Fit but Fat: Fact or Fiction?

The fit but fat concept posits that you can compensate or attenuate the cardiovascular, metabolic, and mortality risk associated with obesity by improving your cardiovascular fitness.  Though there’s no general consensus about the fit but fat concept among scientists and physicians, it’s an area that has stirred debate and ongoing research.

We’ve all been hearing constant chatter from news sources about the rising obesity epidemic.  To clarify, there’s no question that those who are obese do benefit their health from improving their cardiovascular fitness in terms of reducing these risk factors, but can you actually be fit AND fat?

First off, I would like to point out the obvious fact that we as human beings come in all different shapes and sizes.  And let’s be honest here, we’re all sensitive about our weight.  I can look in the mirror and think that I’d like to lose a few pounds, but that’s vastly different from someone telling me that I need to.  Say what?

Can people be fit but fat? Obesity research...

Fit but Fat?

The fit but fat concept seems to have its origins in a study published in 1999 in the American Journal of Clinical Nutrition.  The observational study followed a cohort of nearly 22,000 men for a duration of 8 years.  The authors concluded that the health benefits of leanness were limited to fit men.  What’s more is that the study found that fit men with large waist girths (> or= 99 cm) had a lower risk of all-cause mortality than unfit men with low waist girths (<87 cm).

Score one point for the fit but fat movement…  Not too fast though!  This study was criticized for being limited in 2004 in a study published in the New England Journal of Medicine.  What’s more is that obesity itself has been associated with an increased risk for a number of health conditions ranging from cardiovascular disease, diabetes, certain types of cancer to arthritis.

One important distinction that should be made is between obesity and merely being overweight.  Obesity is defined as having a body mass index greater than 30.  For those that are merely overweight, they can breathe a sigh of relief as no associated between being simply overweight and an increased risk of mortality has been found in studies.  [1,2].

One limitation in studies of this nature though is that in using BMI, they’re unable to discriminate between those who have larger amounts of lean muscle mass.  In fact, a recent study published in the Archives of Internal Medicine found an association between abdominal obesity and all-cause mortality in a large U.S. cohort.

What Proportion of the US Population is ‘Fit but Fat?’

One study estimates that the proportion of the US population that meets the criteria of ‘fit and fat’ is approximately 8.9%.  The same study found that being obese is associated with a 9.2% lower V02 max (measure of cardiovascular fitness) compared to normal weight.

Weight Loss vs. Exercise for Lowering Inflammation?

In a very recently published study (Obesity), the authors compared the effects of diet and exercise (both resistance training and cardiovascular) on markers of inflammation.  Surprisingly, the authors found that weight loss itself was more effective than exercise on reducing markers of inflammation:

“In conclusion, weight loss was associated with decreases in MOI (markers of inflammation). The effect of weight loss appeared to be mediated by changes in total fat mass or IAAT (intra-abdominal adipose tissue). Addition of exercise did not alter the response, suggesting that weight loss has a more profound impact for reducing MOI in overweight women than exercise.”

In a Nutshell:

Though the debate over being fit but fat is far from over, the research in this area points to a few simple conclusions.  First, for those that are obese, there are numerous health benefits associated with exercise and improving their cardiovascular fitness.  Yes, it’s better to be fit and fat, than unfit and fat.

Secondly, the research indicates that it’s far healthier to be lean and fit than fit and fat.  Losing weight can play a role in reducing markers of inflammation that confer disease risk.

However, for those who are unable to lose weight, it’s important to not only get or stay fit, but still find a way to love yourself regardless of your size or shape.

8 thoughts on “Fit but Fat: Fact or Fiction?

  • February 19, 2013 at 8:24 am

    Personally I am overweight and since I have been exercising I have more cardio that some thin people and I am sick less often. I recently was going overboard with exercise and had to get an EKG and also a treadmill stress test. The cardiologist’s nurse told me that it would last two minutes and was surprised that I was able to last the whole test even while running. My doctor later called me and told me that he was very surprised at my level of cardio and blood pressure during vigorous exercise. I have always been able to outwalk and out hike skinnier people. BUT in the long run I know that eventually I will have problems so I am working hard to lose weight.

  • July 8, 2012 at 10:02 am

    From someone who has always had a weight issue the word “fat” is offending. I know it looks great with the whole fat and fit thing, but I was hoping to share this with some who are struggling with weight issues, but will not due to the word fat. I am sure you did not mean to offend anyone, but for future use you may want to consider another word, thanks for the blog.
    Another individual mentioned the thin, but not fit topic, maybe that could come next.

  • January 12, 2011 at 7:56 am

    I notice this article doesn’t address the “thin but not fit” issue. Thin does not automatically equal fit. One can be of a “normal” weight and have an abysmal level of fitness. Bottom line, regardless of body size, it’s important that exercise be part of everyone’s daily routine.

  • January 6, 2011 at 9:22 pm

    I agree to the post .. It’s possible to be fat and fit at the same time. I got cousin’s that are fat but move more active than the thin one. You really can’t assure if that person is in good fit depending on the size.Thumbs up to this.

  • January 3, 2011 at 3:31 pm

    I’m looking forward to more studies being done on the differences between fit & fat and thin & fat. It would seem obvious the second is preferable, no matter what the fat acceptance people want to believe, but from what I see around me being fit even if obese is possible.

  • January 3, 2011 at 7:24 am

    Glad to see your blog post taking a look at the issue. The whole question of “fat vs thin” seems to rather miss the point, though. People will live more enjoyable lives if they get up and do some fun exercises. Fat… thin.. it doesn’t matter. Sedentary lives fueled by processed food are painful.

    On a second note, why does anyone need permission from any authority to be fat or thin? They don’t. And they especially don’t need moralizing from thin people, even in the guise of health advice. Note that I’m not accusing you of moralizing. I’ve just seen it happen.

    In the end, it’s better for individuals and for society if we live in a place where great food and pleasurable exercise are encouraged and supported. Let’s work towards that together.

    • January 5, 2011 at 5:28 am

      Jason, I realize that there are few issues as sensitive to us as our own waistlines or right to make individual choices. On that note, we simply try to provide accurate health information here to help people make more informed decisions about their diet and health.


Leave a Reply

Your email address will not be published. Required fields are marked *