Asymmetrical Information

On the other hand, a lot of thin people die young.

Mostly because they get strangled by fat people.

I heard its not the fat you can see that should concern you but the fat you can't see ( stuck to your guts).

More important than the fact that being overweight makes you less likely to exercise is the fact that exercising makes you less likely to be overweight. A decent exercise program can be worth twenty pounds' worth of pure fat *per year* just in direct energy expenditure - not counting metabolic effects and such. With no change whatsoever in diet or other habits, getting a little exercise during your thirties (prime weight-gaining years for most people) can leave you *a lot* lighter than you would otherwise be.

It's really a very simple feedback loop, but many people are on the wrong side of it.

I think a key distinction is "overweight" versus "obese". Overweight usually means a Body Mass Index above 25. Many men exceed this index, especially those who are in good shape (e.g. professional athletes). There is a lot of debate about BMI's in the 25 - 30 range and the results in this article are probably applicable to that range.

I am in my mid-40's now, but I was a competitive powerlifter in my 30's (116 lb weight class - I'm a petite female). The female weight classes run from 97 lbs to 180+. Once you get into the heavier weight classes - 150 lbs or so, you get a type of woman who does tend to have more body fat - large breasts...big bones - despite all the training and dieting. My team mates in the heavier weight classes worked just as hard as anyone else, and dieted just as hard to get into a lower weight class - but they were simply "bigger" women with a higher "normal" percentage of body fat. And fit as hell - I trained with them and so I can testify to this! So it is these women that come to mind whenever I see "fit and fat".

Megan,
Don't you think using BMI as a proxy for "fatness" is the bigger problem here? I weigh 35 pounds more than my fiancee, but we're the same height (5'9"). We're both a little overweight (I'm 185 pounds), but there's no way that I'm 35 pounds more overweight than she is. If I could do one thing for my health it would probably be to run more rather than eat less. "Obese but fit" makes no sense while "Fat but fit" does, given the unreasonable assumption that a BMI of 25 is on the threshold of overweight.

It's a simple formula. More exercise = fitter you. Funny how that is so difficult for most of us (myself included) to follow.

Too much fat in general, and abdominal fat in particular, are linked to far too many bad things for my comfort. Things like increased blood levels of aromatase in men (which probably is tied to BPH and arguably to prostate cancer), increased levels of some lipids tied to circulatory problems, increased incidence of breast cancer in women (and some men), and so forth.

With all the news coming out about calorie restriction & possible CR mimetics, "fit but fat" is, with exceptions such as cited by ALP above, oxymoronic.

BMI is a crock for anyone whose exercise program does not revolve around distance running, has a large frame (e.g. big boned), or is at the margins of height (short or tall). Anyone who lifts a lot of weights will have an excess a lot more muscle, which adversely affects the BMI. As a heavy weightlifter standing 6'4", I fit into all three categories. Even when I was at 8% bodyfat I was still considered overweight by BMI standards at 220 pounds, just because I have a large frame. Look at any NFL defensive lineman, they are at 10-12% bodyfat and weigh at least 260. BMI says they are morbidly obese. Anytime you hear the stats about obesity, remember that they are overstated by at least 5-10% just for these reasons.

Just as a data point, I was perfectly capable of being very obese while walking a half hour on a treadmill most days, and engaging in rather more lifestyle exercise than my thinner family members. (At least judging from what happens to my pedometer readings when I stay with them. No reflection on them-- it just happens that I walk to and from the L when going to work and they mostly by necessity drive, which makes a difference of a couple miles a day overall.) Of course, I ate quite a bit-- that's my natural inclination, addressable only by constant vigilance. (No, the necessary lifestyle changes never become "force of habit", sad to say. It's more like playing a game against an intelligent and wily-- if somewhat predictable-- opponent. :-) ) Not being overweight-- which I've managed for a little more than two years now-- required substantial dietary changes and upping the treadmill to an hour every day. So these sorts of results are of interest to me, since I've been in both places and have no real certainty as to where I'll end up in the long run.

Obviously, for the moment, I'm all for believing that it's worth it for something other than the social benefits of not being fat and the ability to buy clothes in normal sizes. But as it happens, my cholesterol numbers were okay back when my BMI was a lot higher than they are now. And speaking from experience of both situations, it's a lot easier to become more active than it is to lose a substantial amount of weight. So if the more important variable is activity level and overall fitness rather than weight per se, that's probably an important thing to know. A lot more people can manage adding a regular brisk walk and/or some weight-bearing exercise to their day better than can manage a total lifestyle revamp. (And sustain it. Two years is early days.) Most obese people may be sedentary, but that's not the same as saying that most obese people would cease to be obese by becoming active.

