Obese But “Healthy” May Still Kill You?

Recently, I blogged about Jennifer Kuk’s study showing that even so called “metabolically healthy” obese folks may have an increased risk of premature death. This study certainly supported the notion that the term “healthy obese” may well be an oxymoron.

Now, a new study Johan Ärnlöv and colleagues from Uppsala University, Sweden, published online in Circulation, provides further support for the idea that obesity may still kill you even if you have no other apparent metabolic risk factors.

The researchers looked at deaths in 1758 fifty-year old male participants without diabetes in the community-based Uppsala Longitudinal Study of Adult Men (ULSAM).

After adjustment for age, smoking, and LDL cholesterol, as expected, an increased risk for cardiovascular disease was observed in normal-weight (hazard ratio 1.63), overweight (HR 1.74), and obese (HR 2.55) participants with metabolic syndrome (MetS).

However, even in participants without MetS, overweight (HR 1.52) and obesity (HR 1.92) were associated with a significantly greater risk for cardiovascular disease.

Thus, as in the previous study by Kuk and colleagues, it again appears that excess weight is a significant predictor of heart disease even in people who appear to be metabolically healthy.

Clearly, taken together, these studies challenge the notion of so-called “healthy” or “benign” obesity.

What does this mean for clinical practice and weight-loss recommendations?

As blogged before, unfortunately losing weight and keeping it off is by no means easy and most people will tend to regain any weight they lose. For this reason alone, prevention of further weight gain is a far more achievable and realistic goal than losing weight and keeping it off.

For practical reasons, I have therefore previously recommended that we focus our expensive and limited weight-loss treatments on people with apparent obesity related complications (EOSS Stage 2 and 3). 

But let us not kid ourselves into believing that excess weight can be a benign condition and that simply continuing to gain weight can be OK as long as medical check ups show no sign of obesity-related illness.

It is always the right time to stop the gain!

Edmonton, Alberta