Health: ‘Fat but fit’ people have worse heart health than normal weight people who don’t exercise

‘Fat but fit’ people DO have worse heart health than normal weight people who don’t exercise, study finds

  • Researchers from Spain analysed data on the health of 527,662 working adults
  • They evaluated them based on their weight and levels of regular exercise
  • Exercise does lower your risk of developing both hypertension and diabetes
  • However, they said, obesity still increases the risk of heart attacks and strokes 
  • Being ‘fat and healthy’ is a myth, the researchers said based on their findings

Being ‘fat but fit’ typically leads to worse heart health than being ‘normal’ weight and getting no exercise, a study has warned.

Experts from Spain analysed health data on more than 520,000 adults — and found that exercise does help reduce the risk of developing hypertension and diabetes.

However, they concluded, being overweight leads to a significantly higher risk of having both a heart attack or a stroke. 

In fact, the team added, those who were active and obese were around twice as likely to have high cholesterol than inactive, ‘normal’ weight people.

Such people were also found to be four times more likely to have diabetes — and five times more likely to suffer from high blood pressure.

Being ‘fat but fit’ typically leads to worse heart health than being ‘normal’ weight and getting no exercise, a study has warned

Based on their findings, the researchers have said that the notion that staying active is enough to counteract the effects of obesity is incorrect.

Policy makers who promote sport over weight loss, they added, have been employing the wrong approach.

‘One cannot be fat but healthy,’ said paper author and exercise physiologist Alejandro Lucia of the European University in Madrid.

Surgery ‘better option’ for diabetes

Surgery is more effective than drugs and lifestyle changes for severe type 2 diabetes, a study suggests.

Sixty patients with poorly-controlled blood sugar levels who had suffered from diabetes for more than five years were followed up after undergoing either an operation or drugs and lifestyle treatment.

The surgery involved a gastric bypass or a biliopancreatic diversion, where the stomach is connected further along the small intestine so even fewer food calories are absorbed. Of those who had a gastric bypass, 25 per cent remained diabetes-free for ten years, while 50 per cent who had a biliopancreatic diversion did so. But of those who were given drugs and made lifestyle changes, none were still diabetes-free after ten years.

Professor Geltrude Mingrone, from King’s College London, which carried out the study, told the Lancet journal: ‘Surgery should be considered as a main therapeutic option for the treatment of patients with severe type 2 diabetes and obesity.’ 


‘This was the first nationwide analysis to show that being regularly active is not likely to eliminate the detrimental health effects of excess body fat.’

‘Our findings refute the notion that a physically active lifestyle can completely negate the deleterious effects of overweight and obesity.’

The research team said that they want to dispel the myth that being ‘fat but fit’ might be associated with having a similar heart health to being ‘thin but unfit’.

‘There is some evidence that fitness might mitigate the negative effects of excess body weight on heart health,’ noted Dr Lucia.

In their study, Dr Lucia and colleagues analysed a dataset of health information on  527,662 working adults — of average age 42 — who were insured by a large occupational risk prevention company in Spain. A third were women.

The team divided the subjects into three weight groups — ‘normal’ (42 per cent of the individuals), ‘overweight’ (41 per cent) and ‘obese’ (18 per cent).

In addition, each adult was assigned an activity level based on World Health Organisation guidelines — which recommend either 150 minutes or walking per week or at least 75 minutes of more vigorous exercise, like jogging.

The team found that — while exercise undeniable had positive health effects — being overweight or obese still came with large health risks.

‘More activity is better, so walking 30 minutes per day is better than walking 15 minutes a day,’ Dr Lucia said.

‘But exercise does not seem to compensate for the negative effects of excess weight. This finding was also observed overall in both men and women when they were analysed separately.’

‘Fighting obesity and inactivity is equally important; it should be a joint battle. Weight loss should remain a primary target for health policies together with promoting active lifestyles.’

The full findings of the study were published in the European Journal of Preventive Cardiology. 


Obesity is defined as an adult having a BMI of 30 or over.

A healthy person’s BMI – calculated by dividing weight in kg by height in metres, and the answer by the height again – is between 18.5 and 24.9. 

Among children, obesity is defined as being in the 95th percentile.

Percentiles compare youngsters to others their same age. 

For example, if a three-month-old is in the 40th percentile for weight, that means that 40 per cent of three-month-olds weigh the same or less than that baby.

Around 58 per cent of women and 68 per cent of men in the UK are overweight or obese. 

The condition costs the NHS around £6.1billion, out of its approximate £124.7 billion budget, every year.

This is due to obesity increasing a person’s risk of a number of life-threatening conditions.

Such conditions include type 2 diabetes, which can cause kidney disease, blindness and even limb amputations.

Research suggests that at least one in six hospital beds in the UK are taken up by a diabetes patient.

Obesity also raises the risk of heart disease, which kills 315,000 people every year in the UK – making it the number one cause of death.

Carrying dangerous amounts of weight has also been linked to 12 different cancers. 

This includes breast, which affects one in eight women at some point in their lives.

Among children, research suggests that 70 per cent of obese youngsters have high blood pressure or raised cholesterol, which puts them at risk of heart disease.

Obese children are also significantly more likely to become obese adults. 

And if children are overweight, their obesity in adulthood is often more severe.  

As many as one in five children start school in the UK being overweight or obese, which rises to one in three by the time they turn 10.