The Idea that One can be Healthy Regardless of Bodyweight is Misguided, Study Finds

A number of studies have shown that people classified as overweight or obese do not necessarily have poor metabolic health (characterised by markers such as blood pressure, blood sugar and cholesterol levels), leading researchers to conclude that being fit does not depend on bodyweight (or, more precisely, body fat levels) – an idea presented in the media using the monikers ‘fat but fit’ and ‘health at every size’.

Now, however, a group of scientists at Imperial College London and the University of Cambridge has shown that carrying extra body fat is actually detrimental to the heart even with the absence of metabolic impairment.

A spare tire around the waist is detrimental to health even in the absence of detectable markers of poor metabolic function. Image credit: Steve Baker via, CC BY-ND 2.0.

Data for the study was obtained from the European Prospective Investigation into Cancer and Nutrition (EPIC-CVD) involving more than half a million people in 10 European countries.

“Our findings suggest that if a patient is overweight or obese, all efforts should be made to help them get back to a healthy weight, regardless of other factors. Even if their blood pressure, blood sugar and cholesterol appear within the normal range, excess weight is still a risk factor,” said lead author Dr Camille Lassale, from Imperial’s School of Public Health and now based at University College London.

In the study, researchers selected a representative group of 10,000 individuals as controls and compared them to subjects of the EPIC-CVD.

Bodyweight was classified in accordance with BMI and volunteers were categorised as ‘unhealthy’ if they had three or more of a number of metabolic markers, such as high blood pressure, cholesterol or triglyceride levels, and high waist size.

Even after adjusting for lifestyle factors like smoking, diet, exercise level and socioeconomic status, metabolically healthy but overweight people were found to be 26% more likely to develop coronary heart disease (CHD) than controls, while ‘healthy’ obese people had a 28% increase.

“Overall, our findings challenge the concept of the ‘healthy obese’. The research shows that those overweight individuals who appear to be otherwise healthy are still at increased risk of heart disease,” concludes Lassale.


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