MUNICH, Germany The myth of being “fat but fit” is debunked again by a new study. Researchers found that obese people, even if they appear healthy, have a higher risk of diabetes and heart disease.
In an in-depth study by German researchers, the phenomenon of metabolically healthy obesity (MHO), often referred to as “fat but fit”, was closely examined. The results reveal that even those obese individuals who appear to be healthy are still 50 percent more susceptible to coronary heart disease.
“15-20% of people who live with obesity they have none of the metabolic complications we associate with the disease, namely abnormal blood sugar and blood fat control, high blood pressure, type 2 diabetes, and other signs of cardiovascular disease”, says Professor Matthias Blüher of the University of Leipzig and the Helmholtz Center in Munich in a media release.
Shockingly, statistics show that obese women have a higher chance of developing MHO, ranging from seven to 28 percent, as opposed to men, where MHO is between two and 19 percent. It is also estimated that half of all obese individuals have at least two weight-induced complications.
The researchers emphasize that the behavior of adipose tissue in people with obesity, rather than just measuring BMI, should be a determining factor for MHO classification. People with normal-sized fat storage cells, adipocytes, tend to have fewer complications of obesity. In contrast, those with enlarged and inflamed adipocytes are prone to conditions such as insulin resistance, leading to metabolic problems. Also, how we store fat is probably key to determining whether obesity can be described as MHO or not.
“When obese people have fat stored viscerally or internally around their organs (such as in the liver), the data show that these people are more likely to develop it. Type 2 diabetes than those who store fat more evenly around their body,” notes Dr. Blüher.
In addition, dysfunctional adipose tissue can lead to tissue damage, fibrosis, and the release of harmful molecules that contribute to end-organ damage. For example, hormones secreted by fat, adipokines, can directly affect the cells of the vascular system, leading to atherosclerosis.
Addressing the basic question of whether those classified as MHO are actually healthy, the team of Dr. Blüher strongly refuted this widely accepted theory. The study’s author notes that even compared to normal-weight individuals without associated health conditions, those with obesity but without these conditions still had a 50 percent increased risk of developing obesity. coronary disease.
Historically, MHO individuals were a lower priority for obesity treatments because of their apparently positive health status. Still, the team stresses the importance of treatment and weight loss recommendations for people with MHO.
“So there is still a residual increase in risk for those people living with obesity, even with what we would say metabolically healthy obesity”, explains Blüher. “Even in the absence of other cardiometabolic risk factors, it increased too fat and adipose tissue dysfunction contribute to an increased risk of type 2 diabetes and cardiovascular disease. Therefore, weight management and recommendations for weight loss remain important for people living with metabolically healthy obesity.”
The study is published in the journal Diabetology and presented at the annual meeting of the European Association for the Study of Diabetes (EASD 2023).
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South West News Service writer James Gamble contributed to this report.
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