Rethinking the risks

Obesity on its own isn’t a killer. A study by researchers at York University’s Faculty of Health, Canada, has found that patients with metabolic healthy obesity, but no other metabolic risk factors, do not have an increased rate of mortality. The results could force a rethink in how medicine and health consultants view weight management and obesity, according to Jennifer Kuk, associate professor, School of Kinesiology and Health Science, who led the research team.

“This is in contrast with most of the literature and we think this is because most studies have defined metabolic healthy obesity as having up to one metabolic risk factor,” Dr. Kuk told
Science Daily

“This is clearly problematic, as hypertension alone increases your mortality risk and past literature would have called these patients with obesity and hypertension, ‘healthy’. This is likely why most studies have reported that ‘healthy’ obesity is still related with higher mortality risk.”

Medical literature says that obesity — as a high mortality risk — is in the same league as dyslipidemia, hypertension or diabetes alone. Dr. Kuk and colleagues say this isn’t true.

The categories

In their study, they analysed profiles from 54,089 men and women from five cohort studies who were categorised as having obesity alone or clustered with a metabolic factor; elevated glucose, blood pressure or lipids alone, or clustered with obesity or another metabolic factor. Researchers looked at how many people within each group died as compared to those within the normal weight population with no metabolic risk factors.

Current weight management guidelines suggest that anyone with a body mass index over 30 kg/m2 should lose weight. This implies that if you have obesity (even without any other risk factors) it makes you unhealthy. In their report published in the journal,
Clinical Obesity
, they found that 1 out of 20 individuals with obesity had no other metabolic abnormalities.

“We’re showing that individuals with metabolically healthy obesity are actually not at an elevated mortality rate. We found that a person of normal weight with no other metabolic risk factors is just as likely to die as the person with obesity and no other risk factors,” says Dr. Kuk. “This means that hundreds of thousands of people with metabolically healthy obesity will be told to lose weight, when it’s questionable how much benefit they’ll actually receive.”

Indian context

Obesity is major concern in India. The prevalence of obesity is increasing and ranges from 8% to 38% in rural and 13% to 50% in urban areas, according to the
Indian Heart Journal
. Obesity is a risk factor for development of type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia, coronary heart disease and many cancers. In Asian Indians, excess abdominal and hepatic fat is associated with increased risk for T2DM and cardiovascular disease.

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We’re showing that individuals with metabolically healthy obesity are actually not at an elevated mortality rate.”

Dr. Jennifer Kuk,

School of Kinesiology and Health Science, York University, Canada

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