Study says ‘healthy obesity’ still linked to increased health risks

Despite having “metabolically healthy obesity,” a recent study has shown people still face a heightened risk of disease.

A team at the Institute of Health and Wellbeing at the U.K.’s University of Glasgow has found a normal metabolic profile doesn’t mean a person is truly healthy. This is because they have a greater risk of having heart disease, diabetes, respiratory diseases and strokes.

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The research was conducted in part by study co-author by Dr. Frederick Ho. It was published in the journal Diabetologia.

Metabolically healthy obesity, or MHO, implies certain people with obesity have normal blood pressure, favorable blood fats, little or no systemic inflammation and healthy insulin levels. The University of Glasgow study sought to determine how MHO is linked to a variety of obesity-related outcomes.

Analyzing 381,363 UK Biobank participants, researchers followed up 11.2 years on average. Researchers defined MHO as having a BMI less than or equal to 23.7 pounds per square foot and at least four of the six standards for metabolic healthiness. Some included blood-based biomarkers including LDL cholesterol levels and HbA1c. The latter measures how well blood sugar is managed over 2-3 months.

Associations between MHO and Type 2 diabetes, heart failure, heart attack, stroke, and respiratory illnesses were reviewed.

Participants were classified as metabolically healthy non-obese (MHN), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUN), and metabolically unhealthy obese (MUO) based on metabolic and obesity status.

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Results showed that the MHO group was just over four times as likely to have Type 2 diabetes and 18% more likely to have a stroke or heart attack than the MHN group. Participants with MHO also had a 76% greater heart failure risk and had 28% greater chances of having a respiratory disease than MHN participants. MHO group members also had a 19% greater likelihood of having chronic obstructive pulmonary disease, or COPD.

Additionally, the MHO group was 28% more likely to have heart failure than the MUN group.

“People with metabolically healthy obesity are not ‘healthy’ as they are at higher risk of heart attack and stroke, heart failure, and respiratory diseases compared with people without obesity who have a normal metabolic profile,” researchers concluded.

“Weight management could be beneficial to all people with obesity irrespective of their metabolic profile. The term ‘metabolically healthy obesity’ should be avoided in clinical medicine as it is misleading, and different strategies for defining risk should be explored.”