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Focus on Fitness, Not Fatness

Critics and experts challenge the goal of thinness as unrealistic and unnecessary; they say fitness is better for health in the long run.

Focus on Fitness continued...

"I've never said we should just ignore overweight and obesity," Blair tells WebMD. "But I do think the health hazards of the so-called obesity epidemic are overstated. That diverts attention from a bigger public health problem: declining levels of activity and fitness."

Stanford University's William L. Haskell, PhD, leads a large study of physical fitness, obesity, and heart disease. He's an expert in exercise, health, and healthy aging.

"It is very important that despite being overweight, physical activity has a lot of health benefits," Haskell tells WebMD. "The idea that's out there is if you are not losing weight, you are not getting a benefit from exercise. People think is the case but it really is not."

More Fit Doesn't Mean More Fat

It may actually be healthy for an overweight person to gain some weight - if the new weight comes as muscle and not fat. Los Angeles psychologist Keith Valone, PhD, PsyD, helps a number of patients in the entertainment industry with issues such as exercise, weight loss, and body image.

"The first thing I do is tell patients to stop focusing on weight loss and to focus on changing their body composition," Valone tells WebMD. "Weight loss really is the wrong goal. The real issue is to reduce percentage of body fat and, parenthetically for most, to increase percentage of muscle mass. Actual weight may increase, but body composition must change. And that comes from changing one's diet and altering one's exercise patterns."

Getting active is only half of the equation. Diet -- as in healthy eating -- is just as important.

"The idea that maybe overweight individuals should focus on activity and not weight loss is probably not a bad idea for a number of people," Haskell says. "But the problem is, we can always eat a lot more calories than we can burn."

Changing to a healthy diet means cutting back on high-fat food and on starchy carbs. It means eating a balanced diet that includes protein, whole grains, vegetables, fruit, fiber, and, yes, some healthy fats. People who do this, and who get moderate exercise, can lose body fat and gain lean muscle.

"The studies suggest that if a 300-pound person drops 30 pounds, that person will have substantial reduction in several risk factors," the CDC's Gregg says. "And also that person will probably see an improvement in physical function and musculoskeletal problems and reduce his or her risk of osteoarthritis. And there would be a whole effect on health-related quality of life that is independent of these risk factors."

America Has an Eating Disorder

People with eating disorders have a distorted body image. They think they are fat even though they are dangerously thin. They are disgusted by fat. They exercise not for health, but to burn away calories. They weigh themselves not to check on their health, but to see how much weight they have lost. They starve themselves on crash diets until their brains rebel, forcing them to binge. The guilt makes them even harder on themselves.

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