Still, some health experts are wary of giving the nod to even a few extra pounds, given that nearly 28 percent of Americans are obese, with a BMI of 30 or greater. "If you're at a low or ideal body weight, then gaining an extra five or 10 pounds may be beneficial," says Miriam E. Nelson, Tufts University professor and coauthor of The Strong Women's Guide to Total Health. "But if you're overweight or obese, or have hypertension or impaired glucose tolerance, then you don't want to gain weight." Obesity also dramatically increases the risk of diabetes, certain cancers and heart disease.
Focused on fitness
No matter what the bathroom scale says, the experts agree that a regimen of physical activity and a healthy diet cuts the risk of disease and death.
"Fitness is more important than fatness in determining mortality," says Steven N. Blair, an epidemiologist at the University of South Carolina's Arnold School of Public Health. In studies of thousands of overweight and obese adults over the last two decades, Blair has found fitness reduces the risk of stroke, heart disease and cancer. "We've seen dramatic reductions in mortality even in obese individuals who are fit," he adds.
How much exercise is necessary to join the fat-but-fit club? New federal guidelines advise 150 minutes of moderate exercise a week or 75 minutes of vigorous exercise.
Since developing type 2 diabetes about 10 years ago, James B. Smith II, 73, of Baton Rouge has battled his weight. When one of Smith's medications no longer seemed effective, his doctor raised the possibility of insulin injections. "After that I was even more motivated to get in shape," says Smith. He is enrolled in a three-times-a-week study on exercise and diabetes at Pennington Biomedical Research Center, peddling 20 minutes on an exercise bicycle and walking another 20 on a treadmill. "The other day after exercising my glucose came down 96 points — it was just amazing."
Even though he has only lost five pounds, he hopes the exercise regime will help control his diabetes. "I would love to lose 50 pounds, but it's just really hard to lose weight when you get older."