Healthy obesity ‘misleading concept’

7 th January 2015 – New UK research says the idea you can be obese and healthy is misleading because, over time, most obese individuals become progressively less healthy.
A small but long-term study, tracking the health of more than 2,500 men and women over 2 decades, found that healthy obesityprogresses to unhealthy obesity in most adults.
Lead study author, Joshua Bell, says in a prepared comment: “A core assumption of healthy obesity has been that it is stable over time, but we can now see that healthy obese adults tend to become unhealthy obese in the long-term, with about half making this transition over 20 years in our study.”
According to the latest statistics for England 24.4% of men and 25.1% of women are obese.

Study

Researchers from the Department of Epidemiology and Public Health at University College London (UCL) studied 2,521 UK Government workers (75% male) between the ages of 39 and 62, measuring their body mass index, cholesterol, blood pressure, fasting plasma glucose and insulin resistance.
‘Obese’ was defined as having a body mass index of 30 kg/m2 or more.
Healthy obesity was defined as obesity with no metabolic risk factors.
The purpose of the study was to determine whether healthy obese adults stay healthy in the long term. The authors say few studies have looked into this and previously none had followed people for more than 10 years.

Findings

Among the participants 181 were initially classified as obese, including 66 who were classified as healthy obese.
After 5 years, 32% of the participants initially classified as healthy obese had become unhealthy obese. By 10 years, 41% were unhealthy obese, 35% were unhealthy obese at 15 years, and more than 51% were unhealthy obese at the 20-year mark.
In contrast, only 6% of the healthy obese participants lost weight and became healthy non-obese at the end of the first 5 years of the study, a proportion that changed to 4.5% after 10 years; 6.1% after 15 years and 10.6% after 20 years.

Health risks

Among the most common health consequences of obesity are cardiovascular diseases–mainly heart disease and stroke– diabetes, musculoskeletal issues, and some forms of cancer including endometrial, breast and colon cancers.
Joshua Bell says: “Healthy obese adults show a greater risk for developing cardiovascular disease than healthy normal-weight adults, although this risk is not as great as for the unhealthy obese. Healthy obesity is only a state of relative health – it’s just less unhealthy than the worst-case scenario. And as we now see, healthy obese adults tend to become unhealthy obese over time, providing further evidence against the idea that obesity can be healthy.”
He says the study results suggest long term healthy obesity is the exception, not the norm and that all types of obesity warrant treatment, even those which appear to be healthy.
The research has been published online in a letter in the Journal of the American College of Cardiology.