The Dangerous Myth of Healthy Obesity

HYANNIS – In 2013, theAmerican Medical Associationnamedobesityas a disease. They did so to raise awareness about the medical issues such asmetabolic disease,type 2 diabetesandheart diseasethat can be caused by obesity.

It’s a problem that is not going to go away soon. More thanone-third of Americansare obese, according to theCenters for Disease Control and Prevention.

Unfortunately, there is a lot of denial about the dangers of the condition.Some studieshave even suggested that some obese people are in fact healthier than others, especially when it comes to cardiovascular risk. This has created some ambiguity in the medical world about whether being metabolically healthy obese is harmless.

New research presented at theEuropean Congress on Obesityin May puts to rest the myth of healthy obesity. In thelargest studyof its kind, lead authorRishiraj Caleyachetty, MBBS, PhD, and a team from theInstitute of Applied Health Researchat theUniversity of Birminghamanalyzed the medical records of 3.5 million people who were enrolled in The Health Improvement Network between 1995 and 2015.

None of the patients had cardiovascular disease when the study began. The average follow-up of patients was approximately five years.

“I led the work testing the hypothesis that compared to metabolically healthy normal weight individuals, metabolically healthy obese individuals are at increased risk for cardiovascular events,” Dr. Caleyachetty said in an email interview.

The study showed that compared to metabolically healthy people, obese people have a seven percent greater risk of stroke, a 49 percent greater risk of coronary heart disease and a 96 percent higher risk of heart failure.

“These findings were no surprise, as previous studies had suggested similar, but this research is more conclusive,” he said.

CardiologistElissa Thompson, MD, Medical Director ofCardiac Rehabilitationat Cape Cod Hospital couldn’t comment on the study because it hasn’t been formally published yet, but she agrees with the idea behind it.

“I don’t think there is a real concept of healthy obesity,” she said. “It’s like saying there is a healthy cigarette smoker. The answer is no, because you are at risk. This is a vital sign that is not normal. In obesity, the fat that you carry is a metabolically active entity that increases levels of highly inflammatory chemicals.”

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Some people who have obesity are going to be worse off than others, but eventually even those who are categorized as healthy obese are going to run into health problems. Carrying a lot of extra weight puts a strain on the heart, she said.

Even if a patient’s heart is functioning normal despite the extra strain, patients who are obese have other symptoms of the disease like diabetes, bad backs, compromised joints and shortness of breath.

Dr. Thompson compared being 80 pounds overweight to carrying a fifth grade child around all day long. Most people would find that a strain on their hearts and their bodies.

How To Lose

Losing weight is hard, but not impossible, she said. She recommends a healthy diet, regular exercise and evenbariatric surgery, if necessary to help reverse the risks of diabetes and heart disease.

“You have to think of food as fuel and your body as being an engine,” she said. “We put inappropriate fuels in our bodies sometimes and then the engine doesn’t work right. Most people treat their cars better than their bodies. You would never take your gasoline car and go to a diesel pump and pump diesel into it once a week and say it’s only once in a while. Why would you put bad food into your body, even if it’s once in a while?”

For exercise, walking 150 minutes per week is a great way to start. Dr. Thompson is the Medical Director of theHealthy Parks, Healthy People collaboration between Cape Cod Healthcare and the Cape Cod National Seashore. The program provides maps and guides to trails in theNational Seashore. The program runs during the summer months and is scheduled to resume in June.

By LAURIE HIGGINS, Cape Cod Health News

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