There has been quite a hullabaloo in the size acceptance world about a study that was released earlier this week in the Archives of Internal Medicine. The study, titled "The Joint Effects of Physical Activity and Body Mass Index on Coronary Heart Disease Risk in Women," spawned dozens of news headlines, like "Study Gives the Skinny on 'Fit but Fat'," and "Exercise-heart study casts doubt on 'fit but fat' theory."

Which basically did nothing but add fuel to the fire of the diet hysteria that is engulfing the nation. Granted, the fire is burning sufficiently hot that it's kind of like adding kindling to a kiln, but we don't need any more, either. Much of the response to the study and the articles have been of the moralizing-from-the-high-horse philosophy. We TOLD you that you needed to get off your fat butt and lose some weight. NOW look at the pickle you're in.

Many people--even those in the health profession--look at the idea of "fit and fat" as kind of a cop out by fat people. It might not be what they directly say, but much of the thinking on the subject tends in that direction. It's an excuse, they think, by fat people who just have no willpower and can't lose weight. Except that dieting isn't about willpower and desire; millions of years of evolution can trump willpower and Jenny Craig in a heartbeat. Your brain doesn't want you to starve* and will take every effort to make sure that you eat.

And yes, dieting is a form of starving. Maybe not the Ethiopian kwashiorkor kind, but if you're not eating enough, even a little less than enough, your body and brain go into starvation mode.

So whatever the response to this study is, there remains the simple fact that DIETS DON'T WORK and there is no proven method to make large groups of people lose weight and keep it off long term.

Where are we left, then?

The study itself has some serious flaws, and I will leave it to other people with more time to deconstruct it. But even if the results of this study are true, even if they are, what then?

It might just be an inherent genetic risk factor. You can't do anything about the weight your genes want you to be at. I think of it this way. I have very fair skin- to the point where I tend to glow in photos. I have to look for cover-up in things like "ghost" shades. I got fair skin because my family ultimately hails from northeastern Europe. It means that my risk of skin cancer is higher than those who have darker skin tones.

There's not a damn thing I can do about this. I wear sunblock religiously to reduce my risk. I stay out of the sun the best I can during the most intense hours. But it's part of the genetic draw. I likely have other traits that might reduce my risk for other diseases. Again, I have no control over this.

So if your weight is meant to be at the upper end of the spectrum (or even higher than our society deems "healthy" or "acceptable," which is, you know, practically everyone), it might raise your risk of heart disease. There's no evidence concluding this for sure, but for the sake of argument, let's say there was this evidence. Just like my fair skin/skin cancer combo, it might just be something you have to accept. Not in a oh-crap-I'm-doomed-forever kind of way, but in a proactive way. Enjoyable physical activity is an important part of health. So is sunblock. It can reduce your risk of disease for which your genes might otherwise put you at higher risk.

This study, true or not, doesn't mean that you need to go out a diet. It would be like me using that spray-on tanning stuff (and orange you glad I did!). My skin color might be darker, but it would do precisely nothing to reduce my risk of skin cancer. Dieting won't help reduce your risk. At best it will make you batty and cranky. At worst, it will put you at risk for developing an eating disorder and ruin your physical and mental health.

The take home message remains the same: accept your weight, regardless of your size. Take care of yourself. It's the best thing you can do for your health- and your sanity.

*Unless you have the peculiar neurochemistry that makes starving, I don't know, preferable to eating.