“Can you help me to lose weight?” is what many females ask when first meeting with a fitness professional. In a world where we are constantly barraged by images of beautiful and rail-thin supermodels, it’s no wonder that so many women aspire to reach unrealistic goals in terms of appearance.

However, in doing so, many women are unwittingly laying the groundwork for many chronic diseases associated with aging by placing a higher priority on aesthetics rather than on fitness.

Is “Fit” for Clothing or Health?

For many of our female clients, the only time the word “fit” figures into their vocabulary is in reference to a certain size of clothing. Some women may go so far as to tell their friends that they don’t have to exercise because they are already a Size 0.

Recent research has shown that, in spite of what fashionistas deem acceptable, thin and even skinny women who forego exercise are doing their bodies a disservice in terms of “fit-ness”. Several studies undertaken by researchers at the Cooper Institute in Dallas have illustrated that fitness is a far better indicator of health than body mass index or even body weight.

In fact, fitness, as measured by treadmill tests, was shown to be a much stronger predictor of overall mortality risk, regardless of BMI.

BMI and Weight Tables

Body composition refers to the measure of lean tissues and fatty tissues that comprise one’s bodyweight. A healthy and desirable body composition is one in which there is a greater ratio of lean muscle mass to adipose tissue.  Since lean muscle weighs more than adipose tissue, this may lead to a confusing situation when looking at a number on the scale.

In fact, extreme athletes or bodybuilders often display a bodyweight that is greater than average for their height. Their body composition, however, is highly desirable due to the greater amount of lean muscle mass.

The growing emphasis on fitness as opposed to thinness is definitely a shift in a positive, more healthful direction. Groundbreaking work being done by epidemiologist Steven Blair, a professor at the Arnold School of Public Health at the University of South Carolina, has shown the value of focusing more on overall body composition.  Therein lies the difference between being thin and being healthy.

skinny female runner

Potential and Dangerous Health Risks

Maintaining an extremely thin body while ignoring any attempt at physical fitness has the potential of leading to serious health problems. There are several diseases for which a lack of regular exercise is a major risk factor, including Type 2 diabetes, stroke, and heart disease.

This may come as a surprise to many of our thin, deconditioned clients who may have blindly believed these diseases could only affect overweight individuals.  In addition, being extremely thin while not engaging in any type of weight-bearing resistance training could possibly place a client at an increased risk for osteoporosis, especially if there is a lack of adequate calcium in her diet.

All too often, we see women overdoing cardio and purposely depriving themselves of calories in an attempt to attain what they consider a “thin, healthy physique”. The irony here is that, by starving oneself, and consuming, for example, a mere 1200 calories per day, the body not only is being deprived of necessary nutrients and energy, but it is also going to enter “starvation mode”.

Once this occurs, the metabolism slows and the body will actually hold onto any fat reserves. (Of course, if one deprives oneself drastically, allowing the intake to dip dangerously below 800 or 900 calories/day, one will most assuredly see a visible loss of fat. However, such practices may ultimately lead to severe health complications commonly associated with Anorexia Nervosa.)

Body fat is a long-term energy source; as such, the body will cling to this and will actually defend itself against further metabolic energy needs by destroying lean muscle mass. The result of extreme dieting may reveal a lower number on the scale, but this meaningless number comes at a great cost: skin begins to sag from the bones, all muscle tone is lost, and extreme fatigue sets in. All in all, one has become a “skinny fat person”.

Trainers as a Valuable Learning Resource

How can this be avoided? The answer is simple: proper exercise! Physical activity improves glucose metabolism, leads to better stroke volume, greater cardiac output, promotes healthy weight loss and body composition maintenance, and generally leads to an improved quality of life.

Authors of a 1999 article in the American Journal of Clinical Nutrition concluded that, for long-term health benefits, one should focus on improving fitness levels by increasing physical activity rather than relying solely on diet for weight control.

Certainly, we have the media to thank for our country’s growing obsession regarding weight as a primary measure of health. Yet more and more medical research is showing that not only is thinness a poor indicator of one’s overall well-being; somewhat overweight people may actually be more “fit” than their underweight counterparts.

In August 2008, a report in The Archives of Internal Medicine compared weight and cardiovascular risk factors among a representative sample of more than 5,400 adults. The data points to the fact that half the participating individuals who were somewhat overweight were actually “metabolically healthy”.

At the same time, about 25% of the slim yet deconditioned participants – those whose weight fell into the supposedly “healthy ideal range” — had at least two cardiovascular risk factors typically associated with obesity.  This indicates yet again how weight is a poor determinant of overall fitness health, and that individuals who may be carrying some extra pounds but can perform well on a treadmill test have a much lower heart risk than their thin, unfit counterparts.

As professionals, it is important to realize that the most ideal situation would be the slim client who regularly exercises and includes resistance training along with cardiovascular activity. In addition, even a slightly overweight client who possesses a high level of fitness can benefit from learning about proper nutrition and safely trying to shed those extra pounds. As with any important fitness and wellness suggestions, choose words wisely and judiciously when delivering such information to clients.

Helping Clients Redefine Their Outline

As fitness professionals, we are always going to train a few female clients who desire a very thin physique. The best way to approach such a situation is to encourage them to incorporate resistance training along with their cardio.

Adding lean muscle mass will help to increase metabolism. Muscle tissue is a very metabolically active “furnace”, leading to greater fat-burning capabilities. Lean muscle also adds depth and definition to the body, resulting in a much healthier overall appearance. Soon, we may be able to finally do away with the phrase “Thin is In!” and replace it with the phrase “There is Wealth in Better Health!”





Cathleen Kronemer

Cathleen Kronemer is an NFPT CEC writer and a member of the NFPT Certification Council Board. Cathleen is an AFAA-Certified Group Exercise Instructor, NSCA-Certified Personal Trainer, ACE-Certified Health Coach, former competitive bodybuilder and freelance writer. She is employed at the Jewish Community Center in St. Louis, MO. Cathleen has been involved in the fitness industry for over three decades. Feel free to contact her at trainhard@kronemer.com. She welcomes your feedback and your comments!