This is a story about healthy obesity and other tall tales, perpetrated by some in search of answers.
It started with some “health professionals” noticing that not everyone who is carrying too many pounds has health problems.
Some people who are overweight and even technically “obese” manage to escape the usual hazards…
And they even came up with an official “medical-sounding” name: Metabolically Healthy Obesity. Really.
Typically, health professionals define “overweight” as a body-mass index (BMI) between 25.0 and 29.9, and obesity as a BMI of 30 or higher. (BMI is a measure of weight that takes height into consideration).
Of course, by now we know that it’s not unusual for overweight or obese people to show potentially unhealthy changes in their metabolism. These include:
- High blood pressure
- High cholesterol, which damages arteries in the heart and elsewhere.
- Resistance to the hormone insulin, which leads to high blood sugar and often Type 2 Diabetes.
But some people who are overweight or obese manage to avoid these changes and, at least metabolically, and look like people with healthy weights. So, it seems that obesity does not affect everyone in the same way.
Except that appearing to be healthy does not mean they are healthy or safe. Read about Metabolic Syndrome Here.(Please!)
Several physicians from the Harvard School of Public Health contend that they have identified some specific characteristics of “metabolically healthy” individuals, the healthy obesity group.
• A waist size of no more than 40 inches for a man or 35 inches for a woman
• Normal blood pressure, cholesterol, and blood sugar
• Normal sensitivity to insulin
• Good physical fitness
These are not either or. To be included in the healthy obesity group you must have and maintain all three.
However, BMI is not a perfect measure of weight or obesity. It often identifies fit, muscular people as being overweight or obese. That’s because muscle is more dense than fat, and so it weighs more.
- But, muscle tissue burns blood sugar, a good thing, while fat tissue converts blood sugar into fat and stores it, a not-so-good thing.
Naturally, a lot more research will have to be done before we buy this theory of “healthy obesity.”
In the meantime, we should not use BMI as the only yardstick for measuring health and other factors that contribute to heart disease or Type 2 Diabetes.
Genes, for example, certainly play a role in how a person’s body and metabolism respond to weight.
- Some people may be “genetically protected” from developing insulin resistance.
- Others are genetically programmed to store fat in the hips or thighs, which is less (metabolically) hazardous than storing fat around the abdomen.
Currently, exercise and a healthy diet are the foundation for treating obesity. That’s not about to change. By all accounts, it makes more sense to intensify the lifestyle approach.
Even the metabolically stable need to work to stay that way, as do people who have even undergone bariatric surgery.
That’s one thing all physicians agree on.
Even the authors of the recent study and the researchers involved, warn overweight and obese patients not to rest easy.
Compared to normal-weight people with no metabolic conditions, the ones considered “metabolically stable” (despite being overweight or obese) had a 50% higher risk of cardiovascular disease, a 7% higher risk of stroke, twice the risk of heart failure, and a greater risk of peripheral vascular disease.
Keep in mind that just because someone is metabolically healthy at one point, does not guarantee they will always be healthy.
With aging, a slowdown in exercise, or other changes, metabolically healthy obesity can morph into its harmful counterpart quite easily and quickly.
And, of course, it’s very important to recognize that obesity can harm more than just metabolism.
- Excess weight can damage knee and hip joints, lead to sleep apnea and respiratory problems, and contribute to the growth of several cancers.
Bottom line? Obesity isn’t good, even if it’s the “metabolically healthy” kind.