As family physicians, we see obese patients who have heard the message to “just be fit” and have added 10–15 minutes of walking to their daily routine or have bought a Fitbit to track their physical activity. We applaud these efforts.

But for many obese people, the message that physical activity is more important than managing weight is not only unhelpful but also not true. When it comes to health and wellness, fatness can matter more than fitness.