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Facts About Fat

The pounds that frustrate you most may actually protect you, and more news about weight and your health.

By Suzanne Schlosberg

Illustrations by Juliette Borda


The debate rages on about which diets are best and how much exercise is optimal, but there's one issue that health experts firmly agree on: As a nation, we're way too fat. Two out of every three American adults are walking around -- well, more likely sitting around -- with enough fat to compromise their health. Not only is the obesity epidemic costing us billions in health care and lost productivity, new research suggests it may also be shortening Americans' life spans. Scary stuff, to be sure. You may wonder: What does all this mean to me? Is my own health at risk? How do I know if I'm too fat? To help answer these questions, here are the latest fat facts; some of the information may surprise you.

Good Fat Vs. Bad Fat
You might think that the fatter you are, the more unhealthy you're likely to be. Not necessarily true, because what really matters is location. The type of fat that's dangerous, i.e. visceral fat, is packed in a small region around your liver and other abdominal organs. "You can't feel it, touch it or see it," says Glenn Gaesser, Ph.D., director of the kinesiology program at the University of Virginia in Charlottesville and author of Big Fat Lies: The Truth About Your Weight and Your Health (Guerze Books, 2002). "It doesn't comprise a whole lot of total body fat. The average woman has 40-50 pounds of fat, but of that, only about 5-10 pounds is intra-abdominal fat." Although the only way to know exactly how much you carry around is via high-tech methods like a CAT scan or MRI, you can get an idea of whether you have too much by measuring your waist circumference, Gaesser says. More than 35 inches for women is considered high risk (see "The Easiest Way to Gauge Your Risk," below right).

Why does this type of fat wreak such havoc? Because intra-abdominal fat dumps fatty acids into the bloodstream at a frenetic pace and because these fat molecules head directly to the liver, compromising its ability to control insulin in the blood. Excess insulin can cause high blood pressure, unhealthy cholesterol levels and high triglycerides (unhealthy blood fats) -- the conditions that make up "metabolic syndrome" and typically foreshadow diabetes and heart disease. Stress also plays a role in intra-abdominal fat, because this type of fat has more receptors for cortisol, a stress hormone. When you're under constant stress, you produce excess cortisol, causing more fat to be deposited in your gut.

In contrast, fat that lies close to the skin -- whether it's the jiggly inch you can pinch around your waist or the saddlebags on your thighs -- doesn't seem to cause health problems. In fact, some research suggests that if you have excess intra-abdominal fat, extra thigh fat may actually offer protection against heart disease. "Thighs seem to suck fat out of your circulation," Gaesser says, "preventing a high blood-fat level that can clog your arteries. Think of your thighs as a big sink that can act as a depot for storing fat."

Should you worry?
Fat-wise, women have one big advantage over men: About 80 percent of women are shaped like pears before they hit menopause, which signals less dangerous fat distribution than often found in apple-shaped people. But this doesn't mean that pear-shaped women should be complacent about weight gain. Though women under 50 have substantially lower rates of heart disease than men, this advantage disappears after menopause.

Around menopause, declining estrogen levels cause a redistribution of body fat. The key is controlling your body fat when you are younger, says Deborah Clegg, Ph.D., an assistant professor in the obesity research center at the University of Cincinnati's department of psychiatry. "If you're overweight when going through menopause, your chances of having metabolic syndrome increase exponentially."

Overcoming your fat obsession
Hip and thigh fat may not lead to heart disease and diabetes, but for many women, that's small comfort. They're nevertheless desperate to lose their saddlebags, and this obsession itself may have damaging physical and psychological consequences. "Body dissatisfaction can trigger unhealthy eating behavior and can also affect your self-esteem," says Cynthia Bulik, Ph.D., director of the University of North Carolina at Chapel Hill's Eating Disorders Program and co-author of Runaway Eating: The 8-Point Plan to Conquer Adult Food and Weight Obsessions (Rodale, 2005).

