Research: Overweight, Obesity, or Overfat

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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.

Obesity and Complications
Obesity and Complications

This first article I reviewed was in Science Daily​[3]​ and is based on a journal article in Frontiers​[4]​ which puts forward the notion that need to expand the terminology and add the term overfat. This notion has been supported by further articles on Science Daily​[5]​ and in Cell Biology​[6]​. “Overfat” is simply what the word implies. Overfat is the condition of having excess fat in comparison to the person’s lean body mass​[7]​. 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​[8]​,​[9]​,​[10]​.  This article estimated that 76% of the world’s population is overfat​[3]​.

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​[11]​.  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 the body fat percentage is below 18% has its risks. You can’t upgrade your chassis so putting a battle tank on a VW Beetle chassis will result in the chassis wearing out. Look at the knee replacement rate for retired NFL players and you will that 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​[12]​.  In fact, muscle strength is inversely associated with a risk of all causes mortality​[13]​.  

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​[14]​,​[15]​,​[16]​.
  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: A reduction in body fat and weight is important to a healthy active lifestyle, but body fat loss is more important for health and longevity. It is recommended that you use waist circumference or pants size to follow your progress.

I would recommend the following book:


  1. [1]
    “Obesity and overweight,” World Health Organization, 01-Apr-2020. [Online]. Available: [Accessed: 21-Jul-2020]
  2. [2]
    “Overweight & Obesity Statistics,” National Institute of Health. [Online]. Available: [Accessed: 21-Jul-2020]
  3. [3]
    “Deeper than obesity: A majority of people is now overfat,” Science daily, 03-Jan-2017. [Online]. Available: [Accessed: 21-Jul-2020]
  4. [4]
    P. B. Maffetone, I. Rivera-Dominguez, and P. B. Laursen, “Overfat and Underfat: New Terms and Definitions Long Overdue,” Front. Public Health, Jan. 2017, doi: 10.3389/fpubh.2016.00279. [Online]. Available:
  5. [5]
    “Characteristics of metabolically unhealthy lean people,” Science Daily, 01-Aug-2017. [Online]. Available: [Accessed: 21-Jul-2020]
  6. [6]
    N. Stefan, F. Schick, and H.-U. Häring, “Causes, Characteristics, and Consequences of Metabolically Unhealthy Normal Weight in Humans,” Cell Metabolism, pp. 292–300, Aug. 2017, doi: 10.1016/j.cmet.2017.07.008. [Online]. Available:
  7. [7]
    M.-P. St-Onge, “Are Normal-Weight Americans Over-Fat?,” Obesity, pp. 2067–2068, Nov. 2010, doi: 10.1038/oby.2010.103. [Online]. Available:
  8. [8]
    E. Oliveros, V. K. Somers, O. Sochor, K. Goel, and F. Lopez-Jimenez, “The Concept of Normal Weight Obesity,” Progress in Cardiovascular Diseases, pp. 426–433, Jan. 2014, doi: 10.1016/j.pcad.2013.10.003. [Online]. Available:
  9. [9]
    N. B. Ruderman, S. H. Schneider, and P. Berchtold, “The ‘metabolically-obese,’ normal-weight individual,” The American Journal of Clinical Nutrition, pp. 1617–1621, Aug. 1981, doi: 10.1093/ajcn/34.8.1617. [Online]. Available:
  10. [10]
    N. Ruderman, D. Chisholm, X. Pi-Sunyer, and S. Schneider, “The metabolically obese, normal-weight individual revisited,” Diabetes, pp. 699–713, May 1998, doi: 10.2337/diabetes.47.5.699. [Online]. Available:
  11. [11]
    K. Sakuma and A. Yamaguchi, “Sarcopenic Obesity and Endocrinal Adaptation with Age,” International Journal of Endocrinology, pp. 1–12, 2013, doi: 10.1155/2013/204164. [Online]. Available:
  12. [12]
    P. Srikanthan and A. S. Karlamangla, “Relative Muscle Mass Is Inversely Associated with Insulin Resistance and Prediabetes. Findings from The Third National Health and Nutrition Examination Survey,” The Journal of Clinical Endocrinology & Metabolism, pp. 2898–2903, Sep. 2011, doi: 10.1210/jc.2011-0435. [Online]. Available:
  13. [13]
    J. R. Ruiz et al., “Association between muscular strength and mortality in men: prospective cohort study,” BMJ, pp. a439–a439, Aug. 2008, doi: 10.1136/bmj.a439. [Online]. Available:
  14. [14]
    S. S. Dagan, S. Segev, I. Novikov, and R. Dankner, “Waist circumference vs body mass index in association with cardiorespiratory fitness in healthy men and women: a cross sectional analysis of 403 subjects,” Nutr J, Jan. 2013, doi: 10.1186/1475-2891-12-12. [Online]. Available:
  15. [15]
    J. Patry-Parisien, M. Shields, and S. Bryan, “Comparison of waist circumference using the World Health Organization and National Institutes of Health protocols.,” Health Rep, vol. 23, no. 3, pp. 53–60, Sep. 2012 [Online]. Available:
  16. [16]
    W. Shen et al., “Waist Circumference Correlates with Metabolic Syndrome Indicators Better Than Percentage Fat*,” Obesity, pp. 727–736, Apr. 2006, doi: 10.1038/oby.2006.83. [Online]. Available:
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About the Author

I am a family physician who has served in the US Army. In 2016, I found myself overweight, out of shape, and unhealthy, so I made a change to improve my health. This blog is the chronology of my path to better health and what I have learned along the way.

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