No such thing as ‘healthy obesity’

The latest in a long line of studies on obesity counters the concept of “healthy obesity,” with researchers finding that over time, healthy obesity often devolves into unhealthy obesity, along with its associated health problems.

Some studies have concluded that for certain people, being overweight or obese may not be as dangerous, as long as cholesterol, blood pressure, insulin sensitivity and triglyceride levels fall into the healthy range. But researchers from University College London say their study shows that healthy obesity is often the first phase in the long-term deterioration of overall health.

Researchers examined more than 20 years’ worth of data — a longer period than any previous study on healthy obesity. First, they looked at about 2,500 people, 66 of whom were said to be healthy obese based on their cholesterol, blood pressure, fasting glucose or use of diabetes medication, triglycerides and insulin resistance. Over the next 20 years, more than half moved into the unhealthy obese category, and only 6 percent had lost enough weight to move into the non-obese category.

Researchers then looked at a larger group, consisting of 389 healthy obese. After 10 years, 35 percent had become unhealthy obese. After 15 years, 38 percent had moved into that category, and after 20 years, 48 percent were considered unhealthy obese. Only 10 percent had lost enough weight to move into the non-obese category after 20 years.

About a third of the healthy obese participants still had good metabolic profile after 20 years. But “the tendency for these adults to progress to unhealthy obesity gets stronger with time… Healthy obese adults tend to get worse, not better,” according to study author Joshua Bell.

Obesity increases the risk of a number of chronic conditions, including heart disease, diabetes, cancer and early death.

Dr. Jennifer DeBruler, an Advocate Medical Group physician specializing in weight management, says the key message is: Weight loss really is the best bet.

“Even though your numbers may look good now, they probably won’t in 10 or 20 years. For most people, this isn’t a bullet you can dodge. You’re at a much greater risk of a number of chronic diseases and mortality over the long term,” says Dr. DeBruler, who practices at Advocate Condell Medical Center in Libertyville, Ill.

“Adults of any size can take steps to improve health by avoiding processed foods and including physical activity into daily life,” she says. Many people make these kinds of lifestyle changes at the beginning of a new year, she adds, “but any day of the year is a great day to start.”