Should We Really Be Focusing On Weight Loss?

It is now becoming obvious that waistlines are expanding and it is estimated that world-wide, more than 1 billion adults are overweight and 300 million are obese. We live in societies that make it easy to gain weight with almost unlimited access to calorically dense foods and little opportunity to be physically active throughout the day. It is a lot easier to gain weight than to try to lose, and most people struggle to prevent from gaining weight, never mind attempt to lose weight. I cannot keep track of the countless number of weight loss gimmicks that are advertised on late night TV and in magazines trying to capitalize on society’s unsuccessful attempts to lose weight.

As I was reviewing a recent paper at work that was looking at weight, exercise capacity and mortality, and preparing for a talk I’m giving on weight loss to hospital employees, I started to wonder what would happen if focus was shifted away from weight loss and instead towards increased fitness levels? There is significant evidence that it is more beneficial to be physically fit and overweight than to be thin and out of shape. What often isn’t realized is that exercise is truly a form of medicine and is used to reduce blood pressure, cholesterol, blood glucose in diabetics, prevent chronic disease, and improve mood and sleep. Repeatedly, in different groups of people, some with chronic disease, some without, of all ages, genders, and ethnicities, research demonstrates that being considered moderately fit, which is roughly equivalent to being able to climb a flight of stairs or briskly walking uphill without being incredibly winded, has been shown to result in significant improvements in health and decreased risk of chronic disease and, according to some data, can decrease risk of mortality by up to 50%. This is a greater reduction in risk than can be accomplished by any medication available to us. And yet, all of the messages we hear are focused on losing weight and not improving health.

It is well established that being overweight does result in increased risk of developing heart disease, high blood pressure and cholesterol, and diabetes. However, could it also be argued that it is the same health behaviors that result in someone being unfit and often the ones that result in someone being overweight? When an individual commences a regular moderate exercise program, aiming for at least 150-200 minutes of brisk walking, while they might not lose weight, measurable health outcomes, like blood pressure, significantly improve, and it is these outcomes that ultimately determine someone’s risk for developing disease.
If efforts were focused on improving one’s fitness by becoming more active, engaging in activities that are enjoyable and social, rather than what can often be perceived as being an impossible task of losing weight, would the world become healthier? Would there be a stop to the growing number of people who are becoming obese?