Obese, but nevertheless healthy?
It may really exist: a healthy form of obesity. Canadian researchers from York University come to this controversial conclusion in a study that will soon appear in Clinical Obesity. According to that study, there may be indeed a group of people who are both obese and healthy. But even if the Canadians are right, then that group of healthy obese people is pretty small...
Metabolically healthy obesity
Health scientists have been wondering for some years whether there is such a thing as healthy obesity. Most researchers do not think so, but a minority thinks otherwise.
Don't get us wrong, the latter group is convinced that most obese people are unhealthy. Most obese people have diabetes, bad cholesterol levels or hypertension. But what if those risk factors are absent?
The researchers collected data from 54,089 adult Americans from 5 different epidemiological studies. The researchers knew the BMI, waist, blood pressure, cholesterol values and insulin sensitivity of the study participants, and were able to follow them for an average of thirteen years.
Only 17 percent of the study participants had a healthy weight, healthy cholesterol, healthy blood pressure and no diabetes. Welcome to the 21st century.
The study participants with a BMI of 25-30, and the study participants who were obese, did not have an increased risk of death if they had no risk factors [No RF] like diabetes, hypertension or bad cholesterol levels. The same applied to the study participants with a large waist.
When the researchers looked at the risk factors - type 2 diabetes, bad cholesterol levels and increased blood pressure - another picture emerged. The study participants who, for example, only had diabetes, but who did have a healthy weight, did not had an elevated blood pressure and had healthy cholesterol levels, still had an increased risk of death.
"This is in contrast with most of the literature and we think this is because most studies have defined metabolic healthy obesity as having up to one metabolic risk factor", says first study author Jennifer Kuk in a press release. [sciencedaily.com July 12, 2018]
"This is clearly problematic, as hypertension alone increases your mortality risk and past literature would have called these patients with obesity and hypertension, 'healthy'. This is likely why most studies have reported that 'healthy' obesity is still related with higher mortality risk."
"We're showing that individuals with metabolically healthy obesity are actually not at an elevated mortality rate. We found that a person of normal weight with no other metabolic risk factors is just as likely to die as the person with obesity and no other risk factors."
"This means that hundreds of thousands of people in North America alone with metabolically healthy obesity will be told to lose weight when it's questionable how much benefit they'll actually receive."
Even if Kuk is right, and if such a thing as 'metabolically healthy obesity' exists, then this is of no consequence to the overwhelming majority of obese people. In Kuks research, only 6 percent of all obese study participants were considered to be metabolically healthy...
Clin Obes. 2018 Jul 12. doi: 10.1111/cob.12263. [Epub ahead of print].
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