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Fit vs. Fat: What Matters More?

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Obesity is no longer evaluated by just weight. Listen to Michael Wigger, an Exercise Physiologist, explain how lifestyle, sleep, and exercise all play a big part in how fit you are.

Begin Transcript

Teera Wilkins:          Welcome to this edition of the Vanderbilt University Health and Wellness Wellcast.  I am Teera Wilkins with Occupational Health Clinic.  Today, I am interviewing Michael Wigger, an exercise physiologist at the Center for medical weight loss.  Hey Mike, how are you doing?

Michael Wigger:        I am good.  How are you?

Teera Wilkins:          I am doing pretty good.  Let us talk about the Center for Medical Weight Loss.  What are the different services that you offer?

Michael Wigger:        Well, we are, as you said, a medically focused clinic here at Vanderbilt, and so, what we mean by medically focus is we are a center that is focused on weight loss, but we go through essentially lifestyle changes.  So, we look at an individual’s nutrition habits, their exercise habits, sleep, lots of other issues, medications, that kind of things.  So, we are certainly a lifestyle change oriented clinic and that is what we do here.

Teera Wilkins:          From a medical prospective, what are the qualifications that would set someone at high risk for obesity?

Michael Wigger:        It is a great question and some ways kind of a lot, but I think I would summarize it into lifestyle.  You know that is kind of the big approach that we take.  There is nothing that is insignificant in terms of health behaviors that we have.  So, we look at what you eat and we look at the exercise you get, we take a look at medications that you may be taking, how previous medical issues or problems may now be impacting your weight and how to change those over time slowly, so the change that we make can be maintained over time.

Teera Wilkins:          Other than diet and exercise, what are the other risk categories that are needed when you are evaluating some one?

Michael Wigger:        As I maintained, you know, medication is certainly one, but at the same time, a lot of people, I think, underestimate the importance of sleep issues like obstructive sleep apnea can slow down a person’s metabolic rate; but if you think about the choices that you make when you are tired about food that you eat.  You are less likely to take this the time to do the grocery shopping and come home, and prepare a meal and not going to think it is the first thing you want to do when you get home as and just go to bed.

Teera Wilkins:          Right.

Michael Wigger:        And so, we look a lot at other factors; sleep as I mentioned is obviously a big one, medications, previous illnesses or other complications that are impacting may be what you want to do, but you cannot quite do it.  Lot of time we see joint pain is an example of that.  It will be great to exercise, but I cannot because of this, this, and this.  So, we would like to look at all those things and take those things into account as well.

Teera Wilkins:          Is this program covered by insurance?

Michael Wigger:        It is.  It definitely is, yup.

Teera Wilkins:          And the last question is can you explain the difference between fitness and fatness?

Teera Wilkins:          Yes.

Michael Wigger:        What research is showing now is that there is a difference in that what we mean in terms of how it impacts your health.  A lot of times, if we are honest to look at an individual who is overweight and just think, oh my god.  You know, I cannot believe how unhealthy that person may be, but in some ways it is more so your fitness than it is an individual’s fatness.  We are learning now that a person who is of normal weight but is low respiratory fitness is at a high risk of mortality and is essentially getting sick.  That could be equal to someone that is overweight, and so, visually, you know, we do not see that difference, but at the same time we can look at an individual who may have excess body weight but is in good respiratory fitness.  They are in shape.  Then, their risk of being sick is actually significantly lower than somebody who is not. So it’s not so much kind of what the outside looks like in some ways especially when it comes to fitness, but it is about having good fitness and maintaining a healthy weight as kind of the epitomy of health, and so, it is just interesting the research is showing it is not necessarily all in terms of the body weight.  It is very much important how in shape you are.

Teera Wilkins:          Thank you.

Michael Wigger:        Of course.

Teera Wilkins:          Thanks for listening.  Please feel free to leave us any comments on this Wellcast on the form at the bottom of this page.  If you have any story suggestions, please email us at or you can use the “Contact Us” page on our website at

— end of recording  —

Posted on Friday, March 28, 2014 in Occupational Health Clinic, Wellcasts and tagged , , ,


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