With obesity affecting over a third of the population of the United States, the question of whether there is such a thing as healthy obesity is more important than ever. New research investigates whether people with obesity are still at increased risk of other diseases.
Obesity affects approximately 1 in 3 U.S. individuals. The Centers for Disease Control and Prevention (CDC) define obesity as having a body mass index (BMI) of 30 or higher.
In 2013, the American Medical Association deemed obesity a disease. The rationale behind this was to raise awareness around the metabolic complications that often accompany obesity, as well as around the increased risk of heart disease and type 2 diabetes.
However, some studies have suggested that there are obese people who are perfectly healthy, and who should therefore not be clinically categorized as “diseased.”
New, large-scale research, however, challenges this belief, suggesting that the “healthy obese” person is nothing but a myth.
The new study - which is the largest to have ever investigated this matter - was carried out by researchers from the University of Birmingham in the United Kingdom, and the findings were presented at the European Congress on Obesity, held in Porto, Portugal.
Studying the link between obesity and metabolic health
The researchers analyzed the medical records of 3.5 million adults living in the U.K. between 1995 and 2015 who were enrolled in the Health Improvement Network. The participants had no history of cardiovascular disease.
The team divided the population sample into several groups in relation to their BMI. They also broke down the population into subgroups according to their metabolic health - that is, whether they had or did not have metabolic conditions such as diabetes, high blood pressure, or abnormally high levels of fat in their blood.
Dividing the groups according to their metabolic health resulted in four stages of metabolic abnormality. These were: 0, 1, 2, and 3.
The researchers defined “healthy” - or level 0 on the metabolic scale - as having no signs of metabolic disease, having normal blood pressure and cholesterol levels, and having no signs of diabetes. They also monitored which participants developed cardiovascular conditions.
People with obesity 96 percent more likely to have heart failure
Overall, during the follow-up period, several serious health conditions occurred. These were as follows: 61,546 cases of coronary heart disease, 54,705 cases of stroke and ministroke, 25,254 cases of heart failure, and 23,797 cases of peripheral vascular disease.
Statistically, this amounted to a much higher risk of adverse cardiovascular events among those deemed obese.
Specifically, people with obesity considered to be healthy were 49 percent more likely to develop coronary heart disease, as well as 96 percent more likely to have heart failure.
Additionally, people with obesity had a 7 percent higher chance of having a stroke.
The lead author of the study, Dr. Rishi Caleyachetty, comments on the significance of the findings:
“The idea of being healthily obese is a myth. Our work shows that so-called ‘metabolically healthy’ obese individuals are still at higher risk of coronary heart disease, cerebrovascular disease, and heart failure than normal weight metabolically healthy individuals.The priority of health professionals regarding these patients should be to promote and facilitate weight loss, as it is with any other obese patient.”