It might also be useful for others to know, so that the overweight exercisers aren't inadvertently convinced that the effort was futile when it doesn't make them thin. There's plenty of social approval out there for weight loss, however it's managed-- reasonable diet, unbalanced fad, surgery, anorexia, no one really cares unless the person winds up in the emergency room. Not so much for merely exercising while obese. (No one knows or especially cares that you'd be twenty pounds heavier if you didn't do it-- they just know that you're fat.)

Hammer - I agree with you that BMI is a flawed measure, and that Body Fat % is a better way to determine "obesity". (At one point in my life, when I knew my body fat level, I calculated that I would approach obesity even if I achieved 0% body fat.) That said, I find it hard to believe that BMI overstates obesity in populations by as much as you describe. Yes, big and muscular people will exceed it, but dragging using NFL players (extreme outliers if ever there was such a thing) hardly makes the case. Just like with APL's example of the fit women with high body fat, the high BMI with low body fat is too rare across large populations to really matter.

I just wrote a post entitled, about the lack of real evidence that overall obesity is getting worse, and about how my eyeball (and a stat or two) in fact says obesity is decreasing with more recent generations Some Intolerance of Obesity Intolerance.

Interesting...In the last six months or so I have both gained six pounds and roughly tripled my exercise level. The reason? I moved to a city (Taipei) where there are both much more food temptation and more ways for me to be active (I walk, bike, and go to the gym). So am I healthier or less healthy than I was before?

I think the takeaway message I got from campo's article is not that we can all be fatties but that we should not buy into the conflation of thinness=beauty=health. A lot of enormously harmful behavior results from the desire to be extremely thin, and unrealistic standards probably cause a lot of people to give up in despair even though a little more exercise/lower body fat ratio could do wonders for their health and longevity.

As for me, my new year's resolution is indeed to lose weight, not for health reasons, but because i'm a vain, vain, vain person.

1) Borrow and read Nature, 14 December 2006. There is a special collection of scientific articles on Obesity and Diabetes. My summary is:

We've found all these chemical relationships; fat cells are different than muscle cells; and visceral fat is different from subcutaneous fat is different from intra-muscular fat. Some of the chemical relationships indicate fat cells become clearly harmful at a transition point related somehow to obesity. Many others discoveries need more study, but look like they may be part of a harmful chemical cycle. Send money.

2) What do you mean by fit? Most of the public press focuses on the BMI. It has never been more than a proxy for body fat percentage. Since body fat percentage is hard to measure and correlates well with the easily measured BMI, the public is fed BMI. Many of your "fat but fit" have high BMI and low body fat. If it ends up that you need to separate visceral fat percentage from subcutaneous fat percentage the "hard to measure" effect will be even greater. You may have noticed doctors are now measuring and tracking waist measurements. That seems to be the best low cost measurement to indicate visceral fat percentage, (when combined with height, weight, and fat fold measurement).

If you're a man, there's a very simple, ultra-low-tech way of determining whether your weight is putting you at risk of health problems. There's no need to calculate BMI or body fat percentage or anything. Simply stand up reasonably straight and look down. If you cannot see your toes, your health is in danger no matter how "fit" you consider yourself to bem

Actually one of the comments on that article is far better than the article itself. I regularly post over at TNR (brian@xao.com) Anyway give the comments a read.

http://www.tnr.com/doc_posts.mhtml?i=20030113&s=campos011303

John Kay, you must live in a very different part of the world than I do. My eyes tell me that the percentage of children and young adults who can only be described as "fat" is much higher than 30 or even 20 years ago.

As The Wall Street Journal pointed out last July, taking the BMI charts seriously requires concluding that Brad Pitt, George Clooney, and Michael Jordan are all "overweight," and that Sylvester Stallone and baseball star Sammy Sosa are "obese." According to my calculations, fully three-quarters of National Football League running backs--speedy, chiseled athletes, all of whom, it's safe to say, could beat the world's fastest obesity researcher by a wide margin in a 100-yard dash--are "obese."

I continue to be amazed at how often this sort of point is made.

1) There's this notion that athletes and celebrities (at least who aren't famous for being fat) must necessarily not be overweight. Sylvester Stallone, Sammy Sosa and many pro athletes are, in fact, chubby and even Brad Pitt is a bit pudgy.

