There is no such thing as healthy obesity, a Scottish study reports.
A normal metabolic profile doesn't mean an obese person is actually healthy, because he or she still has an increased risk of diabetes, heart disease, stroke and respiratory illness, University of Glasgow researchers explained.
"The term 'metabolically healthy obesity' should be avoided in clinical medicine as it is misleading, and different strategies for defining risk should be explored," wrote researchers led by Frederick Ho, a research associate at the university's Institute of Health and Wellbeing. The study was published June 10 in the journal Diabetologia.
For the study, Ho and his colleagues analyzed data from more than 381,000 people in the United Kingdom who were followed for an average 11.2 years.
They compared metabolically healthy people who weren't obese to those who were obese but deemed metabolically healthy — meaning they did not have high blood sugar, high blood pressure, insulin resistance and other harmful metabolic changes associated with excess weight.
Compared to healthy folks who weren't obese, those who were metabolically healthy but obese were 4.3 times more likely to have type 2 diabetes; 18% more likely to suffer heart attack or stroke; 76% more likely to develop heart failure; 28% more likely to have respiratory disease; and 19% more likely to have COPD.
Compared to metabolically unhealthy people who weren't obese, those who were metabolically healthy and obese were also 28% more likely to have heart failure.
The study also found that among a subset of participants with follow-up data, a third of those with metabolically healthy obesity at the outset became metabolically unhealthy within 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," the researchers said in a journal news release.
They said weight management could be beneficial to all people who are obese regardless of their metabolic profile.
Worldwide, more than 300 million people are obese. If current trends continue, that number is projected to top 1 billion by 2030 — 20% of the world's adult population.