Can one be ‘fit and fat’ or is it a myth?

PHOTO: Madness & Reality

Not too long ago, I went out to dinner with a few friends and one of my friends went on to order two Shawarmas, one chicken and one beef. Now this friend of mine is not particularly slim, in fact she weighs over 150KG so she has a lot of excess weight on her. I tried to keep mum until she decided to order some French fries along with it and a bottle of carbonated drink! At that point, the health professional in me kicked in and I shouted, “Ah! for how many people?” She explained that she had not eaten anything since breakfast and she was really hungry. I told her I was afraid for her future health and she responded saying she is actually very fit, spends two hours in the gym every other day and walks the treadmill for an hour or more.

This friend went on to say that her last doctor visit returned normal lab test results and we engaged in a debate for a while. She managed to convince a few of our friends as well that she was simply a healthy person with a huge appetite. This made me wonder if one can be overweight and healthy.

The term ‘obesity’ is used to describe a health condition in which a person has excessive body weight or body fat. Overweight is essentially the same thing but not as severe as obese. So, in basic terms, obesity is used to describe people that are very fat. Is it possible to be ‘fat and fit’ or ‘fat and healthy’? I am sure that you know a few overweight people that have been exercising for years, but year after year, they still remain fat. What about overweight athletes that train extensively and partake in sports such as javelin, American football, Shot-Put etc Are they unfit or unhealthy?

As a doctor, I can tell you that it is very common to see patients that are obese but still have normal blood pressure, blood sugar and cholesterol levels. These people are called ‘metabolically healthy obese people’, and are otherwise healthy except for the fact that they are obese. The danger with this is, you may feel ‘healthy’ right now but may not stay healthy. Carrying a lot of extra weight can affect your heart and other body systems in the long run even if you don’t have any other risk factors such as hypertension, diabetes, hypercholesterolemia etc. Being overweight or obese in itself is a risk factor, and that alone increases your chances of developing Heart disease and Strokes – which is one of the most common causes of death. So yes, fat people may be healthy right now but if they don’t get rid of the excess weight, ten years down the line, they may not be that lucky.

A 20-year study of 3.5 million obese people was done by the University of Birmingham, UK. The study showed that about half of these obese people went on to have one ailment or the other. A similar study was conducted by scientists over a 12-year-period on over 520,000 people in 10 different countries to analyse health status and body mass index (BMI). The conclusions were as follows:

*Being overweight or obese with 3 or more risk factors present, more than doubles the chance of getting a heart disease, than in normal weight individuals that don’t have same risk factors.

*People that are overweight have a 26% increased risk of developing a heart disease even without having any risk factors. This just goes to show that having that excessive weight in itself is a risk factor for ill health, if not now then, in the long term.

This is not to say that all skinny people are healthy and have no chance of getting an ailment later in life. There are, in fact, some skinny people who don’t exercise and have bad habits that would otherwise make them unhealthy. Proper diet and regular exercise is always necessary regardless if a person is slim or fat. A body that exercises regularly is generally healthy for the most part. This is because muscles are the largest consumers of sugar in the body. Hence if you exercise regularly, you will have increased muscle mass and this means less sugar accumulation in the blood which essentially means the chances of developing diabetes will be very low. Also, regular exercise reduces inflammation in the cardiovascular system and allows improved blood flow to muscles and organs and prevents the formation of blood clots which may damage the heart.

Exercise stimulates the secretion of a hormone known as Irisin from the muscle. Irisin transforms ‘white fat’ to ‘brown fat’ which are metabolically active and actually burn calories. Regular exercise and healthy nutrition helps to reduce the amount of fat especially in the abdomen. This excessive abdominal fat is the most important because it directly correlates to heart disease and increased mortality risk.

This term ‘fat but fit’ has been a controversial one for a long time now, and I think people just lose the point. The goal is not to be skinny like Angelina Jolie or have a stick-thin model figure, and the goal is not to fat-shame people that are overweight either. Rather, the goal should be to promote healthy nutrition and regular exercise in all individuals.


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BMIFit and fat

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