Healthy eating and exercise must go hand in hand

If you doubt the extent of the obesity epidemic in the Western world, go find some winter sun. I am writing this a couple of days after a short break in Tenerife. Wherever I looked, there were people whose shorts were stretched over large buttocks and big tummies! It was not a pretty site. ‘Lean machines’ were in the minority! Despite the huge investment in public health we must remember that improvements in public health will take a long time. It is nearly 50 years since the health risks of smoking were first recognised but only recently that a smoking ban has been achieved in public places. So we just have to keep plugging away at it.


As predicted at this time of year, there have been a few articles promoting the view that exercise is not important in weight loss programmes. According to them, all you need to do is reduce your food intake but new to the argument is that exercise does not work if your goal is weight loss. True, if you eat less you will lose weight and it is possible to exercise without losing weight, but the issue is not simply about shedding a few kilograms. It is about being healthy and improving all the components of fitness with which we are familiar. For that to happen, healthy eating and exercise must go hand in hand.

Secondly, research is increasingly showing that fat people can be aerobically fit – the so-called ‘fit fat’. When overweight people embark on a programme of progressive aerobic exercise their VO2 max rises, several indicators of health and fitness improve and the risk of developing obesity associated illness falls. It is tempting to conclude therefore that people do not need to lose weight they just need to get on a treadmill or rower.

However, fitness is not only about aerobic fitness. Muscle strength and endurance, flexibility and motor function also need to improve if somebody is to achieve all round fitness. Being overweight has other complications. The musculoskeletal system is overburdened so arthritis of the hips, knees, ankles and spine are common. Weight loss plays a major part in its management and prevention.

Something else people are unaware of is that being overweight significantly increases the risk of surgical operations – and most of us will have atleast one major operation during our lives particularly after the age of 65. Not to mention the fact that Thrombosis, infection, slow rehabilitation and delays in wound healing are all serious risks when an obese person has major surgery.

So to be fat and fit is good but to be lean and fit is better. We need to go on measuring the waist circumference and helping clients to get it within the optimum range.

John Searle
Chief Medical Officer
Fitness Industry Association