Fat but fit? It’s a misleading myth, doctors warned
By Shaun Wooller Health Correspondent
It is not possible to be ‘fat but fit’ and doctors should stop using the misleading phrase, researchers warn. Obese patients were still more likely to suffer lifethreatening conditions even if they had normal blood pressure, blood sugar and cholesterol levels. Researchers from the University of Glasgow tracked 381,263 adults over an average period of 11 years. those who were ‘metabolically healthy’ but obese were 22 per cent more likely to die than those of a normal weight. they were also 18 per cent more likely to have a heart attack or stroke, 76 per cent more likely to develop heart failure and four times more likely to suffer from type 2 diabetes. their odds of respiratory disease were 28 per cent higher and their likelihood of chronic obstructive pulmonary disease was 19 per cent greater. Participants with ‘ metabolically healthy obesity’ (MHO) were even 28 per cent more likely to have heart failure than ‘metabolically unhealthy’ slim people, the results revealed. Study leader Dr Frederick Ho said: ‘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. ‘Weight management could be beneficial to all people with obesity irrespective of their metabolic profile. ‘the term MHO should be avoided in clinical medicine as it is misleading and different strategies for defining risk should be explored.’ Obesity typically leads to metabolic problems, characterised by high blood sugar, raised blood pressure and insulin resistance. But the effects are not universal and between 3 and 22 per cent of the population are thought to have MHO, defined as having a body mass index (BMI) of 30 or more and at least four out of six health criteria. these included blood pressure, blood fat, ‘ bad’ cholesterol, ‘good’ cholesterol, blood sugar and inflammation. A third of those with MHO at the start of the study became metabolically unhealthy within three to five years. Participants with MHO were generally younger, watched less television, exercised more, had a higher education level, were richer and had a higher red and processed meat intake than those with metabolically unhealthy obesity. they were also more likely to be female and from a black or minority ethnic background. the findings were published in Diabetologia, the Journal of the European Association for the Study of Diabetes.