The serious health risks of obesity are well known; heart disease, stroke, diabetes, joint disease, and gout are just some of the conditions that are strongly associated with obesity. But, over the years, a few studies have suggested that it is possible to have your cake and eat it too, as the expression goes: being fit trumps the increased risk of developing obesity-associated conditions.
This week, the results of a new study on the relationship between obesity and bad outcomes was reported in the NYT (Tuesday, November 6, 2017, p D4). The article was entitled: “Fat but Fit? The Debate Continues,” and was written by Roni Caryn Rabin. The article is well worth your reading, even if you are skinny. The bottom line is that weight matters, although physical fitness may decrease risks somewhat (from about 50% greater risk to about 30%). What I found most interesting is that cardiovascular disease risks were increased in overweight people, even if they did not have a history of traditional risk factors, such as hypertension or lipid abnormalities.
In my opinion, I don’t think we should be spending any more energy debating whether fit and fat is ok, and put our efforts into finding more effective ways to help overweight people trim down. As I have written about in earlier entries, most overweight is caused by a mix of environmental factors and genetics. We can’t do anything much about the genetics, but we can all be more active and cut down on the calories. I think, many physicians take one of two approaches in dealing with patients who are overweight. They either fuss at the patient or are reluctant to address the issue. Neither approach works very well for most patients.