Published on January 12, 2018

The dangerous myth of healthy obesity

In 2013, the American Medical Association named obesity as a disease. They did so to raise awareness about the medical issues such as metabolic disease, type 2 diabetes and heart disease that can be caused by obesity.

It’s a problem that is not going to go away soon. More than one-third of Americans are obese, according to the Centers for Disease Control and Prevention.

Unfortunately, there is a lot of denial about the dangers of the condition. Some studies have even suggested that some obese people are in fact healthier than others, especially when it comes to cardiovascular risk. This has created some ambiguity in the medical world about whether being metabolically healthy obese is harmless.

New research presented at the European Congress on Obesity in May puts to rest the myth of healthy obesity. In the largest study of its kind, lead author Rishiraj Caleyachetty, MBBS, PhD, and a team from the Institute of Applied Health Research at the University of Birmingham analyzed the medical records of 3.5 million people who were enrolled in The Health Improvement Network between 1995 and 2015.

None of the patients had cardiovascular disease when the study began. The average follow-up of patients was approximately five years.

“I led the work testing the hypothesis that compared to metabolically healthy normal weight individuals, metabolically healthy obese individuals are at increased risk for cardiovascular events,” Dr. Caleyachetty said in an email interview.

The study showed that compared to metabolically healthy people, obese people have a seven percent greater risk of stroke, a 49 percent greater risk of coronary heart disease and a 96 percent higher risk of heart failure.

“These findings were no surprise, as previous studies had suggested similar, but this research is more conclusive,” he said.

Cardiologist Elissa Thompson, MD, Medical Director of Cardiac Rehabilitation at Cape Cod Hospital couldn’t comment on the study because it hasn’t been formally published yet, but she agrees with the idea behind it.

“I don’t think there is a real concept of healthy obesity,” she said. “It’s like saying there is a healthy cigarette smoker. The answer is no, because you are at risk. This is a vital sign that is not normal. In obesity, the fat that you carry is a metabolically active entity that increases levels of highly inflammatory chemicals.”

Some people who have obesity are going to be worse off than others, but eventually even those who are categorized as healthy obese are going to run into health problems. Carrying a lot of extra weight puts a strain on the heart, she said.

Even if a patient’s heart is functioning normal despite the extra strain, patients who are obese have other symptoms of the disease like diabetes, bad backs, compromised joints and shortness of breath.

Dr. Thompson compared being 80 pounds overweight to carrying a fifth grade child around all day long. Most people would find that a strain on their hearts and their bodies.

How To Lose

Losing weight is hard, but not impossible, she said. She recommends a healthy diet, regular exercise and even bariatric surgery, if necessary to help reverse the risks of diabetes and heart disease.

“You have to think of food as fuel and your body as being an engine,” she said. “We put inappropriate fuels in our bodies sometimes and then the engine doesn’t work right. Most people treat their cars better than their bodies. You would never take your gasoline car and go to a diesel pump and pump diesel into it once a week and say it’s only once in a while. Why would you put bad food into your body, even if it’s once in a while?”

For exercise, walking 150 minutes per week is a great way to start. Dr. Thompson is the Medical Director of the Healthy Parks, Healthy People collaboration between Cape Cod Healthcare and the Cape Cod National Seashore. The program provides maps and guides to trails in the National Seashore. The program runs during the summer months and is scheduled to resume in June.