In a new study, researchers may have debunked the myth of the “heavy but healthy” population — at least when it comes to heart disease.
The research, which involved more than 3.5 million people over a 10-year span of time, shows that obesity is linked to higher rates of coronary disease even in people considered to be “metabolically healthy.” The study, presented at the European Congress on Obesity, suggests that previous ideas of “healthy” obese people may be a public health misconception.
“This is another study highlighting that, if you are overweight, you are more likely to suffer from heart disease. It’s not often that research on this scale and magnitude is able to clarify an age-old myth,” said Mike Knapton, M.D., Associate Medical Director at the British Heart Foundation.
“These findings should be taken extremely seriously and I’d urge health care professionals to take heed,” added Knapton.
People with metabolically healthy obesity have a high body mass index (BMI) but don’t show signs of other complications, such as high blood pressure, elevated blood fats or diabetes, that typically come with being overweight.
Just because those markers aren’t there, that doesn’t mean an elevated risk of disease isn’t lurking, shows the study.
“Metabolically healthy obese individuals are at higher risk of coronary heart disease, cerebrovascular disease and heart failure than normal weight metabolically healthy individuals,” said Rishi Caleyachetty, M.D., an epidemiologist with the Institute of Applied Health Research at the University of Birmingham.
In comparing the health outcomes of non-obese people with obese people who are metabolically healthy, the researchers discovered that long-term health challenges tend to crop up more often in the obese individuals. Specifically, obese individuals had double the risk of heart failure and a 50 percent heightened risk of coronary heart disease.
“This is the largest prospective study of the association between metabolically health obesity and cardiovascular disease events,” said Caleyachetty.
Assessing Health Implications
The findings could very well change how the medical community approaches obese individuals who don’t show clear signs of other risk factors.
“At the population-level, so-called metabolically healthy obesity is not a harmless condition and perhaps it is better not to use this term to describe an obese person, regardless of how many metabolic complications they have,” said Caleyachetty.
The researchers also discovered that the number of metabolic risk factors in an obese person was tied to an increased risk of experiencing a cardiac event. An obese person with three metabolic risk factors — such as poor blood-sugar control, hypertension and other abnormalities — was about 2.6 times as likely as a non-obese person to develop coronary heart disease.
“It’s important that advice is given about the risk of heart and circulatory disease, along with the lifestyle choices that can be made to reduce this risk,” said Knapton. “That includes not smoking, eating a balanced diet, exercising regularly and limiting alcohol intake to the recommended guidelines.”
The new study serves as a warning for health professionals to focus on weight loss goals.
“The priority of health professionals should be to promote and facilitate weight loss among obese persons, regardless of the presence or absence of metabolic abnormalities,” said Caleyachetty.
Richard Scott is a health care reporter focusing on health policy and public health. Richard keeps tabs on national health trends from his Philadelphia location and is an active member of the Association of Health Care Journalists.