Tackling myth of “metabolically healthy obesity:” excess waistline is risky even if blood pressure and cholesterol are OK

“Metabolically healthy obesity” is a common medical classification of people with obesity (BMI>30) who have a normal metabolic profile, such as normal blood pressure (BP) and cholesterol levels. Some schools of thought suggest that these individuals are therefore not at significant risk; however, in a 2017 study following 3.5 million participants for an average of 5.4 years, researchers found that individuals with obesity and no metabolic abnormalities had a 49% increased risk of coronary heart disease and 96% more heart failure than their normal-weight counterparts.

My recommendation:

Anyone with an excess waistline needs to lose weight, and it can be very motivating to consider the impact weight loss has on future independence and quality of life. When faced with the myriad of weight loss options available, we should always choose the option with the best evidence for improving overall long-term health rather than focusing only on short-term weight loss.  The most sustainable and evidence-based weight-loss program to date is a whole food Mediterranean diet, portion control, and a daily habit of physical activity.  Start now!  For a wealth of practical strategies to help incorporate these choices into your own life and transform your health trajectory, see pages 60-61 and 69-92 in Good Food, GreatMedicine (3^rd edition) or see our free weight loss handout at goodfoodgreatmedicine.com.
 

Miles Hassell MD

[1] Caleyachetty, R. et al. J Am Coll Cardiol 2017;70:1429-37