A new study debunks the myth of “healthy obesity” perpetuated by a long tradition of jolly men whose otherwise normal health readings — levels of cholesterol, sugar — bely a heightened overall risk of premature death.
In analyzing data from more than 61,000 patients from eight studies, investigators in Toronto said on Monday they’d found great evidence challenging the popular notion that some may live healthy lives while overweight or obese.
“Our research findings challenge the myth that there is such a thing as healthy obesity if people maintain normal-range readings of cholesterol, blood glucose, and blood pressure,” Ravi Retnakaran, an endocrinologist at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, said in a statement.
Not surprisingly, investigators found the lowest risk of premature death among people of healthy weight and body mass index. But they also found evidence that obese people enjoying good metabolic health — with relatively low levels of cholesterol, for example — were also at a higher risk of death. People who were overweight but not obese carried the same risk for premature death as those who were obese, investigators added.
Those effects appeared only in studies that tracked subjects for at least 10 years. Even with no metabolic problem, such as high cholesterol or hypertension, obese people carried a much higher risk of premature death — as much as 24 percent higher risk than others.
“The finding of increased risk of death or cardiovascular events for obese individuals suggests that gaining excess weight is associated with risk that may accumulate over time, even before metabolic and cardiovascular signs become apparent in tests,” Retnakaran said. “This is a signal to general practitioners and family physicians to guide their obese patients to weight loss, regardless of lab tests.”
Aside from a higher risk for cardiovascular and metabolic diseases, obesity increases risk of type 2 diabetes, kidney disorder, some cancers, and has been linked to orthopedic problems, reproductive health issues, renal disease, back pain, skin infections, and cognitive decline. Thus, the investigators advise that obesity be viewed holistically, given the condition’s effect throughout the human body.
Bernard Zinman, a senior investigator at the institute, described the new evidence on Monday. “When we compared … weight groups, we found that obesity stood out as the key risk factor for premature death from any cause, including cardiovascular events,” he said in the statement. “That’s true for obese people with so-called healthy metabolic status as well as obese people with poor metabolic status — that is, high blood pressure, cholesterol, and blood glucose levels.”
Investigator Caroline Kramer said the new evidence should spur further research as well as policy changes in health care. “The idea that we don’t need to target health care resources toward obese people whose lab tests are ‘normal’ turns out to be false,” Kramer said. “Our message to physicians is that for obese individuals, normal metabolic status regarding blood pressure, cholesterol and blood glucose is not protective. If they can start to lose weight, that’s a benefit.”
In an accompanying editorial, medical experts from the University of Colorado also sought to dispel the notion that obesity cannot be treated effectively in a clinical sense. “Although we lack a simple algorithm or medication to eradicate this condition, clinically significant weight loss can be achieved with behavioral treatment, pharmacologic agents, and bariatric surgery,” they wrote.
Source: Kramer, C.K., Zinman, B., Retnakaran, R. Overweight and healthy' is a myth. Annals Of Internal Medicine. 2013.