Thursday, October 6, 2011

Continuing the Fat and Fit debate...

So last night I posted on Twitter:  Can you be Fat and Fit? 

Someone responded that it is not possible. 

However, no one ever defined "fat."  What is fat to you?

Before we get into is yesterday's blog post:

How do we define fat?  If you use the BMI chart, then I am fat if I am over 200 pounds (and I tend to agree).  At 200 pounds, my BMI is around 27 (still considered overweight but in the somewhat close to healthy range).  I wear about a size 14 (I'm close to dropping down to a size 12, but pants would be a little snug and I tend to stick with a 14 for dresses thanks to my ginormous boobs).  My definite healthy weight is 180, which gives me a BMI of 24.4.  That was my lowest weight after gastric bypass.  I haven't been that weight since 2005, and my current goal is to only get back to 200. 

BMI Classification
18.5 or lessUnderweight

18.5 to 24.99Normal Weight

25 to 29.99Overweight

30 to 34.99Obesity (Class 1)

35 to 39.99Obesity (Class 2)

40 or greaterMorbid Obesity

At my currently weight -- 240 pounds *gulp* -- I'm fat.  I'm a size 16 (well, those pants are a bit tight but a size 18 falls off of me so I get to look dumpy no matter what I'm wearing).  It's funny because when I took phen fen 15 years ago and got down to 220 pounds (or so), I was still wearing a size 22.  Either the clothing sizes have changed, or I wasn't wearing the proper size. 

Anyway, regardless...I currently define myself as fat.  According to the BMI calculator, my BMI is 32.55.  Not only am I fat...but apparently I'm obese.  Again. 

BMI is between 30-34.99 (Obese Class 1)

Individuals with a BMI of 30-34.99 are in a physically unhealthy condition, which puts them at risk for serious illnesses such as heart disease, diabetes, high blood pressure, gall bladder disease, and some cancers. This holds especially true if you have a larger than recommended Waist Size. These people would benefit greatly by modifying their lifestyle. Ideally, see your doctor and consider reducing your weight by 5-10 percent. Such a weight reduction will result in considerable health improvements.

Read our Obesity Treatment article for some measures you can take.

Note: Since Body Fat Percentage calculations use total body weight and not estimates of lean muscle mass and fat, BMI can not determine between the overweight and the more muscular. Use our Body Fat Calculator and Waist to Hip Ratio Calculator in combination with our BMI Calculator for a more accurate view of your body fat.


This morning, my friend posted this article on Facebook ("The appearance of fat does not mean the absence of muscle, nor does the absence of fat mean the presence of muscle.....")

Are You Skinny Fat?

by Beth Shepard, M.S., ACE-CPT, ACSM-RCEP, Wellcoaches Certified Wellness Coach

Most people know that being overweight or obese increases your risk of serious health problems — it's old news. If your body mass index (BMI) is within a normal range, you probably think you're off the hook, even if you don't exercise or eat right.

Think again. More than a decade of clinical research shows that many people are skinny fat, a popular buzzword describing men and women who appear healthy and fit on the outside. Many of these unsuspecting people have healthy BMIs, but are normal-weight obese; they're over-fat and at risk for developing obesity-related illnesses like heart disease, type 2 diabetes, stroke, and more. What about you?

BMI vs. Body Fat Percent

Body mass index is a number used by health professionals to assess whether or not your weight is in a normal range based on your height. But a normal BMI of 18.5–24.9 offers a weight range of about 35-40 pounds — you could be at either end of the range, or somewhere in the middle, and still be considered normal. It doesn't account for body composition — fat or lean percent — and it's not accurate for heavily muscled or pregnant individuals. In essence, it's an imperfect measurement that offers a quick and easy, best-guess approach for assessing weight-related health risk.

In contrast, body fat percent offers an entirely different picture — it's a measurement that reveals whether or not you're carrying too much fat weight, regardless of the number on the scale.