To overcome an unhealthy obsession with your hips and thighs, focus on all the things they do for you, Bulik says. Exercise that tones and strengthens your lower body -- whether it's weight training, hiking or cycling -- can also help improve your relationship with your hips and thighs. By helping you shed pounds, a healthy diet will help you feel better about your body too.

Are you destined to be fat?
If fat seems to cling to your body, you may wonder if you can do anything to alter your destiny. "For the average person, [genetic influence] is in the 60-80 percent range," explains Philip A. Wood, D.V.M., Ph.D., director of the division of genomics at the University of Alabama at Birmingham and the author of How Fat Works (Harvard University Press, 2006). Although this is significant enough to suggest that Rosie O'Donnell is never going to be as thin as, say, Courteney Cox, it also means that most of us can avoid obesity with a combination of healthy eating and exercise habits.

Nevertheless, for some people, weight is especially difficult to control. The classic evidence: a Canadian study of twins published in The New England Journal of Medicine. Twelve sets of identical male twins were fed an extra 1,000 calories per day six days a week. After 100 days, each subject had consumed enough extra calories to gain 24 pounds (it takes approximately 3,500 calories to gain 1pound). But some men in the study gained only 9.5 pounds whereas others gained 29 pounds. The difference in weight gain between the various twin pairs was three times greater than the average difference within the pairs. The location of the extra fat deposited also was similar within the pairs but varied greatly between pairs. Clearly, genetics counts for a lot.

"We would expect that calories are calories are calories," says Paul Ribisl, Ph.D., chairman of the health and exercise science department at Wake Forest University in Winston-Salem, N.C. "But that's really not the case." The reasons are many. For example, some people fidget more than others (thus burning more calories), and some people's bodies have a higher metabolism, which means they end up hanging on to fewer of the calories they eat.

Still, experts say, regardless of the genetic cards you are dealt in life, your store of deep abdominal fat is a matter of lifestyle too. So make sure you hit the gym regularly, control your stress levels, and eat a balanced diet full of fruits, vegetables and whole grains.

The best way to lose fat
Good news: The type of fat that does the most damage is also the easiest to lose. Thigh fat may hang on to you for dear life, but with the right lifestyle changes, fat packed deep in your abdomen will quickly melt away. "Studies show that people who lose 10 percent of their body weight may reduce their visceral fat by 30 percent," Wood says.

What works better, diet or exercise? In the short term, cutting calories is easier. For a 145-pound woman, it takes a full hour and 10 minutes of walking at 4 mph to burn the number of calories -- 390 -- in one Starbucks oatmeal raisin cookie. It's a lot easier to just forgo the cookie -- in theory, anyway. "In reality, exercise works better long term because people are more willing to adopt exercise behaviors than dietary changes," Gaesser says.

The best approach is to combine a moderate increase in exercise with small, manageable dietary changes, like switching from mayo to mustard on your sandwich (savings: almost 100 calories per tablespoon) or eating an apple instead of drinking a glass of apple juice (savings: 45 calories). If you choose foods that are low in fat and high in fiber instead of processed and fast foods, you will likely consume fewer calories and stay satisfied longer.

Since stress has been linked to abdominal fat, it's also important to keep your anxiety level down by exercising regularly, getting enough sleep and taking time out to relax, whether in a yoga class or a 10-minute daily meditation session at home.

Don't be in a hurry to lose fat. Dropping about 2 pounds a week might sound realistic, but in truth, that's an aggressive goal, requiring about a 1,000-calorie deficit every day. "That's just not sustainable," says Ribisl, who would prefer to see that people aim for 1/2 pound a week. Over a year, that's still an impressive 26 pounds. The best way to reduce your body fat over time, experts say, is to make a healthy lifestyle your goal -- not to focus on the number of pounds you're losing. Once you adopt healthy habits and stick with them consistently, you can rest assured that eventually the weight will come off.

SUZANNE SCHLOSBERG lives, writes and has a healthy waist circumference in Bend, Ore.

Here's the link: http://www.shape.com/livehealthy/7201