‘Healthy obesity’ is a myth, the term is misleading and dangerous

There’s this myth floating around that one can be obese and healthy at the same time. However, rarely has one ever seen or heard of such a person, nor has a serious study ever been made to support this claim. In the 80s, the term “metabolically healthy obesity” started appearing in some medical circles. This term referred to those who were obese and yet did not display any other symptoms of conditions which could be related to their obesity, such as diabetes or hypertension. The term later evolved into its more popular form “healthy obesity”.

A British scientist called William Johnson from Loughborough University insists on the harmfulness of this phrase and called on people to completely refrain from using it. He calls this “idea” of healthy obesity problematic at best in a commentary which was published in an issue of the journal Annals of Human Biology. He also writes that this notion that one can experience no issues at all despite their obesity is dangerously appealing, especially to people who have a body mass index of 30 or higher and who would rather not deem themselves unhealthy or obese. By the way, Johnson holds a doctorate in epidemiology and human biology.

It’s worth noting that Johnson has pointed out that many of the studies have declared those people to be extremely rare and that they will eventually run into health problems compared to people who aren’t overweight. Even without any existing health problems, these “healthy obese” people are still at a much higher risk of developing diseases such as chronic kidney disease and Type 2 diabetes, in addition to having higher mortality rate compared to people who have a normal weight.

This can be quite a disillusionment for people who look up to athletes who look overweight, but who train a lot more, carry a lot more muscle mass and eat a healthier diet than them. Current body-mass-index measurements are calculated by using only height and weight. So, this means that the person that carries more muscle mass but weighs the same as another person with more fat would actually have the same BMI. This results in a lack of clear indicators about comparative health.

Johnson further explains that people who are overweight, yet healthy are more likely to be younger, of European ancestry, have a lifestyle that is comprised of a healthy diet and lots of physical activity, have less fat around their belly and less fat stored in the abdominal cavity, also known as visceral fat, and be higher on the socio-economic ladder than overweight individuals who have already developed health complications.

This is why it shouldn’t be surprising that the levels of cardio and metabolic disease risk factors such as systolic blood pressure and fasting glucose are much worse among healthy obese people than healthy normal-weight people, even though both groups are carrying the same label: “healthy”.

Johnson is not the first scientist to call for this idea of “healthy obesity” to be completely retired. He is less interested in trying to find out if healthy obesity even exists and more interested in re-purposing research money to find out why two people who have similar BMIs can have such different outcomes, with one of them dying of disease and the other one being completely healthy.

It is a fact that obesity is bad for one’s overall health, but research has shown that there are clear differences between individuals about the extent to which it can cause problems. While the very concept itself is very ill-defined and problematic, and it’s best to be considered quasi-scientific, it is, however, a great opportunity for further delving into the domain of investigation about the levels, causes and possible consequences of the heterogeneity in health among people who have the same BMI.

Another interesting thing to note. People with fat around the waistline have been found to be more likely to develop type 2 diabetes and heart disease according to the National Heart, Lung and Blood Institute. For women, the ideal number is 35 inches (89 cm) or more, and for men, it is 40 inches (102 cm). Anything bigger than this and you put yourself at a greater risk. To measure yourself, stand up straight and run a tape measure above the hip bones, across the waistline. Take the measurement after you exhale.

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