2) Obviously a simple statistic isn't going to apply to physical outliers, and certainly not to people who spend hours in the weight room every day. That BMI isn't useful for NFL running backs (many of whom do, again, have a spare tire) hardly means that it's not a useful metric for how the overall population shapes up.

(In fairness, I should note that Campos weakly makes the second point himself...)

Also, regarding the paragraph "Obesity research in the United States is almost wholly funded by the weight-loss industry...."

1) This may well be true, but he doesn't provide a single fact to support it.

2) Using NIH funding statistics from 1995 is obviously flawed, especially since both NIH and applicants tends to move projects between categories as public priorities shift.

3) Whenever people like the quoted Laura Fraser talk about the influence of advertisers on scientific journals, it's usually a clear sign of cluelessness. (Research journals typically have 2-4 pages of ads, and medical journals a few more in hundreds of pages per issue. They're not subject to advertising pressure the way Vogue is. Anyway, no one reads journals on paper any more.)

Several people who suffer from weight related illnesses (heart disease, high blood pressure, type II diabetes to name a few) have lectured me on the inaccuracy of BMI, when obviously trying to justify their own high BMI. This tells me they don't understand the BMI.

BMI is not intended to be a measure of some elusive level of "fitness".

A BMI score in the overweight range ONLY indicates an elevated risk of suffering from a weight related illness.

A BMI score in the obese range only indicates an even more elevated risk of suffering from a weight related illness.

It's not an absolute. It's possible to have a normal BMI and suffer from a weight related illness or be obese and never suffer from one. The BMI only indicates risk level. It's like saying a smoker has an elevated risk of lung cancer. But, we all know non-smokers with lung cancer and smokers that live to 103.

Additionally, BMI researchers do say that body builders do not necessarily fit into their model. In other words, weight gain from higher muscle mass does not necessarily translate to elevated risk of suffering from a weight-related illness.

But, I also know people who think they are body builders who aren't and thus get a pass on BMI. Sorry.

It's tough to tell the people with the weight-related illnesses that BMI does apply to them, as evidenced by the fact that they are suffering from the very ailments the BMI predicted that they might.

NFL players are constantly trotted out as examples of why BMI is a meaningless standard when applied to muscular athletic people. Keep in mind, however, that they are not typical of all athletes and therefore may not provide much of a lesson when it comes to the usefulness (or lack thereof) of BMI.
Football differs from many sports in that it places great emphasis on size and power, but relatively little emphasis on endurance. According to people who've timed games with stopwatches, the average NFL game involves only about 12 minutes of actual, ball-in-play action. That translates into no more than six minutes of action for each player, spread out over three hours. As a result, I'd caution against drawing too many conclusions from the size of NFL players.

The problem with just using body fat % is that there is some basic truth to the fact that being heavier - whether by fat or muscle, requires more effort by all of your sub-systems.

More blood to pump, more cells with a 1 in whatever chance to develop cancer, more food to intake (which includes harmful elements, potentially), etc.

I'm not sure that the life expectancy for people who are 6'4" and 260lbs is very good, even if they have 8% body fat. Sometimes our cultural stereotypes about what is "healthy" (like a football player) can be as out of whack as our stereotypes about what is unhealthy, from a longevity standpoint.

Adam

Ellipsis, I don't want to hijack this thread for this argument. I will confine myself to noting these stats, suggest you read the post, and note that comments are open in my post. Feel free to lengthen them!

John Kay, I live pretty far away from Rhode Island, in an area where Type II diabetes is so common among pre-teens that at least one medical school is considering creating a special research center solely to investigate that issue. Maybe it's a different sub-set of the human genotype, or maybe it's culture, but I don't think Rhode Island's stats are going to apply down here.

Well, ellipsis, if you'll read the actual post and thread, in fact that's already been addressed in the thread, with CDC nationwide stats. I'm not responding to you any more on this thread.

Peter @ 3:16,
Off topic. The actual football game in and of itself may or may not be more than 6 mins. of action. But,the hours and hours of practice are very tough. I think most people underestimate the physical fitness of football players. I ran a Marathon in April of 2006, and realized afterwards that I did not feel any worse than after the average 2 per day "summer camp" practices we enjoyed as high school football players. Essentially, the "2 a days" were 3 hour ordeals of constant physical exertion (twice a day). That was 17 years ago, but the fitness level stayed. I'm obese by any rational standard: 5'6 and 180 lbs.

The author's name is Paul Campos, not Peter

Moreover, active people are overwhelmingly not fat.

If you had to do all your daily activities with a 13-year-old girl strapped to your back, I imagine you'd move less too.

