A Challenge of Terminology: Overweight or Overfat

One of the problems with our current state of diet, weight loss, and obesity in the United States is the language we use. Every article I read refers to weight loss when they mean fat loss. I am no different because I interchange the worse at will. Although I am not as adamant to make a change as the writers of two articles a read preparing for the post, I agree that we need to change our mindset.

Obesity is a pandemic in the world. Based on conservative numbers from the World Health Organization (WHO) 39% of adults are overweight, and 13% are obese worldwide​[1]​. According to the National Institute of Health (NIH), nearly 70% of United States citizens are either overweight or obese​[2]​. Clearly, this is a problem that needs to be addressed immediately.

The first article I reviewed was on Science Daily​[3]​ based on a journal article in Frontiers Public Health​[4]​ which puts forward the notion that needs to expand the terminology and add the term overfat. “Overfat” is simply what the word implies. Overfat is the condition of having excess fat in comparison to the person’s lean body mass​[5]​. The body weight may be too high or normal or even low.  Normal body weight and elevated body fat have been referred to as normal weight obesity in the past​[6]​,​[7]​,​[8]​.  This article estimated that 76% of the world’s population is overfat​[9]​.

Why should we add this term? Overfat is an excellent addition to the terminology because if you have excess body fat, you are more likely to develop central obesity, metabolic syndrome, and the many obesity-related illnesses that come with it (high blood pressure, insulin resistance, diabetes for example). It is also important for us to shift our focus from losing weight to losing fat.

As we age, our bodies adapt our metabolism and we become increasingly less muscular and add central body fat or obesity.  This is called sarcopenic obesity​[10]​.  It is a risk factor for metabolic syndrome and insulin resistance.   

So why don’t we just ditch the term overweight for overfat? It seems like a simple swap but it is not. Weight is more complicated than just being overweight. My muscle-bound friends would like me to skip this one, but I can’t. Being overweight even if the BMI is low and body fat percentage is below 18% has its risks. You can’t upgrade your chassis so putting a battle tank on a WV Beetle chassis will result in the chassis wearing out. Look at the knee replacement rate for retired NFL players and you will that being overweight has its risks even without excess fat.  That being said, higher levels of muscle mass have been shown to lower the risk of diabetes and metabolic syndrome as long as body fat is not also increased​[11]​.  In fact, muscle strength is inversely associated with a risk of all causes of mortality​[12]​.  

The importance of this article:

1. Body fat not weight. This publication acknowledges a need to refocus health changes on body fat loss and not weight loss.
2. Body Mass Index is a poor measure of obesity or body fat. The article explains the shortcomings of BMI and indicates that waist circumference is a better and more practical measure of overfat or obesity​[13]​,​[14]​,​[15]​.
3. Overfat Awareness. The change in terminology may alter the focus in individuals and medical providers away from body weight and heaviness to body fat reduction. I have an even easier one to use – pants size.

Recommendation: reduction in body fat and weight is important to a healthy active lifestyle, but body fat loss is more important for health and longevity. Use waist circumference or pants size to follow your progress.