In this era where obesity is so prevalent, the question has arisen as to whether everyone with obesity is at risk of developing complications of their excess weight, such as heart disease.  It turns out that all obesity is not equal, and that Healthy Obesity is a very real phenomenon.

A recent study that adds to our growing knowledge on this topic examined data from over 22,000 people in the United Kingdom, and compared the risk of developing cardiovascular disease, or death, in people who were obese vs not obese, according to whether they had other metabolic risk factors for cardiovascular disease or not (including high blood pressure, low levels of good cholesterol, diabetes, waist circumference, and a blood marker of inflammation called CRP).

Over an average of 7 years, the obese people who were metabolically healthy (with 0 or 1 of the above risk factors) were not at increased risk of cardiovascular disease, compared with metabolically healthy people who were not obese.  Amongst people who were metabolically unhealthy (with 2 or more of the above risk factors), body weight didn’t make a difference in risk – it was the metabolic factors that mattered, not the body weight.   Amongst people with obesity, those who were metabolically unhealthy were at 72% increased risk of death compared to those who were metabolically healthy.

The bottom line here is that it is not body weight that is the primary determinant of health, but rather, it is the risk factors for disease that may or may not be present (or develop) in the person who carries excess body weight that are the key.  In this study, one quarter of the people who were obese were metabolically healthy, and were therefore not at increased risk.

Once again, we learn that it is not about ‘curing’ obesity.  Rather, it is about each individual achieving their Best Weight – a realistic weight goal (which is different for everyone) that optimizes metabolic health and overall wellbeing.

Dr Sue Pedersen © 2012 

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