Fitness and fatness in relation to health: Implications for a paradigm shift

Health care professionals most often approach health promotion for large pe rsons in the context that health improvement can be attained only through w eight loss. Unequivocal acceptance of the notion that thinness equals healt h and fitness has been the only health intervention strategy available for many large men and women. The apparent ineffectiveness of traditional diet and exercise programming to reduce body weight has caused many health care providers, obesity researchers, and lay persons to challenge the further us e of diet and exercise for the sole purpose of reducing body weight in the large person. A brief survey of the most popular dieting techniques used ov er the past 40 years shows that most techniques cycle in and out of popular ity, and that many of these techniques are hazardous to health. Data from t he scientific community indicate that diet and exercise programs for weight loss are ineffective in producing reduced weight maintenance after a perio d of 3 to 5 years. On the other hand, there are data indicating that overwe ight men and women can become healthy without losing significant amounts of weight. Furthermore, epidemiological studies indicate that fitness, not fa tness, is related to disease and mortality. Any intervention strategy for t he obese should be one that promotes the development of a healthy lifestyle . The outcome parameters used to evaluate the success of such an interventi on should be specific to disease risk and symptomatologies and not limited to medically ambiguous variables like body weight or body composition.