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Fat and Fit: Who Says You Can't Be Both?

“I’m still not convinced that fat doesn’t matter,” says Rachel Wildman, a researcher at Albert Einstein College of Medicine in New York and a coauthor of the Archives study. “But long-term, the incorporation of physical activity is easier to accomplish” than losing weight through dieting. It’s still possible, Wildman says, that exercise and weight loss are both important.

The idea that the rotund among us can be healthy is a hard one for some people to accept. Readers of a New York Times blog on the subject were often angry, pointing out, among other things, that twice as many fat people as slim suffer health problems tied to their weight.

But by concentrating only on fat, health care practitioners could be missing an important chance to show people another path to better health. Increasingly, the idea of “dieting,” with its counting of carbs and calories, its portion control and rigidity, is falling by the wayside in favor of a more balanced approach to disease prevention.

Blair, at 69 among the most celebrated medical experts on fitness and health, walks the walk. A self-described “short, fat, bald guy,” Blair runs about 25 miles a week, sometimes admitting to a “run-walk” if the hill is steep. Some days he eats too much, he says, but “I try every day. I don’t say we should discourage people from losing weight. But the bottom line from a public health standpoint is to concentrate on behaviors: Don’t smoke, do some physical activity five days a week, and eat a healthy diet.”

The toughest physical trainer he knows, he says, is his three-and-a-half-year-old grandson, who loves chasing his grandparents around the yard. Losing weight on a diet “might get you a date or more room in the airline seat,” says Blair. But for some people, it’s too much pain for too little health gain.

One of the struggles for overweight people is overcoming the embarrassment they sometimes feel being active in public. Sherry Mayrent, 57, of Boston, loves to ride her bike on the Charles River bike path. But at 5’3” and 265 pounds, she felt intimidated by the slim young folks whizzing past her on their way to work. “Then I thought, ‘Wait a minute! These people are half my age and half my size! I’m not doing so badly.’ ”

Mayrent credits her increased confidence to several stays at a Vermont spa called Green Mountain at Fox Run, one of an increasing number of health retreats that focus on physical activity, self-knowledge and sound nutrition. “It was a safe place to get active,” she says. “I could try things without looking like an idiot.” She first concentrated on strengthening the core muscles in her trunk, which she discovered was the secret to gaining strength and fitness in the rest of her body. Then she moved on to generalized strength training and aerobics. “It was amazing, it totally changed my life,” she says.

Her knees still hurt and she continues to receive treatment for high blood pressure and asthma. But recently, she says, she walked up a familiar hill “for the first time without wheezing myself to death.”

Mayrent hasn’t stopped trying to lose weight—regardless of her fitness level, obesity raises the risk for diabetes, heart disease and stroke, and some research still links obesity to a higher risk of death. But she’s no longer the one who stays behind while others walk to get the car, and she can get down on the ground and play with her grandkids. She hasn’t lost a pound, but the fitness payoff came last year when she completed a 26-mile bike ride at a charity event in Boston.

Mayrent’s advice? “You have to do things you love to do.”

Linda Greider is a freelance writer who lives in Washington.

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