You are overweight or obese, and your blood tests—cholesterol and blood sugar levels, ECG, blood pressure—are all within normal limits. You say to your doctor, “Hey doc, see, I am totally healthy.” And that is the typical mindset of someone who weighs fifty or sixty extra pounds (or even more) who undergoes testing with normal results, despite the excess weight.
I have always been disturbed by these claims, since it’s quite obvious that (a) though the current results read normal, they will not typically remain normal (b) there are changes happening at the cellular level that cannot always be gauged by standard tests and (c) we know through anecdotal experience that carrying extra weight typically leads to health issues. You’re kind of a time bomb waiting to go off, with an element of Russian roulette at play.
A new analysis suggests that “obese people” who appear otherwise healthy, are at risk of heart disease (and possibly other health issues) down the road. Can we really then say they are healthy just because a moment in time showcases normal results? Many overweight individuals believe they are fit and fat, despite the fact that a waist size over 35 inches for women, and 40 inches for men, or a BMI greater than 30, is associated with strong risk factors for diseases like diabetes, heart disease and certain cancers. These individuals will tell you that they “feel well, function well, and even exercise,” and certainly believe that because screening tests currently show no frank disease, they are indeed fat and healthy.
Canadian researchers who recently reviewed a number of past studies found that heavy people who do not have high blood pressure or diabetes DID HAVE more heart attacks and strokes, compared to healthy “normal weight” individuals. That finding alone ran counter to short term studies that suggested that some people could be overweight but heart-healthy.
The conclusion of a leading expert, James Hill, Ph.D., who reviewed this new meta-analysis, which looked at eight different past studies, believed it was reasonable to think that there could be a group of patients who carried excess fat, but were not necessarily at higher risk of health issues. After reviewing all the data he concluded that based on the assessment, health complications are largely inevitable if you carry persistent excess weight. You cannot be overweight and healthy.
So heavy but healthy means that you will inevitably become heavy with risk for disease and finally, as more time passes, heavy with frank disease present, over time. And it's clear that obesity, newly classified as a disease, puts stress on one’s cardiovascular system, though the stress levels may be higher in some, compared to others.
So metabolically unhealthy but normal weight, or overweight, or obese individuals are all three times more likely to develop heart-related conditions, compared to normal weight healthy individuals. A key message is that whether you are overweight or not, lifestyle habits impact disease risk. And if you have genetic predisposition to heart disease, weight and lifestyle management can delay or limit heart disease in many individuals. If you carry a genetic predisposition and you carry excess weight, you will encourage early expression of disease….add in poor lifestyle and you further increase that probability.
You can’t classify obesity as benign just because you feel healthy or because a finite set of blood tests happens to show no abnormalities. Obesity is never healthy. Even though some health professionals believe that an elevated BMI on its own is not a sufficiently unique measurement of a person’s health, it does raise a big warning flag. And let’s remember that obesity can silently affect kidney health, joint health and raise the risk of certain cancers. So “fat but fit” does appear to be a myth, and I daresay the naysayers who are in denial will persist in perpetuating this myth….because it’s easier to live with denial than face the facts and modify entrenched behaviors.
Amy Hendel is a Physician Assistant and Health Coach, journalist and host of Food Rescue, Simple Smoothies and What’s for Lunch? Author of Fat Families, Thin Families and The 4 Habits of Healthy Families, she tweets health headlines daily @HealthGal1103. Catch her guest appearances on local and national news and talk shows, and check out her website. Follow her blogs.
Published On: December 03, 2013