“Ooh, you are a strong one, aren’t you?” Words addressed to me this summer during a trial session with a potential new trainer. Words I was reminded of this week when it was revealed that 27% of women in the UK aged 40-50 are categorised as having “metabolically healthy obesity” (MHO). Or, as is more commonly said, they’re “fat but fit”.
When I read the research, made public last week by Professor Matthias Blüher at the annual meeting of the European Association for the Study of Diabetes in Hamburg, I saw something of myself in it. Instead of the usual gnawing anxiety I experience when I get anywhere near the word “fat”, I felt something like relief. And I’m sure I’m not alone. At last, some evidence that carrying some extra weight is not synonymous with being lazy, weak or inactive – as is so often the assumption of many, among them both trainers and doctors.
According to the NHS and its slavish devotion to the BMI (body mass index), I am perilously close to statistically being labelled “obese”. Sure, I am heavier than I was a few years ago, particularly since lockdown and what I suspect is the incoming creep of perimenopause. But I’m also a size 12-14 who exercises five times a week – a combination of swimming, cycling, weights and reformer pilates. I have a muscle mass percentage of 32, pretty decent for my age. And in my recent Zoe gut health tests, I had a score of 92/100. I suspect that the gut specialist Professor Tim Spector is proud of me – but that my own GP is rather less so.
Yet I am also pretty confident that I’m better off at my current weight than I would be if I were surviving on processed diet snacks, exercising half as much and fitting snugly into size 8-10 jeans. By many metrics – particularly mentally – I am healthier.
As Prof Blüher explains, the UK is very similar to Sweden, Norway and Germany in that these “fit but fat” people are considered to be obese by their BMI score while using physical activity to “override” the complications associated with obesity such as high blood sugar levels, high cholesterol, high blood pressure and type 2 diabetes or other signs of heart disease. His research indicated that the way fat tissue behaved could be a better predictor of health than the BMI score alone, including whether that fat was stored viscerally (internally, around the organs) or, more positively, stored evenly around the body. And this is where exercise helps.
I should note that Prof Blüher was clear that weight management remains important, and that there are residual, longer-term risks for “MHO” people, even if they’re currently fighting fit. But this can’t quash my delight at feeling recognised as someone who, while statistically overweight, is also doing their best to lead a healthy lifestyle – and reaping some genuine benefits.
It is no secret that I should fall prey less often to the temptation of a croissant after a hectic school run or a leftover fish finger at 5pm. But I also know how miserable life can be when enslaved to a calorie-counting app or a years-long fear of carbs. Given the choice, I have and always will take the joy of regular exercise in all its gleeful forms over prioritising weight at any cost.
Since I wrote Running Like a Girl, my book about the thrill of being a really quite terrible runner, I have enjoyed a decade of women contacting me to say “Thank you! I thought you had to look a certain way in order to be sporty!” and I continue to be struck by how slow the diet and fitness industries have been to engage with this cohort of “fat but fit” women. Slowly, images are shifting to show a wider range of body types, but still, the focus on exercise is so often on what we look like rather than how well we might be.
It is undeniably more challenging to take up exercise when you’re not already an athletic shape, and being bombarded by marketing and promotional images of those who are only makes it harder still. It is also a thankless tussle to separate the knowledge that you’d be healthier a few pounds lighter while trying to resist society’s exhausting prioritising of neat, slim women who don’t take up too much space. Fatphobia is real, particularly in the workplace. This summer the Wall Street Journal reported that 11% of human resource executives said applicants’ weight was a part of the decision in their hiring.
I long ago grew tired of apologising for taking up more space than I used to, and with it came a certain giddy liberty … only for it to be followed by a whisper of anxiety that my health might suffer as a result. So this news that my enthusiasm for gleeful exercise will still have an impact on my health has made my week. Comments like the one I received last month still rankle, but now I have some data to prove that I’m neither lazy nor a lost cause, and nor are any of us. Onwards.
