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There's no reason one can't be "fat" and healthy at the same time. I'll prove it, simply.
Biologically speaking, fat on its own isn't problematic, not unless you're like super obese. The problem is diet. It just so happens that most people who get fat do so by eating terrible food, as it's the easiest way to blow up.
But let's say I eat healthy. I cook my meals without littering them with unnecessary sodium and fats. I eat fruit and vegetables regularly. I rarely eat fast or junk food.
However, my healthy diet consists of 3000 calories worth of food everyday.
I also do 500 calories worth of intense cardio almost daily.
Assuming I need more than 2000 calories to gain weight, I'd gain a pound a week. After a year I'd have gained about 50 lbs.
I would be "fat," yet I would be the healthiest person in the room 95% of the time. Your health is primarily determined by your diet and the strength of your organs, not by how much space your body occupies.