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Focus On Fitness, Not Fatness

Subtitle: Pete Edwards, Thrive Health Management Ltd.
Excerpt: The surprising reasons why fitness is more important for your health than weight or body fat.

I get it, many of you reading this want to get lean and show off the new bod’ on a beach somewhere this summer. There’s nothing wrong with that. But underneath the shameless vanity of your upcoming holiday body goal, I bet there is a real desire to be healthy driving at least part of your quest for abs. If that is the case, please absorb this message: It is far more important for health to be fit than it is to be lean. As measured by lifespan, health-span, vitality, injury risk, all cause mortality or mental health, being fit and getting fitter has a deeper, more meaningful impact than weight. Our focus should be on fitness not fatness. Allow me to explain. 

Many studies demonstrate the relationship between being overweight and numerous ill health outcomes, from cancer, to diabetes, to heart disease. The limitation of these studies is that they use BMI, or body mass index, to stratify people, and this has a huge flaw. To measure a persons BMI all you need is height and weight. Two easily acquired metrics that are low cost, non invasive, and often part of existing medical records. These strengths allow BMI to be used in very large sample size studies (tens of thousands of people) easily and cheaply. Not hard to tell why researchers readily use it. But there is one glaring limitation of this metric; it homogenises mass. 

What I mean by that is that it assumes all mass above an average for your height is fat, no accounting for muscle. At my height, for example, the average weight is 75kg, but I am closer to 85. BMI would assume 100% of that nearly 10kg is fat. But at lower than average body fat I know this is not true. My extra muscle mass has me as borderline obese. Clearly my health outcomes are not the same as those for someone my BMI but obese and sedentary. This fact is highlighted when studies take the extra step to measure body fat percentage, separating out muscle from fat. The predictive power of BMI quickly now fades and fat becomes the new predictor, statistically.

But! When studies use a measure of fitness as well as either BMI or body fat, the predictive power of either fades away and fitness is shown to be what matters. If you have a person who is overweight, but with high fitness and metabolically normal, they have the same health risks as someone who is normal weight. Furthermore if you have a person who is normal weight, but with high visceral fat (fat wrapped around their internal organs), low muscle mass, and low fitness, they have the same risk as someone who is unfit and obese, about 4.5x more likely to die of any cause. Clearly, the attention has been put squarely on obesity as a cause for concern, when the real culprit is inadequate fitness. This is due to the huge amount of data showing an association between obesity (as measured by BMI) and ill health. As we know, however, correlation is not necessarily causation. Although, where there’s smoke there is often fire, and that leads us to the question...

If overweight is not the concern, why does all that data seem to suggest it is?  The correlation is still real, and needs explaining. The robust correlation BMI studies illuminate is the very strong likelihood that you’re not very fit if you’re overweight. Yes, overweight yet fit and healthy is possible, just not common. The overwhelming likelihood is that if you are overweight, and especially if you’re obese, you are also unfit. 

This leads me to my main point: Regardless of wether you are overweight or not, you should care about and be invested in getting and staying fit. The overemphasis on weight and fat without at least equal emphasis on fitness leads the overweight and unfit to focus on fat loss without improving fitness. While the overweight and fit are led to worry needlessly about the extra weight, and the normal weight but unfit to not worry when they probably really should. 

I have coached people to greater health and fitness for 20 years and I have made this observation repeatedly: Those who focus on fitness, particularly strength, have a healthy and enjoyable relationship with both their body and their fitness practice. Those who focus only on fat levels are constantly judging themselves (even when they get shredded) and often have a strained relationship with their training practice. 

In closing, let me implore you to care about your fitness for your physical and mental health. Let fat loss happen as a by product.