The Big Deal

The concept of skinny fat is getting a lot of attention because we all know people who seem genetically blessed — maintaining a healthy weight without exercising or watching what they eat. But weight isn't the only thing that matters. Studies show that whatever you weigh, poor nutrition and a sedentary lifestyle elevate your health risks. Check out these research highlights related to the skinny fat concept:
  • A recent study found 29% of subjects classified as lean and 80% of subjects classified as overweight via the BMI method fell within the obese category when body fat percentage was measured. Compared to subjects with normal body fat percentage, these individuals also had higher levels of cardiometabolic risk factors such as C-reactive protein, a marker of inflammation.
  • Another study of BMI-assessed normal-weight subjects found abnormal metabolic profiles associated with obesity, including elevated triglycerides, glucose, and C-reactive protein; low HDL cholesterol, insulin resistance, and high blood pressure. Subjects with higher body fat percentages were most likely to have abnormal metabolic profiles, despite having a normal BMI.
  • A 17-year study of over 37,000 apparently healthy 17-year-old males found risk for heart disease increased 12% with every one unit increase in BMI — even within the normal range.
  • In a well-known 1999 study, Dr. Steven Blair and colleagues found that active obese individuals have lower rates of disease and death than normal weight individuals who are sedentary.
What To Do About It

If you think you might fall into the skinny fat category, schedule a preventive health care visit. Your health care provider will evaluate your health risks and recommend appropriate tests, treatments or lifestyle changes. Ask about your numbers — such as cholesterol and blood pressure — they're important to know. Depending on your needs, you may be referred to other health professionals, such as an exercise specialist or registered dietitian to help you establish an exercise program and improve your eating habits.

Should I Get My Body Fat Measured?

It's up to you. BMI aside, if your health measures are normal, you're exercising regularly, and eating right, you probably don't need a body fat test — unless you're curious. Cost, comfort, and accuracy varies considerably among different methods.

The most important thing to keep in mind is that one number — whether it's weight, BMI, or body fat % — doesn't offer a complete picture of your health. Your everyday behaviors have an incredible amount of power over whether you develop preventable diseases that could cut your life short — or remain vibrant, healthy, and loving your life well into your later years. Make health-promoting choices each day — and chase the skinny fat away.

  1. Shea JL, King MT, Yi Y, Gulliver W, Sun G, Body fat percentage is associated with cardiometabolic dysregulation in BMI-defined normal weight subjects, Nutr Metab Cardiovasc Dis. 2011 Jan 5. [Epub ahead of print]
  2. Gómez-Ambrosi J, Silva C, Galofré JC, Escalada J, Santos S, Millán D, Vila N, Ibañez P, Gil MJ, Valentí V, Rotellar F, Ramírez B, Salvador J, Frühbeck G. Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity. Int J Obes (Lond). 2011 May 17. [Epub ahead of print]
  3. Blair SN, Brodney S. Effects of physical inactivity and obesity on morbidity and mortality: current evidence and research issues. Med Sci Sports Exerc. 1999 Nov;31(11 Suppl):S646-62.
  4. Antonino De Lorenzo, Vera Del Gobbo, Maria Grazia Premrov, Mario Bigioni, Fabio Galvano and Laura Di Renzo Normal-weight obese syndrome: early inflammation? American Journal of Clinical Nutrition, Vol. 85, No. 1, 40-45, January 2007
  5. 5. Tirosh A, Shai I, Afek A, et al. Adolescent BMI trajectory and risk of diabetes versus coronary disease. N Engl J Med. 2011;364(14):1315-1325, cited in


Clearly, just because you're thin doesn't mean you're in shape and just because you have a few extra pounds doesn't necessarily mean you're unhealthy.  One last note on the is an old post from me where I discuss what "average" means.  The words "average size" and "fat" are so subjective...yes, we should learn how to love ourselves at any size but we should also make sure we are being healthy so we can be around for years to come!  But why does it bother other people if I'm fat anyway?!  Avert your eyes if it bugs you so much.  I feel bipolar.  I could go on for years about this...

I remember having an argument with someone on Facebook about what "average" sized means.  He was on a dating site and a girl called herself "average."  She ended up being a size 12.  He felt that she shouldn't have been over a size 8.  He compared it to a guy adding a couple of inches to his height on his profile.  They are not even close to the same issue.  Height is something you can actually measure.  Asking someone to choose:  Slender, Athletic, Average, or "More to Love" is completely subjective, and, therefore, open to interpretation.  My argument was that a girl who wanted to call herself "average" instead of "more to love" had every right to do so (a size 12 IS the American "average" size now).  A guy adding two inches to his height was just a tool, because if all six feet of me -- er, 5 feet, 11-3/4 inches -- showed up for a date, I'm going to notice that you're 5'10" and not 6' -- especially since I'll probably be in four inch heels.  

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