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What is ‘metabolically healthy obesity’?

A new study indicates that you can’t really be obese and healthy

“I’m curvy”; “I don’t believe in the weighing scale”; “So what if I’m a overweight, I am healthier than most”. If you have heard any of your girlfriends say this, you might want to share this article with them. Because new research has shown that even women who fall under the category of ‘metabolically healthy obesity’ can develop cardiovascular diseases in over a period of 20 years.

Though ‘healthy obesity’ sounds like an oxymoron, it is an actual term used in the medical world. A metabolically healthy obese person may not have any other complications associated with obesity, like hypertension or diabetes. Though their BMI (greater than 30kg/m²) may be high, the person is still healthy.

A new study carried out in the US, tracked the health of over 90,000 female nurses aged 30-55. They were divided into groups based on their BMI category and metabolic risk factors like type 2 diabetes, high BP, and high blood cholesterol. The study was followed for 30 years between 1980 and 2010, in which participants were sent questionnaires every two years to update their BMI and other health statuses.

The final report, published in The Lancet Diabetes & Endocrinology journal, says that during the follow-up years, the majority of women who were initially metabolically healthy obese (84%) converted to the unhealthy category in 20 years time. They also say that this group had a 39% higher risk of developing cardiovascular diseases.

Though the study was done on a population of European descent, it still holds important messages for Asians, as we are more predisposed to metabolic obesity, as we have higher body fat and high triglyceride levels.

“Though you may not have high BP or diabetes, obesity in itself can lead to a lot of complications. It can cause inflammation of the blood vessels in the body and lead to cardiovascular diseases,” says Prof K Srinath Reddy, President, Public Health Foundation of India (PHFI) and former head of the Department of Cardiology at AIIMS, Delhi. “Women are naturally protected by estrogen and they have more levels of high-density lipoprotein or the good cholesterol in their system. It is an evolutionary advantage. It is needed for the placenta and reproduction. But once they cross the reproductive age and hit menopause, their oestrogen goes low and the protection is lost.”

Women who smoke and those who have diabetes have an even higher risk of developing cardiovascular diseases, as these two can bring down the estrogen levels in the body.

“Even if you are a metabolically healthy obese woman, it is highly recommended that you exercise and maintain a healthy lifestyle. Quit tobacco, and if you are a long-term oral contraceptive pill user, get regular health check-ups. The final question is do you want to live healthy till 60 or 80,” he adds.