Society has come a long way since the days of The Biggest Loser where even the most unfit individuals were forced to lose weight in an effort to mould their body into the cookie-cutter shape deemed socially acceptable. Now, with the knowledge and understanding that health looks different on everyone and isn’t confined to a number on the scale, we’ve become more accepting of different shapes and sizes. Granted, there’s still a lot that can be done, particularly when it comes to the stigma associated with weight gain, but as we have come to embrace the phrase “fit but fat”, scientists are urging many to reconsider their health goals.
According to a new study, those who are best defined as ‘fit but fat’ are actually at an increased risk of suffering from obesity-related health issues. The term is often used in relation to those with metabolically healthy obesity. Those belonging in this category tend to have a body mass index of 30 or higher, but don’t have the systemic inflammation, problematic blood fats or insulin issues often associated with obesity.
Conducted by researchers at the University of Glasgow, the study found that compared with metabolically healthy people who aren’t medically obese, those with metabolically healthy obesity were 4.3 times more likely to suffer from type 2 diabetes, 18 per cent more likely to suffer heart attack or stroke and, most shockingly, their risk of heart failure increased by 76 per cent.
Researchers monitored more than 380,000 individuals who fell into one of four categories: metabolically healthy obese, metabolically unhealthy obese, metabolically healthy non-obese, or metabolically unhealthy non-obese. Those who were metabolically healthy obese were generally younger, watched less television, exercised more and had a lower deprivation index. Despite this, they were still at greater risk of suffering from obesity-related issues.
As Dr Frederick Ho, a research associate of public health at the University of Glasgow, explains: “People with metabolically healthy obesity were at a substantially higher risk of diabetes, heart attack and stroke, heart failure, respiratory diseases and all-cause mortality compared with people who were not obese and with a healthy metabolic profile.”
Ho continued, “Generally, rates of cardiovascular and respiratory outcomes were highest in metabolically unhealthy obese, followed by metabolically unhealthy normal and metabolically healthy obese, except for incident and fatal heart failure, and incident respiratory diseases. For these outcomes, people with metabolically healthy obesity had higher rates than those with metabolically unhealthy normal.”
Researchers also discovered that those who were metabolically healthy obese at the beginning of the study became metabolically unhealthy within just three to five years. “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,” said Ho.
Ho added, “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.”