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

Journal/Book: J Soc Issues. 1999; 55: 350 Main Street, Ste 6, Malden, MA 02148, USA. Blackwell Publishers. 207-219.

Abstract: Health care professionals most often approach health promotion for large persons in the context that health improvement can be attained only through weight loss. Unequivocal acceptance of the notion that thinness equals health 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 use 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 over the past 40 years shows that most techniques cycle in and out of popularity, and that many of these techniques are hazardous to health. Data from the scientific community indicate that diet and exercise programs for weight loss are ineffective in producing reduced weight maintenance after a period of 3 to 5 years. On the other hand, there are data indicating that overweight men and women can become healthy without losing significant amounts of weight. Furthermore, epidemiological studies indicate that fitness, not fatness, is related to disease and mortality. Any intervention strategy for the obese should be one that promotes the development of a healthy lifestyle. The outcome parameters used to evaluate the success of such an intervention should be specific to disease risk and symptomatologies and not limited to medically ambiguous variables like body weight or body composition.

Note: Article Miller WC, George Washington Univ, Med Ctr, Exercise Sci Programs, 817 23rd St NW, Washington,DC 20052 USA

Keyword(s): ALL-CAUSE MORTALITY; WEIGHT-LOSS; CALORIC RESTRICTION; PHYSICAL-ACTIVITY; EXERCISE; OBESITY; WOMEN; DIETS; IMPROVEMENT; SUCCESS

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