Some obese people are, in fact, healthy

We've been told by doctors that it's bad to be overweight. And, for many people, that's true. But research is accumulating to show that it's the location of the fat that matters. You can be normal weight and be just as bad off as old tubby next door.

Two studies in today's issue of the Archives of Internal Medicine demonstrate this. In one, researchers  in Germany studied 314 people ages 18 to 69, assessing their weight and glucose tolerance. Glucose tolerance is a measure of insulin resistance, a pre-diabetic condition that contributes to heart disease. They found that obese people with insulin resistance had more fat within their skeletal muscles and livers than obese people without insulin resistance.

In the second study, researchers at the Albert Einstein College of Medicine examined the records of more than 5,000 adults, looking at metabolic abnormalities such as high blood pressure, high cholesterol and low HDL cholesterol. They found that 23.5% of adults of normal weight were metabolically abnormal whereas 51.3% of overweight adults and 31.7% of obese adults were metabolically healthy. Normal weight people with metabolic abnormalities tended to be older, less physically active and have larger waists than healthy, normal-weight people.

"Both reports emphasize the benign nature of fat accumulation outside the abdomen," Dr. Lewis Landsberg, of the Northwestern University Comprehensive Center on Obesity in Chicago, said in an editorial accompanying the studies. "In both studies, the detrimental effect of visceral fat accumulation and its surrogate, waist circumference, were clearly demonstrated, confirming older studies showing that waist circumference is a risk factor even in normal-weight individuals."

For more information on abdominal fat and measuring your waist circumference, see this article by Harvard Health Publications.

-- Shari Roan

Photo:  J. Emilio Flores, for the Los Angeles Times

Comments

[nfg2u]

Come on, lets get real here.. You can't tell me that we are now going to tell everyone that is ok to be FAT? What type of society are we living in? I guess its ok to Lie, Cheat and Steal as long as you don't get caught either! The media in this country is out of control!
Just my 2 cents.
Its called eating garbage and not exercising. Yes there are people with medical conditions that are "overweight", but there are predominate amount of people in the world that eat too much get fat and can't loose the weight because they are too "fat" to exercise and have no will power to eat healthy foods. The entire world is getting fatter and the Health Care system is starting to pay for it with my tax money!

[bill edwards]

Marketers covering a broad spectrum of consumer products, from food to OTC drugs, exercise equipment to clothing and more, are going to jump all over this news. Already, domains (web addresses) like www.FatAndHealthy.com and www.FatAndFit.com are getting offers from marketers eager to sell to suddenly "OK" heavyweights.

[thinforlife]

These stats are misleading -- they are not apples to apples. The clearer comparison would be that "23.5% of adults of normal weight were metabolically abnormal" (as quoted in the article) and that 68.3% of obese adults were metabolically abnormal.

Rather than focusing on the 31.7% of obese people who are "metabolically normal," the more telling stat is that being obese nearly triples the risk of being "metabolically abnormal," from under 25% to nearly 70%.

[Jason]

That's because this study was based on the Body Mass Index, which only takes into account weight and height. BMI is a ridiculously oversimplified measurement of nothing. It assumes that you can lump together couch-potatoes and body builders, as long as their the same weight. I weigh 176 lbs and I'm six feet tall. My body fat percentage is a little over 10%. I work out 6 times a week and can run a 6 minute mile. Last time my blood pressure was taken, it was 72/36. According to BMI, I'm only point away from being overweight.

Two years ago, I was exactly the same weight I am today. However, I never worked out, my blood pressure was a little high and I have no idea what my body fat percentage was because I never measured it. However, I wouldn't be surprised if it was nearing 20%. That's because I had no muscle. I was a skinny fat person. However, my BMI was the same, because my height and weight were the same. This proves nothing.

[Gwendolyn M]

"old tubby?"

REALLY? We have to denigrate human beings and use derogatory terms about people who don't have the preferred LOOK?

REALLY?

[James]

I'm considered fat, but I eat healthy food and exercise for about an hour a day. All of my measurable health indicators are better than normal: heart rate, bp, cholesterol, glucose tolerance etc. I've competed in 5k runs (beating about a 1/3 of the field), done ok at rock climbing and excelled at mountain hiking. I feel healthy, both physically and mentally. Can you say the same?

Oh, and name-calling is not exactly the height of journalistic excellence. I'll try and avoid calling you a moron, though.

[Brian Quebbemann, MD]

Yes, this is what we see in clinical practice. As a physician specializing in weight control, it is important to recognize that there is a fairly wide range of body types (shapes) that are healthy; and certainly some naturally heavy set people are healthy. This balances the fact that some people who are very skinny are healthy.

This does not imply that severely obese people are ever, through any stretch of the imagination, healthier being severely obese than they would be if they were simply on the heavier side of the "healthy morphology spectrum." However, the severely obese person may very well be healthy at a weight that is heavier than the weight they are told to shoot for by the "hard body--thin is in" crowd. The important thing to realize here is that being healthy does not always imply being thin.

When a person honestly feels healthy, often times they are, whether they are on the thin side or larger.