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Individuals with Obesity who are Metabolically Healthy Still at Risk for Health Problems

Obesity is often the harbinger of numerous health problems, such as high blood pressure, diabetes, high cholesterol levels, and cardiovascular disease. Some individuals with obesity, however, don’t exhibit any of the typical risk factors for heart disease or diabetes, a new study finds. Researchers analyzed information from about 1.3 million U.S. adults who were either overweight or obese. None had previously been diagnosed with diabetes. The researchers looked to see whether these participants had any of four common risk factors for heart disease and diabetes: high blood pressure, high levels of fat in the blood, low levels of “good” cholesterol, and elevated blood sugar levels. Among those who were obese, 10 percent did not have any of these four risk factors.

Though it’s still not clear why some people with obesity are able to avoid these problems, several factors could help explain this conundrum. “Diet and exercise almost certainly play a role,” said study researcher Gregory Nichols, a senior investigator at Kaiser Permanente Center for Health Research in Portland. However, the new study did not assess those factors. In addition, the distribution of a person’s fat can also affect his or her risk of cardiovascular disease: fat stores in the belly area (visceral fat) pose a greater risk to health than fat found just beneath the skin (subcutaneous fat) in other parts of the body. Some previous studies have found that individuals with obesity who are metabolically healthy have less visceral fat than individuals with obesity who aren’t metabolically healthy.

While some individuals with obesity don’t exhibit symptoms of diabetes, heart disease, or other metabolic disorders typically seen with obesity, that doesn’t mean these individuals are healthy. According to Nichols, regardless of their current metabolic health, individuals with obesity who are metabolically healthy still have a greater risk of developing type 2 diabetes at some point in their lives when compared to individuals of normal weight. Furthermore, obesity increases the risk of cancer, joint problems, kidney disease, and other health problems. Thus, people who are overweight or obese should still aim to lose weight, even if they otherwise appear healthy, Nichols said. “Weight loss could improve other types of health [problems], and might reduce the likelihood of developing cardiometabolic risk factors,” he said.

Sources: 1) Retner R. Medical mystery: Why are some obese people “metabolically healthy?” LiveScience site. March 9, 2017. http://www.livescience.com/58198-metabolically-healthy-obesity.html. Accessed 1 May 2017. 2) Nichols GA, et a. Cardiometabolic risk factors among 1.3 million adults with overweight or obesity, but not diabetes, in 10 geographically diverse regions of the United States, 2012–2013. Prev

Chronic Dis. 2017;14:160438. DOI: http://dx.doi.org/10.5888/pcd14.160438

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