It Isn't Enough To Be Thin If You Never Exercise

The analysis of data from over 330,000 people for 20 years found that getting more exercise did not predict whether people would maintain the same weight, gain weight, or lose weight. The authors of the study note that thin people who never exercise are at greater risk of early death from cardiovascular disease, cancer, and other ills than obese people who do. What is it about physical inactivity that increases the risk of death even more than obesity?

• Physically inactive people are at greater risk for deep-vein thrombosis, the formation of blood clots in veins in the legs that can travel to the heart and brain.
• Physically inactive people are less able to literal "fight or flight" situations, and may be more likely to succumb to accidents or intentional injury.
• Physically inactive people do not put stress on their bones, so their bones renew and remodel themselves less frequently. They are more likely to suffer fractures and breaks when they fall, and breaks of certain bones (the hips, the skull) are associated with increased risk of death.
• Physically inactive people are more prone to feelings of anxiety and depression.
• Physically inactive people are at greater risk for development of diseases that become confining, such as lower back pain, which increase the effects of their inactive lifestyle.
• Physically inactive people are at greater risk for certain kinds of cancer, notably breast cancer and colon cancer, and have more difficulties dealing with complications of cancer treatment such as lymphedema.

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Moreover, the data revealed that while exercise seems to prevent numerous physical ills, it does not necessarily prevent weight gain.

• Some people compensate for exercise by eating more. This means they get the cardiovascular benefits of exercise without getting the full range of metabolic benefits of exercise. People who try to lose weight by exercising more typically gain weight, less than a kilogram (2 pounds) or so, in the form of muscle.
• Type 2 diabetes can make exercise tricky. Diabetics who are not used to exercising on a regular basis may take too much insulin or fail to eat enough carbohydrates to prevent crashing blood sugars during their workout. The natural response to falling blood sugars is to eat ravenously, and to consume more calories than are burned in the workout. The solution is to do short sessions of mild exercise, testing blood sugar levels before and after, slowly building up to full workouts when blood sugar responses are well known.
• Obesity has a genetic component (as do habits for getting exercise). Genetic factors may amplify the effects of choices that have smaller impact on other people who do not have the gene.

Ideally, everyone should exercise, maintain a "normal" weight, and avoid smoking. If you can only accomplish one of these three goals, however, exercise. Physical activity is even more important to health than weight control and avoiding tobacco.