“Healthy” Obesity in Question

Obese individuals in good metabolic health still at risk for diabetes and heart disease

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) How the body’s metabolism functions can determine a lot about a person’s health. But even people with good metabolic health can’t escape the health risks associated with obesity.

A recent study looked at the rates of type II diabetes and heart disease in a group of people over several years.

The results of the study showed that being obese increased the risk of developing diabetes and heart disease regardless of having good metabolic health measures, such as blood pressure, cholesterol, and blood sugar.

"Get your metabolic health evaluated."

Carlos Lorenzo, MD, of the University of Texas Health Science Center in San Antonio, worked with a team of researchers to study the relationship between obesity and metabolism in relation to diabetes and heart disease.

Previous studies have suggested that obese individuals with good metabolic health may not be at the same risk for type II diabetes or heart disease as obese individuals with poor metabolic health.

Metabolic health is measured through blood pressure, HDL and LDL cholesterol, blood sugar, and insulin resistance. Insulin is the hormone responsible for regulating how the body absorbs sugar.

For this study, the researchers followed 4,202 Mexican-American and non-Hispanic white individuals, ages 25 to 64, for an average of 7.4 years to check for type II diabetes and heart disease.

In order to qualify as obese but metabolically healthy, a person had to have a body mass index (BMI) of 30 or greater with no more than one metabolic measure out of the healthy range.

Among 1,453 normal weight individuals, 12.8 percent had poor metabolic health. Out of 860 obese individuals, 44.4 percent had good metabolic health.

To qualify as normal weight but in poor metabolic health, a person had to have a BMI of less than 25 with two or more metabolic measure out of the healthy range.

After controlling for race, age, gender, and family history of diabetes, obesity itself was found to increase the odds of a person developing type II diabetes by nearly double (1.7 times).

Normal weight participants with poor metabolic health were at 2.5 times the risk of developing type II diabetes, and 2.9 times the risk of developing heart disease, compared with normal weight metabolically healthy individuals.

Obese participants with good metabolic health were at 3.9 times the risk of developing type II diabetes and 3.9 times the risk of developing heart disease, compared with normal weight metabolically health individuals.

The study authors recommended that health care professionals screen for metabolic health and obesity in a clinical setting, and promote preventive care to reduce the risk of diabetes and heart disease.

This study was published in November in The Journal of Clinical Endocrinology & Metabolism.

The National Heart, Lung, and Blood Institute helped support funding for this project. The authors declared no conflicts of interest. 

Review Date: 
November 22, 2013
Last Updated:
November 22, 2013