Metabolically Healthy Obese – Apparently an Oxymoron

August 22, 2017 in Health, Weight Management by Joyce Bunderson

Researchers at Imperial College in London and University of Cambridge have conducted a study that compares “healthy” and “unhealthy” obese individuals and published the findings in The European Heart Journal. Use this doi number: doi/10.10936/eurheartj/ehx448/4081012.

There’s been a lot of chat about overweight and obese persons who are healthy; you may be acquainted with the concept of “fat and fit.” Actually healthcare workers have even named the group the “metabolically healthy obese.” The group has a higher-than-normal body mass index (BMI) but no identifiable health issues. [Be sure to just glance at the limitations of BMI, if you go to the site and are not familiar with BMI. One quick example is a body builder; he/she may have an unusually high weight, but it is from their unusually large volume of muscle mass – not fat.] In essence, the study cited above has found that even those that seem healthy are actually at an increased risk of developing coronary heart disease. This is a serious concern in the United States and increasingly throughout the world. In the U.S., according to the National Institute of Health more than 68.8% of adults are overweight or obese; 35.7% are obese and 6.3% are extremely obese. In adult men, 74% are considered to be overweight or obese. One of the saddest statistics is that in the 12 – 19 year old group, there is a 20.5% rate of obesity.

The study used data for well-over 500,000 people; aged 35 to 70. It was a surprise that the overweight and obese people who were in the metabolically healthy category ended up in the high risk of developing coronary heart disease compared with those of a normal weight. The participants who were only in the overweight category were found to have a 26 percent higher risk of coronary heart disease than the normal weight counterparts. If they were obese then they had a 28 percent higher risk of coronary heart disease.

The researchers suggest that there is no longer a concept of healthy obese. The lead researcher, Camille Lassale said; “It’s another brick in the wall of evidence that being healthy overweight is not true.” Lassale added that the metabolically healthy with excess weight should not rest on their laurels: “We saw that they go on to develop (more) heart attacks.” The researchers’ thesis is that those that seem healthy have simply not yet developed the unhealthy metabolic profile. It just comes later in their lifetime. They also say that it may not be the weight, per se, that causes the coronary heart disease; but is probably caused more directly by factors like high blood pressure and hyperglycemia (high blood sugar – diabetes). These in turn are influenced by overweight / obesity.

The bottom line of this research is that if a patient is overweight or obese, efforts should be made to help them get to a healthy weight – even if their blood pressure, blood sugar and cholesterol are at the time in the normal range, because the excess weight is still a risk factor by itself.

Overweight and obesity have many negative health consequences, in addition to coronary heart disease. Two examples are hypertension (high blood pressure) and type 2 diabetes. So now that we’ve debunked the term “metabolically healthy obese,” maybe we spend some effort on keeping our bodies as close to normal weight as possible; or losing weight if that’s what’s necessary. It seems sensible not to wait to develop high blood pressure, high cholesterol or type 2 diabetes. Right?