Increase fitness or reduce weight? In the perfect world, healthy people do both, but which is more important for heart health and a longer life? A new study investigating the relationship between fitness, weight, heart health, and longevity revealed that obese people lower their health risks far more by improving their fitness than by dropping weight, proving that active people can be healthy at any weight.

The researchers reviewed more than 200 analyses and individual studies involving tens of thousands of obese men and women to determine the benefits of losing weight versus exercise for improving metabolism and longevity.1 Their biggest takeaway You do not need to lose weight to be healthy. Simply increasing physical activity and fitness reduces mortality risk.

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In fact, sedentary obese individuals who started an exercise program and improved their physical fitness lowered their risk of premature death by as much as 30 percent or more, even if they did not lose weight. These people are actually at lower risk of early death than those who are a normal weight but out of shape. In contrast, heavy individuals who lose weight through dieting may decrease their risk of early death by 16 percent; however, some studies found that weight loss among obese people does not decrease mortality risk at all. Often, those who shed pounds by dieting regain them, and calorie restriction is difficult to sustain over a prolonged period. A yo-yo approach to weight loss can contribute to metabolic problems like diabetes and high cholesterol and lower life expectancy.

The research provides further support for an obesity management approach that focuses on improving fitness rather than losing weight. It also supports mounting evidence that adults can be healthy at any weight if they remain active and engage in regular exercise.

Authored by Zach Meeker, Research Assistant for Midwest Orthopaedics at Rush University Medical Center


1 Gaesser, G.A., Angadi, S.S. (2021). Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. iScience.

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