, it could be that you are both fat — according to BMI — and perfectly fit and healthy.
Still, if you’re not carrying a lot of muscle and your BMI puts you in the overweight category, you have to be unhealthy, right? Some research suggests the answer is probably yes.
For example, a recent study of men in the city of Uppsala by Swedish researchers found what you might expect, that overweight men were at a significantly higher risk for heart disease than their normal weight peers, regardless of other factors. Being a fat man was unhealthy. Being an obese one was very unhealthy indeed.
“Some researchers have suggested that a heavy person without other risk factors didn’t need to lose weight,” said Johan Arnlov, PhD, the lead Swedish researcher. “Our data does not support this notion.”
But Arnlov’s reference to other research is telling. Other studies seem to suggest that if you exercise regularly and eat quite healthily, carrying a few excess kilos might not do you too much harm. One or two studies have even suggested that it might do you some good.
A 2008 report by the Centers for Disease Control and Prevention (CDC) in America found that overweight people — calculated by BMI — have a higher risk of dying from kidney disease and diabetes than people of normal weight.
But the report also concluded that they have a lower risk of dying from a range of conditions including emphysema, pneumonia and lung disease. In those cases, a few extra kilos seemed to have a protective effect.
And it found that overweight people are no more likely to die from heart disease and cancer than those of normal weight. In other words, the report muddied the waters on weight and health, and it wasn’t the first to do so. Lead researcher Dr Katherine Flegal said that the “the relation of weight to mortality is a complex issue.”
Another researcher put it more directly. “You can’t just say being overweight is unhealthy. Nothing is that simple.”
Put simply, you can be a skinny man who spends all day eating fast food and slobbing out on the sofa, and you can be an overweight man who exercises regularly and eats home-cooked food. In these examples, weight isn’t necessarily an indicator of good or poor health.
And much of the research suggests that if you’re overweight (rather than obese) you should focus on healthy living, rather than shedding kilos. Eating well and exercising could be more important than dieting, even if you never shift that excess weight.
Steven Blair, a professor of exercise science at the University of South Carolina, is one of the foremost experts on weight and health and agrees that overweight people are unhealthier than normal weight people, if they’re unfit. But his research has thrown up another finding. If they’re fit, says Blair, “the harmful effect of fat just disappears.”
Fat and fit?
So can you be fat and fit? Many experts would say that you can, and that being fit means that you cancel out many of the negative health effects of carrying a few excess kilos.
It’s worth noting that there is less of a debate about obesity. If you’re clinically obese, you’re unlikely to be doing enough exercise to also be fit. Even in the CDC study obese people were found to be at greater risk of a whole range of life-threatening conditions.
And that’s one thing men who are fat but fit need to remember. Experts say that it can be easy to slide from ‘overweight’ to ‘obese’ without knowing too much about it, particularly as we get older. You can only be fat and fit if you maintain a steady weight.
But whatever the details of the debate, one thing seems to be certain. Whatever your weight, the more you move your body around the healthier it will be.