If someone works out several times a week, including cardio, strength training, lifting weights, etc., you would probably say they are in shape and healthy if you were asked. But what if that same person is also considered obese by medical standards and the BMI scale? Are they healthy?
This idea of being “fat but fit” has been debated for years, and viewpoints have differed and also changed. If someone exercises regularly, it makes sense to think they are in good shape, but does physical activity make up for the health risks that are associated with carrying excess fat?
Today we are going to look at the feasibility of being fat and healthy. We will talk about the standard measurement used to determine if a person is at a healthy weight, overweight, or obese, point out some flaws with this method, and look at some more accurate alternatives. We will also look at the fat but fit debate and discuss what the latest research says about being overweight or obese while still being physically active and how it relates to your health.
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How The Medical Community Quickly Categorizes Health
The BMI scale (body mass index) is a tool that is used to categorize individuals as underweight, normal weight, overweight, or obese based on height and weight. It is important to understand that this scale was developed in the late 1800s by a mathematician with no medical background, and the calculations were all based on Caucasian men.
BMI does not account for muscle mass, bone density, or fat distribution, nor does the scale consider differences in gender, ethnicity, or body composition. This leaves fairly big margins for error when placing people into categories. For example, a muscular athlete might have a high BMI, placing them in an overweight or obese category even though they may have very little body fat. Muscle weighs more than body fat, so the BMI of athletes is often miscalculated, and other methods are needed to get an accurate measurement. Another example is that Black women naturally have a higher concentration of body fat that is distributed much differently than an Asian woman, which can lead to misclassifications when using BMI alone.
Alternatives To BMI
BMI only looks at height and weight, and we have already discussed some of its shortcomings. There are better tools for measuring body fat that can provide a better overview of someone’s health, which include:
- Measuring your waist circumference can roughly assess potential abdominal fat, which is a risk factor for many health conditions.
- Computing your waist-to-height ratio by measuring your waist (usually just above your belly button) and dividing that number by your height. If the result is above 0.5, you may be at a higher risk of developing serious health conditions.
- Measuring fat with calipers, which is a tool that is used to pinch the skin in certain spots to measure the thickness of the fat underneath. A trained person can estimate body fat percentage based on these readings.
- Using a BIA scale (bioelectrical impedance analysis), which uses a small electrical current to estimate fat, muscle, and water in your body.
- DEXA scan, which is a highly accurate scan that breaks down fat, muscle, and bone density.
- Hydrostatic weighing (water displacement) which involves sitting on a special scale while fully submerged in water. Since fat is less dense than muscle and bone, it floats, and the amount of water you displace helps estimate your body fat percentage. It is considered the gold standard for assessing body fat percentage because it is very accurate, but it is not easy to access.
Other Tests To Determine Health
With the limitations of using the BMI scale, experts usually rely on other methods when assessing a patient’s health. Blood tests can be used to evaluate many health markers, including:
Cholesterol Levels
This would include total cholesterol, LDL (bad), HDL (good), and triglycerides. These numbers can provide some insight into the condition of your heart.
Blood Sugar (Glucose)
This reveals how your body handles sugar and can highlight your risk for diabetes or insulin resistance.
Hemoglobin A1c
This measures your average blood sugar over the past 2–3 months to indicate normal levels, prediabetes, and diabetes.
Inflammation Markers
It can identify CRP (C-reactive protein) and can show if there is inflammation in the body, which is often linked to heart disease or obesity.
Liver Enzymes
Helps detect fatty liver disease, which people with excess weight are more at risk to experience.
Thyroid Hormones
Can identify issues like a slow thyroid, which might be affecting your metabolism or weight control.
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Are There Obese People Who Are Healthy?
Some of the people who are classified as obese by BMI standards but who do not experience typical obesity-related health issues have a condition known as Metabolically Healthy Obesity (MHO). Individuals with MHO have normal blood pressure, cholesterol, and blood sugar levels despite having a higher BMI. So, are these people obese and healthy, or is their reduced risk just temporary?
Research has determined that MHO may not be a permanent state and is usually only a temporary situation. A multi-ethnic study published by JAMA (Journal of the American Medical Association) found that around half of individuals with MHO eventually developed metabolic health problems like high blood pressure, cardiovascular disease, and diabetes.
Being Active Is Not Always Enough
Just because someone with obesity works out regularly and feels fine does not mean their health is in the clear, and truthfully, they may be living with a false sense of security. They might be lucky for now and not showing signs of high blood pressure, high blood sugar, or other issues, but if they do not form healthy lifestyle habits and lose some weight, their luck will probably run out.
Being active and getting an adequate amount of exercise is very important and should be included as a routine part of a healthy lifestyle, but it does not erase the risks that come from carrying too much body fat. Regular exercise improves your cardiovascular health and helps provide your body with better insulin sensitivity and reduced inflammation.
Long-term obesity puts extra stress on the body, and metabolic conditions can begin to develop gradually, which is why it is so important to reach a healthy weight. You may feel fine now, but you need to be proactive to protect your health in the future.
Start Your Journey To Protect Your Future Health Now!
If you are living with an unhealthy weight, you are at greater risk of developing metabolic conditions that can affect your quality of life and even your lifespan. Let Dr. Steven Batash at Batash Endoscopic Weight Loss Center in New York City help you reach and maintain a healthy weight.
He and his team are experts in weight management and have been helping individuals from all over the world overcome the challenges they have had in the past with achieving sustainable weight loss. You may have an underlying condition, or your body may be working against you, making it impossible for you to lose weight with just diet and exercise alone.
It is possible to be overweight and healthy temporarily, but the longer you carry that extra body fat, the more it can increase your risk of developing chronic metabolic diseases, heart issues, and stroke. You may be a good candidate for a non-surgical weight loss procedure, or prescription weight loss medication may be an effective solution to help you reach your goals. The team at Batash Endoscopic Weight Loss Center will create a plan that will target your needs and work with your circumstances as well as provide the guidance you need to successfully navigate your weight loss journey. Set up your consultation today and get started on the path to better health.
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