Here's a (non-paywalled) press release from the journal: https://www.escardio.org/The-ESC/Press-Office/Press-releases/Being-fat-linked-with-worse-heart-health-e

Here's a (non-paywalled) press release from the journal: https://www.escardio.org/The-ESC/Press-Office/Press-releases/Being-fat-linked-with-worse-heart-health-even-in-people-who-exercise https://www.escardio.org/The-ESC/Press-Office/Press-releases... > The researchers investigated the associations between each BMI and activity group and the three risk factors. At all BMI levels, any activity (whether it met the WHO minimum or not) was linked with a lower likelihood of diabetes, high blood pressure or high cholesterol compared to no exercise at all. Dr. Lucia said: “This tells us that everyone, irrespective of their body weight, should be physically active to safeguard their health.” > However, overweight and obese participants were at greater cardiovascular risk than their peers with normal weight, irrespective of activity levels. As an example, compared to inactive normal weight individuals, active obese people were approximately twice as likely to have high cholesterol, four times more likely to have diabetes, and five times more likely to have high blood pressure. Dr. Lucia said: “Exercise does not seem to compensate for the negative effects of excess weight. This finding was also observed overall in both men and women when they were analysed separately.” > He concluded: “Fighting obesity and inactivity is equally important; it should be a joint battle. Weight loss should remain a primary target for health policies together with promoting active lifestyles.” I don't totally follow the establishment of causation here - in particular, it would seem to me like the arrow of causation is likely to go from diabetes to inability to lose weight, instead of vice versa? That is, equally active people with diabetes probably weigh more than people without, and the underlying cause is not their weight, it's their diabetes. So the conclusion in the press release that they should lose weight to get rid of their diabetes doesn't obviously make sense to me.