This weekend I took my course and test to be re-certified by the Aerobics and Fitness Association of America (and I passed Yay!). It was exactly as super fun as you can imagine (which is to say, not very super fun at all) but I was pleasantly surprised to find out that there was much more talk about healthy lifestyle than about weight loss. One of the tools that I was tested on is the American Society of Sports Medicine’s Risk Factor Stratification. This tool looks at the risk factors for Cardiovascular and Pulmonary Disease.
One of the risk factors is “obesity”. I have an issue with this since I think that they are trying to use weight as a proxy for behaviors (specifically behaviors that are already covered by the tool). But, for the sake of argument, let’s say that obesity is a risk factor. Some of the other factors include age and heredity. But unlike obesity, there isn’t a sixty billion dollar a year industry that tries to change our age or genetics because we know that, even if it would help, it’s not possible. Intentional weight loss, and the diet industry as a whole, only make sense as a way to lower risk if they in fact succeed in changing the risk factor, in this case obesity.
That means that, for weight loss to be advisable as a way to lower the risk for cardio/pulmonary disease, the average obese person who attempts to lose weight would have to become and stay non-obese. The problem, of course, is that the research doesn’t bear that out. Based on all of the science, only 5% of people will be successful at long term weight loss, and let’s not forget that many of those people did not start off as obese, or lose an amount of weight that would change their BMI category at all. So a 5% success rate does not indicate that even 5% of obese people can become and maintain a BMI-defined “normal weight” that would, in theory, lower their risk. In fact most obese people who attempt to lose weight end up as heavy or heavier than when they started which means that their risk is as high or higher than it was to begin with, and now they have the added risks that come with weight cycling. That does not sound like an advisable treatment plan.
Personal trainers are not instructed to give up on health just because someone’s age or heredity is a risk factor that can’t be changed. By the same token, if health is a goal for you, there is no reason to give up just because body size is a risk factor that can’t be changed. The good news is there are still a lot of risk factors that we may be able to control:
- Move about 30 minutes a day, about 5 days a week
- Eat whole grains, fruits and vegetables
- Get enough sleep
- Don’t smoke
- Lower the stress in your life
My point here is that obesity may be a risk factor for cardio/pulmonary issues but even if it is, evidence points to the fact that it is an unchangeable risk factor – like age or heredity. The fact that healthy habits are unable to change our age, heredity, or body size, doesn’t mean that they aren’t making us healthier or lowering our risk for disease. Indeed, the available science suggests that healthy habits are where it’s at if you choose health:
“Groundbreaking work on fitness and weight has been done by [epidemiologist Steven] Blair and colleagues at the Cooper Institute. They have shown that the advantages of being fit are striking and that people can be fit even if they are fat … and thus have lowered risk of disease. A remarkable finding is that heavy people who are fit have lower risk than thin people who are unfit.” -Dr. Kelly Brownell, Director of the Yale Center for Eating and Weight Disorder
“We’ve studied this from many perspectives in women and in men and we get the same answer: It’s not the obesity—it’s the fitness.” -Steven Blair, P.E.D., Cooper Institute for Aerobics Research
“Consistently, physical inactivity was a better predictor of all-cause mortality than being overweight or obese.” -Annals of Epidemiology
So it’s time to stop pretending that if obesity is present than health cannot be, or that there is no point in healthy habits if they don’t make us thin. It’s simply not so. Health is multi-dimensional and not entirely within our control, so all we can do is work on the things that we can control and then do our best to deal with whatever happens.
This blog is supported by its readers rather than corporate ads. If you feel that you get value out of the blog, can afford it, and want to support my work and activism, please consider a paid subscription or a one-time contribution. The regular e-mail subscription (available at the top right hand side of this page) is still completely free. Thanks for reading! ~Ragen