The “Fat but Fit” Paradox

The Reznick family has always struggled with weight issues. We enjoy eating large portions, snacking and having our wine and spirits in moderation.

I remember accompanying my dad to his checkup in my teenage years. His internist was a highly respected chief of the internal medicine department at a large NY academic teaching facility as well as a long-time family friend. I remember the conversation well. Dr. Cohen would say, “Lou you are too heavy and I don’t want you to get sick from it!” Dad would respond with,” Ted I am not too fat I am just too short.! I am really fit working on the loading docks at my business and running around on my feet all day.”

Here we are 60 years later and the “fat but fit“ paradox has been examined in the journal Preventive Cardiology where researchers looked at 527,662 adults aged 18-64 years. This was performed by reviewing insurance information of patients who underwent regular health checkups through an occupational risk- prevention company.

They divided the group into normal weight, overweight and obese. They then separated them by activity levels with some being inactive (64%), insufficiently active (12%) and regularly active (24%). Of the study group, 30% had elevated cholesterol, 15% had high blood pressure and 3% had diabetes.

The study showed that those who were physically active reduced their cardiovascular risk. The overweight and obese individuals who were active were never ever able to reduce their cardiovascular risk to the level of a normal weight active individual of similar age. Overweight individuals are still more likely to develop hypertension, high cholesterol and diabetes due to insulin resistance in lipid rich cells.

The goal for physicians is to help you to live longer with a high-quality life. To accomplish this, we still need to emphasize achieving a normal body mass index or weight, maintaining a healthy active lifestyle and controlling those health issues that still develop in fit active adults.

Weight control and regular check-ups with your physician remain extremely important!