Dr. Hyman is an independent Orthopedic Surgeon. Our Mission is to provide expert sports medicine education. This is not a site for medical treatment. This site is not affiliated with, sponsored by, endorsed by, nor approved by CrossFit, P90X, Insanity or any other third party.
If fitness were defined strictly in physical terms, one can make the case that fat can be fit, but not for long.
Yes, there are heavy/fat athletes. Sumo wrestlers come to mind. Selected at an early age from rural villages in China and Japan, they are normally strong and agile athletic types. They excel. Once chosen, they enter a cloistered life where they become part of a school for training in this ancient warrior's art. They train 7 days a week, 52 weeks out of the year. Their life is very circumscribed. They are literally force fed two gargantuan meals per day. Sleeping until noon and working out between meals, the successful ones become 400-700 lbs. behemoths in a few short years. They are fat and strong and recognized around the world for their ability to push and shove opponents from the small circle where they wrestle. They develop a hard core mental toughness enduring the disciplines of SUMO wrestling. It is a harsh and brutal sport.
Unfortunately Sumo wrestlers often do not live beyond the age of 50. Carrying such heavy weights takes a toll on their joints and internal organs, especially the heart, liver , and kidney. Knee, back, and shoulder issues, diabetes, and cardiovascular diseases often dog the latter years of those who have been Sumos.
While fat does not exclude the possibility of being fit, thin does not predict it either. One can be thin and dying of cancer or anorexia.
Scientists, like Dr. Caroline Kramer, an endocrinologist at Mt Sinai Hospital in Toronto, have done the studies. The BBC and the CDC have followed thousands of subjects for decades. They have collected and analyzed the data from those studies.. In general they agree in their conclusions. Every pound up or down can and does make a difference.
Here in America, the average man needs to consume 2500 calories per day. The average woman requires 2000. A child 5-10 years old needs 1800 calories. Consuming these amounts, augmented by periods of rest and sleep, will render them functional. They will be able to perform daily tasks without fatigue. Veering from these daily caloric requirements can produce problems at both ends of the spectrum. There is no such thing as benign anorexia or benign obesity. It is not OK to be underweight. It is not OK to be obese. Carrying around large amounts of extra weight also produces ancillary problems like sleep apnea and abnormal breathing created by having a fatty throat. The excessive vomiting that typifies bulimic anorexics affects the throat too. On the one hand the airway becomes occluded. In the other the acid and bile of vomiting erodes the digestive tract. Both extremes can lead to disruptions and deprivations in sleep that result in poor daytime/ wake time concentration. This is followed by the higher risk of injury to self and others. It creates a domino effect spiraling one's health downward.
Americans desperately want to believe that their consumptive lifestyle is OK. But it isn't. While denial may work in the short term, it fails in the long haul. We have argued that TRUE FIT is a matter both physical, mental, and spiritual. It is neither wise nor enlightened to speak of fitness in physical terms alone. We seek a balanced view which incorporates both Eastern and Western perspectives. We embrace a one world view that acknowledges the whole human being.
If one is "stuffed to the gills", as anyone who has eaten more than their body can digest knows, the pain and discomfort resulting from that behavior leads to mental fatigue, poor decision making , and difficulty thinking clearly, One may be upright, but not up right, walking in a fog, and easily losing one's way. Just as the mental channels are clogged, so also are the spiritual ones. The eating required to become obese or even simply fat, saps energy from that belonging to spiritual pursuits. Sitting in a yoga posture in meditation, or getting on one's knees in prayer are compromised by the fat and the obsession with food. The channel for connection with a power greater than oneself is shut down often resulting in feelings of isolation, anger and abandonment. The breath of life itself can be at risk of being extinguished.
Of course there are exceptions to every rule, but they are exactly that, exceptions. It is far better to err on the side of normalcy. Therefore we conclude that while all things are possible, some are not probable. It is not probable that one can be both fat and fit.
Dr. Hyman is a Board Certified Orthopaedic Surgeon and Sports Medicine Expert who concentrates on helping his patients understand their problem and get the results they want. Understanding the problem from the patient's perspective, how it impacts their life, their family, their sports/jobs and goals is his primary concern.
Aside from surgical and technical expertise, he has a reputation of providing thorough second opinion evaluations. He seeks to answer all your questions and teach you about things you may not have known to ask, so you leave feeling informed, re-assured and satisfied. Knee, Hip and Shoulder surgery and non-surgical options generally, are his specialty.