Can You Be Obese and Healthy?

Obese patients considered healthy may still face health declines and metabolic risk factors over time

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Making healthy lifestyle changes to lose weight is likely a smart choice for the long-term health of all obese people — even if they don't yet have medical issues related to their weight.

A new study found that what some people consider "healthy" obesity may not be all that healthy in the long-term.

"Healthy obesity is only a state of relative health — it's just less unhealthy than the worst-case scenario," said lead study author Joshua A. Bell, MSc, of the Department of Epidemiology & Public Health at University College London in England, in a press release.

"Healthy obesity" is usually considered obesity without any other metabolic issues — issues that increase the risk for heart disease and other health problems.

To study the concept of healthy obesity, Bell and team looked at data from the Whitehall II study — a study of 2,521 British government workers between the ages of 39 and 62. These researchers identified 181 obese patients — or patients whose body mass index (BMI) was 30 or higher. BMI is a measure of body fat based on height and weight.

Patients were considered "healthy obese" if they had fewer than two metabolic risk factors. These risk factors included high cholesterol, high blood pressure, high blood glucose (sugar) levels, and taking anti-high blood pressure or anti-diabetes medications.

Patients' health was analyzed when they first enrolled in the study and every five years after for 20 years.

Of the obese patients, 66 (36.5 percent) were identified as healthy obese at the study's start. Five years later, 21 (31.8 percent) of these initially healthy obese patients were no longer considered healthy. After 20 years, the same was true for 51.5 percent of this group.

Bell and team also found that a low percentage of the healthy obese patients were able to lose enough weight to no longer be considered obese during this study. After five years, only 6.1 percent were considered healthy non-obese, and after 20 years, the same was true for 10.6 percent.

"Healthy obesity is only valid if it is stable over time, and our results indicate that it is often just a phase," Bell explained. "All types of obesity warrant treatment, even those which appear to be healthy."

The Centers for Disease Control and Prevention (CDC) stresses that efforts to achieve a healthy weight should focus on long-term — not short-term — changes.

"It's about a lifestyle that includes healthy eating, regular physical activity, and balancing the number of calories you consume with the number of calories your body uses," the CDC wrote on its website.

The CDC stressed that, although weight loss can seem overwhelming, even modest weight loss can lead to big health benefits.

Most of the patients in the current study were men. Further research is needed to confirm these findings among a more diverse group, Bell and team noted.

This study was published Jan. 5 in the Journal of the American College of Cardiology.

Several of the study authors received research support from a number of organizations, such as the British Heart Foundation and the National Institutes of Health. The authors disclosed no conflicts of interest.

Review Date: 
January 3, 2015
Last Updated:
January 5, 2015