In a new study from the University of Glasgow, researchers found that having a normal metabolic profile does not mean that a person with obesity is actually healthy (referred to as metabolically healthy obesity), since they face an increased risk of diabetes, heart diseases, strokes, and respiratory diseases.
It is estimated that globally there are over 300 million people with obesity, and if current trends continue then this figure will likely exceed 1 billion people by 2030 and comprise 20% of the world’s adult population.
Obesity typically leads to metabolic problems, such as high blood sugar, increased blood pressure (BP), insulin resistance, and other adverse metabolic changes.
These effects are not universal, and some people with obesity have normal blood pressure, favorable blood fats, little or no systemic inflammation, and a healthy level of insulin.
This is sometimes referred to as having ‘metabolically healthy obesity, and its occurrence is estimated to be 3% to 22% in the whole general population.
In the study, the team examined whether individuals who had obesity and a normal metabolic profile are healthy, or if they too have a higher risk of developing obesity-related health issues.
They analyzed data of 381,363 individuals (excluding those classed as ‘underweight’) for a median follow-up period of 11.2 years.
The team found that healthy obese people were 4.3 times more likely to have type 2 diabetes, 18% more likely to suffer a heart attack or stroke, had a 76% higher risk of heart failure, were 28% more likely to suffer respiratory disease and 19% more likely to suffer COPD compared to metabolically healthy participants without obesity.
In addition, these people were 28% more likely to have heart failure compared to metabolically unhealthy people without obesity.
The findings suggest that 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.
Particularly worth noting is that people with metabolically healthy obesity had a higher risk of heart failure and respiratory disease than metabolically unhealthy participants without obesity.
Furthermore, the team also found that, amongst a subset of participants with follow-up metabolic and obesity data, one-third of those with metabolically healthy obesity at the beginning of the study period became metabolically unhealthy within 3 to 5 years.
The team says 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.
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The study is published in Diabetologia. One author of the study is Dr. Frederick Ho.
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