People with ‘healthy obesity’ still have higher risks of diseases

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In a study from the University of Glasgow and elsewhere, scientists 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.

The research examined whether people who had obesity and a normal metabolic profile are healthy, or if they too have a higher risk of developing obesity-related health issues.

The ongoing global epidemics of type 2 diabetes (T2D), high blood pressure, heart disease (CVD), and many other serious health problems are linked to obesity.

Obesity typically leads to metabolic problems, characterized by elevated 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’ (MHO), and its occurrence is estimated to be 3% to 22% in the whole general population.

In the study, the team looked at the association between MHO and all-cause mortality, T2D, heart attack and stroke, heart failure (HF) and respiratory diseases, including chronic obstructive pulmonary disease (COPD).

They analyzed the details of 381,363 individuals (excluding those classed as ‘underweight’) for a median follow-up period of 11.2 years.

The team found that MHO individuals were generally younger, watched less television, exercised more, had higher education levels, lower deprivation indexes, higher red and processed meat intake, and were less likely to be male and non-white than participants who were MUO.

Compared to metabolically healthy participants without obesity (MHN), participants with MHO were 4.3 times more likely to have T2D, 18% more likely to suffer 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 unhealthy people without obesity (MUN), those classed as MHO were 28% more likely to have heart failure.

The team says 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.

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 one-third of those with metabolically healthy obesity at the beginning of the study period became metabolically unhealthy within 3 to 5 years.

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The study was conducted by Dr. Frederick Ho et al and published in Diabetologia.

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