Fitness Not Fatness More Important to Health (cont.)

Getting active is only half of the equation. Diet -- as in healthy eating -- is just as important.

"The idea that maybe overweight individuals should focus on activity and not weight loss is probably not a bad idea for a number of people," Haskell says. "But the problem is, we can always eat a lot more calories than we can burn."

Changing to a healthy diet means cutting back on high-fat food and on starchy carbs. It means eating a balanced diet that includes protein, whole grains, vegetables, fruit, fiber, and, yes, some healthy fats. People who do this, and who get moderate exercise, can lose body fat and gain lean muscle.

"The studies suggest that if a 300-pound person drops 30 pounds, that person will have substantial reduction in several risk factors," the CDC's Gregg says. "And also that person will probably see an improvement in physical function and musculoskeletal problems and reduce his or her risk of osteoarthritis. And there would be a whole effect on health-related quality of life that is independent of these risk factors."

America Has an Eating Disorder

People with eating disorders have a distorted body image. They think they are fat even though they are dangerously thin. They are disgusted by fat. They exercise not for health, but to burn away calories. They weigh themselves not to check on their health, but to see how much weight they have lost. They starve themselves on crash diets until their brains rebel, forcing them to binge. The guilt makes them even harder on themselves.

Americans, Campos argues, have a collective eating disorder: We see normal people as fat. We are so disgusted by fat that the only perfectly acceptable prejudice is prejudice against people who are overweight or obese. We go on all kinds of crash diets, then feel guilty for binging on fast food. We are obsessed with weight, to the detriment of our health.

"The emaciated anorexic who looks in the mirror and says, 'I am fat' -- she is just working out the logical consequence of how we have demonized body fat in this culture," Campos says. "It is astonishing what is considered fat in this society."

According to Census data, the average American woman is about 5'4" tall and weighs a little more than 150 pounds. Her body-mass index or BMI -- a measure of weight adjusted for height -- is 26.3, which puts her in the "overweight" category. Yet she's leaner than half the population.

Campos criticizes those who argue that healthy body mass is between 18 and 21.9 BMI -- "for the average woman 5'4" tall, this is between 108 and 127 pounds," he says. "People flinch if you even say the word fat. It is seen as a poison. We see the elimination of fat as desirable. That is eating-disordered thinking. The difference between fashionable thinness and anorexia is whether you have been hospitalized or not."

"Let's focus on what people can do -- which is eat a healthy diet and improve fitness."

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