Overweight, but moving

Q I've heard weight doesn't matter much when it comes to health, as long as you're not very thin or very fat. I'm 20 pounds overweight and exercise for an hour four times a week--should I worry?

A Timothy Church, M.D., Ph.D., medical director of the Cooper Institute in Dallas, a nonprofit institute that studies obesity, physical activity and other health issues, answers our reader.

In a word, no. In Fact, you're probably healthier than your naturally thin friend who doesn't get off the couch. While excessive weight can lead to bone and joint problems and even depression, our data show that regular physical activity more than overcompensates for a little bit of extra weight. And a study just published in the Journal of the American Medical Association suggests that fitness level is a better predictor of heart disease than the body mass index (BMI).

You didn't mention where you carry your weight, but the fat you can pinch that bothers us all is not the real problem. Waist girth, rather than BMI, is becoming the new driver in health-risk assessment because it is a good indicator of the amount of internal fat you have between your organs, which can lead to diabetes, cancer, heart disease and other health problems.

The good news is that exercise selectively melts away this "bad" fat, and all it takes is 30 minutes, five days a week. You're doing more than that, so I doubt you have a lot of excess weight around your middle. If that's the case, don't get down about what the scale reads--some people are simply never going to obtain their "ideal" weight.

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