Why do metabolic healthy obese people keep comparing themselves to “unhealthy thin” people when they should be comparing themselves to metabolically healthy THIN or normal weight people?
This is a great question, and finally, a large-scale study shows what many fitness/health enthusiasts and medical professionals have known all along.
To put it in layman’s terms, fat and healthy is still a lot worse than thin and healthy.
Perhaps I should replace “thin” with “normal weight,” but often, very overweight people will refer to a normal-weight or “medium” sized individual as “thin” or “skinny.”
I’ve even witnessed this odd phenomenon among normal-weight people, referring to themselves as skinny.
Study Results No Shock
That all said, Dr. Rishi Caleyachetty et al from the Institute of Applied Health Research, College of Medical and Dental Sciences, the University of Birmingham, UK, conducted a study with some not-so-surprising results.
Good metabolic health basically means that a person’s blood lipids, blood pressure and blood sugar levels are normal.
The “fat and healthy” camp, however, often dismisses this definition and uses “healthy” in a much broader sense.
You CAN be fat with good cholesterol numbers, low blood pressure and normal blood sugar, but what about OTHER problems that obesity is notoriously linked to, such as some cancers, osteoarthritis in the knees, chronic back pain, tiring quickly, increased rate of complications while giving birth or after surgeries, and mobility problems?
Metabolic health has nothing to do with these other obesity-linked issues.
Can a “metabolically obese” person still be at higher risk of cardiovascular disease than metabolically thin people?
The primary care health records of metabolically healthy obese patients and their thinner counterparts were analyzed — for the period 1995-2015.
The records came from a large UK database called The Health Improvement Network and consisted of 3.5 million adults who were initially free of cardiovascular disease.
The patients were divided into groups according to body mass index and the absence or presence of three metabolic abnormalities (high blood pressure, high blood fats and diabetes).
A metabolic score ranging from zero to 3 was then constructed. Metabolic healthy obesity (MHO) meant zero abnormalities.
Four Cardiovascular Conditions
• Heart disease
• Cerebrovascular disease (which can lead to stroke)
• Congestive heart failure
• Peripheral vascular disease
Is the risk of these four conditions greater in people with MHO than in metabolically healthy thin patients?
• People with MHO has a 50 percent bigger risk for heart disease.
• Seven percent increased risk for cerebrovascular disease
• Doubled risk for CHF
• The presence or absence of smoking was adjusted for, too.
• When smoking was excluded from the equation, MHO patients had an 11 percent higher risk for PVD.
You may think that seven, “doubled” and 11 are too small to count, but from a population statistical standpoint, these figures are significant.
An increased number of metabolic abnormalities meant a higher risk of CVD conditions. A score of 3 meant the highest risk for all the conditions:
• 2.6 times higher risk of heart disease
• 58 percent greater risk for CVD
• 3.8 times higher risk for heart failure
• 2.2 times greater risk for PVD
“Metabolically healthy obese individuals are at higher risk of coronary heart disease, cerebrovascular disease and heart failure than normal weight metabolically healthy individuals,” says Dr. Caleyachetty in the report.
If you’re fat but metabolically healthy and are poo-pooing these results, then how about considering the possibility that if you don’t get down to a medically acceptable weight, you’ll eventually develop one of the metabolic conditions, maybe all three?
You can be 30, fat and metabolically healthy NOW, but what about when you’re 35? This is one bridge you do not want to cross when you get to it. You want to avoid ever getting in the vicinity of that bridge.
“At the population-level, so-called metabolically healthy obesity is not a harmless condition,” says Dr. Caleyachetty, “and perhaps it is better not to use this term to describe an obese person.”