This week’s story comes from Tara Parker-Pope’s Well blog in the Health section of The New York Times. It originally ran online August 18th…

Better to Be Fat and Fit Than Skinny and Unfit

I appreciated this article greatly, especially in light of last week’s AP story on Patrick Deuel that focused mainly on the perceptions of fat as unfit. This isn’t to say that I necessarily agree with it, but I appreciate the varying perspectives presented.

Ms. Parker-Pope poses a question all of us have surely asked ourselves, “… is a person’s weight really a reliable indicator of overall health?”

If we’ve asked ourselves that question enough, most of us have probably answered in the negative…weight is not necessarily the most reliable indicator of overall health…but I believe it’s an indicator nevertheless. I have a couple of friends who are larger than I am, and are in better health so to say. One friend in particular (let’s call him Freddy) weighs in at about 380, does not exercise regularly, and to my knowledge does not have high blood pressure or cholesterol problems. I, on the other hand, last weighed at 346, am on medication for high blood pressure, and received an e-mail from my doctor last week to “renew [my] mission to get in better shape.”  He’s a great doctor, but I hope he realizes that’s exactly what I’ve been trying to do. Perhaps he hasn’t noticed my weight loss as much as I would have hoped.

But that’s just it.  I’ve dropped some pounds, and yet I’m clearly still at risk. My “comorbidities” have definitely manifested themselves in one form or another. The one thing that I think I can attribute to weight-loss and exercise is that my cholestorol has gone down considerably, and I no longer have to take medication for that.

Last week, my wife told me that weight-loss is not an exact science. I believe she’s right. No two people are the same. Parker-Pope’s story uses a lot of statistical information, and also points out that some of the data used in studies sparked the ire of many readers and bloggers. If I look at it statistically, I can’t help but think that the error term–the “unobservables” that somehow may or may not factor into our weight–is always too great to ever provide a definitive, uniform method of weight-loss.

Or, you could be like me, who after having tried every diet from here to the moon lives by the mantra “Eat better, move more.”  Some people might phrase that “eat less, move more,” but we all know that less is not always best.

Later on in her post, Parker-Pope noted a study in the Journal of the American Medical Association that found that “fitness level, regardless of body mass index, was the strongest predictor of mortality risk.”  Of the test used for fitness, she wrote:

During the test, the treadmill moved at a brisk walking pace as the grade increased each minute. In the study, it didn’t take much to qualify as fit. For men, it meant staying on the treadmill at least 8 minutes; for women, 5.5 minutes. The people who fell below those levels, whether fat or thin, were at highest risk.

The results were adjusted to control for age, smoking and underlying heart problems and still showed that fitness, not weight, was most important in predicting mortality risk.

OK, then…so, last week I discovered I can run 20 minutes straight now. Does that mean I’m fat and fit?

And, may I just point out that these “underlying heart problems” were never specified. In my opinion, there are probably myriad threats to the validity of this study.

It’s not the most inconceivable thing to be overweight (and for all purposes intended in the article, obese) and be somewhat fit. But the vast majority of people who struggle like I do…they definitely don’t make the case.

Your thoughts?

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