No such thing as “healthy obesity,” say experts

By Sally Robertson, B.Sc.May 18 2017

A new study from the University of Birmingham has presented evidence that could settle the debate over whether people can be obese and healthy at the same time.

The study, which is the largest of its kind, involved an analysis of electronic patient records for 3.5 million people across the UK between 1995 and 2015.

The results showed that obesity increased the risk of heart disease by half, even when blood pressure and cholesterol levels were normal, as well as significantly increasing the risk of stroke and heart failure.

For the study, a team from the Institute of Applied Health Research checked GP records for markers of metabolic health, normal blood pressure, the absence of diabetes and a healthy cholesterol level among people who classified as obese. All individuals were aged 18 years or older and were initially free of cardiovascular disease.

The researchers then tracked how many individuals suffered from one of the following four cardiovascular conditions: coronary heart disease, cerebrovascular disease, peripheral vascular disease and heart failure.

The results, which were presented at the European Congress in Porto, Portugal earlier this week, showed that obese individuals who were considered healthy were at a 49% increased risk of coronary heart disease, a 7% increased risk of stroke and a staggering 96% increased risk of heart failure, compared with people of normal weight. Even when factors such as smoking were taken into account, these figures remained the same.

Previous research has suggested that being obese doesn’t necessarily make you unhealthy, based on the fact that up to one third of obese people have an apparently normal health profile, despite having a body mass index (BMI) of 30 or more. Terms that have emerged for this concept include “healthy obesity” and “fat, but fit.”

Lead author of the study, Rishi Caleyachetty, says: “Metabolically healthy obesity is not a harmless condition, and it would be incorrect to think so… It’s actually better not to use this term as it can create a lot of confusion.”

“The priority of health professionals regarding these patients should be to promote and facilitate weight loss, as it is with any other obese patient,” concludes Caleyachetty.