Is getting fit more important than losing weight?

There has been a simmering debate within the medical community about whether it is time to shift the focus of obesity treatment away from weight loss as the primary goal and towards a more general concept of fitness. 

Obesity, as you're probably aware, is a disease state defined by a BMI greater than 30. What does that mean in terms of actual numbers? I'm 5'9" (or 175 cm) tall and weigh 150 pounds, which is considered normal. At 170 pounds (77 kg), I am considered overweight. I'd be considered obese if my weight climbed above 200 pounds (91 kg).

Losing weight does not always work. What else can we strive for?

The majority of obese people would be much healthier if they lost weight. The problem is that even when they try hard, a significant number of people still fail to lose weight. We can argue about why people are so unsuccessful in their weight loss efforts . Fad diets, a lack of knowledge, poor food options, and the media can all be blamed. But all of this pointing of fingers isn't solving the problem. A large and growing proportion of our population, including our children, now suffers from seemingly intractable obesity and the associated health risks and conditions that go along with it. 

If we can't help people lose weight, perhaps we should concentrate on what else we can do to reduce those health risks.

Should we prioritise fitness over losing weight?

Glenn Gaesser and Siddhartha Angadi argue for a weight-neutral strategy for treating obesity in a paper published last month. The authors present data from over a hundred individual studies and meta-analyses on the relationships between weight loss, exercise, disease risks, and mortality to back up their claim.

They argue that achieving moderate-to-high levels of physical activity or cardiovascular fitness can be just as effective in lowering the risk factors associated with obesity, even if those people do not lose weight. (This serves as a good reminder that weight loss is not the primary benefit – or outcome – of exercise.)

They also point out that weight cycling, in which people repeatedly lose and gain weight, has a number of negative health consequences. In fact, losing and regaining weight may be worse for your health than not losing it at all. In other words, telling obese people to lose weight may be more harmful than beneficial, especially if this goal is prioritised above (or to the exclusion of) improving fitness.

So, should we stop advising people to lose weight and instead focus on getting them more fit?

This argument makes sense to me: let's not let what we can't do stop us from doing what we can. But, for those who are obese, I'm not sure achieving moderate-to-high levels of physical activity or cardiovascular fitness is any less difficult than losing a significant amount of weight.

Excess body weight, which limits endurance and mobility, can make even light exercise difficult. Overweight and obese people are more likely to suffer from back problems, knee pain, and exercise-related injuries, which is why it’s critical to start with a workout program like our Beginner Bootcamp that has been specifically designed to meet you at the beginner level of fitness intensity, with exercises that are achievable if you haven’t worked out in years or even decades. Of course, you can (and should) begin wherever you are, even if it's just walking 5 minutes per day, and work your way up. However, if you are looking for a fat loss optimized workout that will progress you forward day by day, and that will meet you at the beginners start line, the Beginner Bootcamp will get you exercising consistently, doing the best types of workouts for fat loss, toning up and building you endurance and agility, and will deliver results much faster than just walking.  You can expect significant improvements in fitness, like weight loss, strength, muscle tone and overall athletic conditioning.

Must we make a decision?

There's no denying that a fitter body, regardless of size, is a healthier body. At the same time, I'd like to believe that this can be a Both/And situation rather than an Either/Or. That appeared to be the general consensus among a group of health professionals discussing the study on LinkedIn recently. The real takeaway here is not that weight doesn't matter, but that weight loss should not be prioritised over other outcomes. 

Marlena Hanlon, a social scientist, emphasises the importance of the intervention's focus. "If you focus on exercise and healthy habits, weight loss may occur; if not, better health will."

I would add that this is especially true because weight loss is a goal that is so infrequently and fleetingly attained. Indeed, as the authors of this recent paper point out, some data suggest that an obese person in good shape may have a longer life expectancy than someone of normal weight but below average fitness. They are quick to point out, however, that "physically active adults in the normal BMI range had the lowest risk."

However, it is not always the case that health professionals are overly concerned with weight loss. Dr. Jonathan Ehrman, who runs a preventive cardiology programme for a Michigan hospital, says that the majority of his obese patients "first and foremost want to lose a significant amount of weight."

Weight is not the only factor to consider.

Part of the problem is undoubtedly our approach to weight loss. Dr. Tom Rafai of the Harvard Medical School of Lifestyle Medicine opposes extreme food restriction approaches. "There are, in my opinion, better ways to achieve health and even weight loss than to worship at the altar of the scale or meal replacements." Following a balanced Meal Plan gives people a massive advantage over people that are just winging it without structure or guidance. 

So, let's not pretend that your weight has no bearing on your health. It is significant. It's just not the only important factor. Let's keep working on understanding and resolving the issues that make losing weight so difficult. But let us use all of our tools to help people live the healthiest lives possible. Finally, let us strive for a society in which people are not stigmatised, judged, or discriminated against because of their body size.

If you like our vibe here at BodyRock, we’d like to invite you to come and give give our Beginner Bootcamp workout series a try. In just 10-15 minutes per day, you get a full body workout that you can do at home or anywhere that you feel comfortable training. The exercises have been specifically designed for beginners, and the workouts will challenge you without overwhelming you. We also have dozens of other beginner level workout programs that you can try. Use code: NY22 to get a full year of access to our fitness streaming service BodyRockPlus.com for just $69. 

Thanks for reading,

Rachel.