Actually, that's not a bad idea. I can tell you that if I had that affliction, I would be running all day long in order to try and escape the alternate terrors of immature giggling and prissy whining. Sort of like hanging a carrot in front of a mule, but with the effect of driving instead of leading.

Moreover, active people are overwhelmingly not fat.

Is there a cite for this? For all I know, it may be true, but I'd like to see the data (and the definition of "active" being used).

"That BMI isn't useful for NFL running backs (many of whom do, again, have a spare tire) hardly means that it's not a useful metric for how the overall population shapes up."

Name 5, no, even one NFL running back who has a spare tire. Not fullback or H-back, but running back. Have you seen NFL running backs lately?

I've always assumed that those "obese athletes" usually go onto obsene diets to keep their weight up.

Sorry no cite, just a hunch.

My scale measures body fat. It asks whether one is an athlete or not when making the computation. The booklet defines athlete as 'working out 10 hours a week.' When I bought the scale I thought, no problem, 10 hours sounds like nothing. Yet at my most intense workout weeks (15 miles of swimming per week), I never hit 10 hours. Never. I was never athlete-quality.

I think the BMI exceptionalism should follw that same rule - if you work out 10 hours a week then you can be excused from the 25 and 30 level cutoff points. Which is the case for athletes and hunky actors. They really do work out 10+ hours a week. It's their job.

Everyone else is fooling themselves (that extra jolt of testosterone really does make people think they are incredible hulks).

Some anecdotal evidence.

There is no question in my mind that the BMI is flawed. For example, I read several years ago that Michael Jordan was fat based on his BMI. How the world's greatest basketball player would be considered fat is beyond my comprehension. His higher percentage of muscle, which is heavier than fat, no doubt contributes to his high BMI.

I've never read of the effects that weightlifting has on the BMI. The development of large (and heavy) muscles has to skew any simple relationship of height and weight, which is what the BMI essentially is.

I have read that a better indicator is the ratio of waist to hip size. The smaller the ratio, the better. Below .92 is pretty good.

I'm afraid I didn't read the original article as I'm not registered for TNR, but I just read a different article that may shed some light on the idea of whether one can be fit and fat at the same time.

"XXL", but Janet Robertson of the Miami Herald (available here http://www.keepmedia.com/pubs/MiamiHerald/2005/12/27/1125205 and also included in "The Best American Sports Writing: 2006") is about super-sized football players, many of whom can bench 300-plus lbs and run 40 yards in under 5 seconds. They are fit in that sense.

But they also develop weight-related problems in mid-life. Some problems, like joint and spinal injuries, are doubtless related to the violence of the sport. But they also have much higher incidences of sleep apnea and heart disease.

But they also develop weight-related problems in mid-life.

Do they stay active in mid-life? I'd think that between the absence of training and the accumulation of injuries, retired football players would tend towards greatly reduced activity compared with their professional years, but how about just compared to people who aren't ex-athletes? The sorts of athleticism that are hard on the body may not be good for health in the long term, if they interfere with staying active in later life while at the same time getting one used to eating to support a football player's mass or a marathon runner's energy expenditures.

That's one reason that I'm suspicious of the casual association of "athletic" with "healthy". Activity is pretty clearly beneficial in reasonable amounts, but as with anything the dose makes the poison. No one's going to be keeping their cardiovascular health up at 65 by doing Olympic-style gymnastics or playing tackle football, and someone who ruins their knees or their hips in a high-impact sport is going to be more limited in their options when they really need them. The long term impact on health isn't necessarily clear or one-way. That said, I don't know if anyone's done a study of older ex-athletes to see how their activity level in later life compares with the general population. (If nothing else, they're a population that likes physical activity more than most of us do.)

I let myself get fat this winter, stopped going to yoga and excersizing, kept eatin and drinking. I think I've actually crossed over from overweight to obese. I'm 5'8" and 190. [While I'm starting to look fat, I definitely don't look obese.] Anyway, I've noticed that my chronic pain problems got much worse.

Also, when I was just 5lbs ligher than now, but skinnny, I eventually decided that I need to switch to more aerobic exercise because I didn't think the weight was good for my frame. I get knee pain from running when down to 160 and I didn't even want to consider it at 185. Even "healthy weight" was causing some problems/discomfort for me.

Oh. Also, the pain and discomfort generally made me less active.

[This winter, I still did the same tasks, but didn't do them with as much energy and my posture would get lazy. I'm pretty sure that even though I was accomplishing the same task/work, I wasn't performing as well. My posture was bad and I'm pretty sure that I wasn't using as much energy to do the same things as when I was skinny.]

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