Better to Get Fit or Lose Weight?
Both achieved with physical activity, expert notes
WebMD News Archive
Sept. 7, 2004 -- No matter what size you are, your risk of heart disease is
lower if you're fit.
That's the news from a U.S. study of middle-aged women who already have some
sign of heart disease. The report appears in the Sept. 8 issue of The
Journal of the American Medical Association (JAMA).
"These results suggest that fitness may be more important than
overweight or obesity for [heart] risk in women," conclude study leader
Timothy R. Wessel, MD, of the University of Florida, Gainesville, and
But heart disease isn't the only health problem linked to being overweight
or obese. Another new JAMA study shows that among otherwise healthy
women, obese women have a ninefold greater chance of developing type 2
diabetes. Overweight women have more than a threefold higher risk of type 2
diabetes than normal-weight women.
Being fit helped lower diabetes risk. But not as much as being overweight
increased it. The study used body mass index -- BMI, a measure of weight
relative to height -- to determine "normal" weight levels. If your BMI
is 25 to 29, you're considered overweight. If your BMI is 30 or more, you're
"We observed a modest reduction in the risk of diabetes with increasing
physical activity level, compared with a large increase in the risk with
increasing BMI," conclude study leader Amy R. Weinstein MD, MPH, of
Boston's Beth Israel Deaconess Medical Center, and colleagues. "These
findings underscore the critical importance of [body fat] as a determinant of
type 2 diabetes."
Fitness vs. Fatness
So what's more important, fitness or fatness? For type 2 diabetes, there
seems to be something special about extra body fat, especially abdominal fat.
People who have or are at high risk for type 2 diabetes need to keep their
weight as close to normal as possible.
But a focus merely on weight ignores the many benefits of fitness, argues a
JAMA editorial by Steven N. Blair, PED, president and CEO of the
Cooper Institute in Dallas.
Blair scolds doctors and policymakers involved in the ongoing debate over
which is more important, fitness or fatness. There's no doubt that fitness is
extremely important. And there's no doubt that successful weight loss means
becoming more physically active.