Some fit obese individuals have no greater risk for chronic disease than normal weight people

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(CBS News) Usually being obese means a higher chance of developing health problems. But, a new study shows that it is possible to be fat and fit - and also to be at no greater risk for some chronic diseases.

People who were deemed "metabolically healthy" obese individuals - meaning they had no insulin resistance, diabetes, high cholesterol or blood pressure issues - had a lower risk of death than unfit obese individuals. They had no greater risk of death than normal weight fit people.

"It is well known that obesity is linked to a large number of chronic disease such as cardiovascular problems and cancer. However, there appears to be a sub-set of obese people who seem to be protected from obesity-related metabolic complications," first author Dr. Francisco Ortega said in a press release. "They may have greater cardio-respiratory fitness than other obese individuals, but, until now, it was not known the extent to which these metabolically healthy but obese people are at lower risk of diseases or premature death."

The study was published in the European Heart Journal on Sept. 4.

The 43,265 participants in the study were all part of the "Aerobics Center Longitudinal Study" (ACLS) between 1979 and 2003. The study participants were 98 percent white and mostly worked in executive or professional positions. About one fourth of the subjects were women.

Each subject completed a detailed questionnaire on their medical and lifestyle history, had a physical examination that included a test on their cardio-respiratory fitness and had measurements of height, weight, waist circumference and body fat percentage taken. Blood pressure, cholesterol and fasting glucose levels were also recorded. The researchers followed the subjects from when they entered the study until they died or until 2003.

Out of all the obese subjects, 46 percent were deemed "metabolically healthy." When all factors were accounted for, 38 percent of metabolically healthy yet obese people had a lower risk of death than their metabolically unfit obese peers. They also had no significant increased death risk compared to metabolically fit, normal weight participants.

It's important to note that these "metabolically fit" obese individuals regularly exercised and had a higher level of fitness than most obese people.

""There are two major findings derived from our study," Ortega said. "Firstly, a better cardio-respiratory fitness level should be considered from now on as a characteristic of this subset of metabolically healthy obese people. Secondly, once fitness is accounted for, our study shows for the first time that metabolically healthy but obese individuals have similar prognosis as metabolically healthy normal-weight individuals, and a better prognosis than their obese peers with an abnormal metabolic profile."

The researchers suggested that physicians should pay closer attention to body fat percentage and fitness levels when assessing a patients risk for cardiovascular disease and cancer.

"It is possible to be fat and fit -- but relatively few people are," Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine, told HealthDay. He was not part of the study.

"It is certainly possible to be thin and unhealthy, which is why health, not a particular weight, is what we should be aiming for as both individuals and a society," he said.

Amy Thompson, a senior cardiac nurse with the British Heart Foundation, added to the BBC that it's important to remember that for the majority of people obesity is an "undeniable risk factor" for coronary heart disease. Keeping tabs on your body mass index and measuring your waist while maintaining a healthy diet and fitness regiment are some ways to help keep your risk lower.

"It is particularly important to be aware of your weight if you are carrying excess fat around your middle," she said. "The fat cells here are really active, producing toxic substances that cause damage which can lead to heart disease."

[AutumnFoghamar]

My obese grandma lived to 102. My slender Mom died at 62. :-( That being said, I've lost a lot of weight, still need to lose more, exercise regularly and probably am considered "fit but fat" since my trainer marvels at how fit I am. I've changed from working on endurance and toning to body building to see if that will get more weight off. Ultimately, it isn't what I weigh (BMI)it is my % of body fat.

[howbizarre]

Unfortunately, 99% of all obese people will read only the headlines and decide ALL obese people have no greater risk. I also wish the article had defined "regular exercise". Now someone who exercises 20 minutes a month will deem themselvers "regular exercisers" with no need to worry. I'm guessing "regular exercise" means 60 minutes a day at least 5 days a week.

[nohater]

were these 43k plus participants all here in the USA or were they of other nation states? the study was published, after all, in the european heart journal.

[rwsmith29456]

And SOME people could be skinny and unhealthy. And SOME people.... Oh give me a break. It must be awfully easy to write 'news' stories these days.

[foo8259]

Possible? Yes. Probable? No. Just think how much healthier the "fit and fat" would be after losing weight? I know, I was one. It's actually easy, just say goodbye to all the carbage. No need to try to work/sweat the fat off either. After a few weeks or months eating whole foods you won't miss the processed stuff, and you won't be hungry. Oprah Winfrey ** lost her weight on a specialized high-protein low-fat liquid diet, but that's just not healthy nor sustainable long term so she gained it all back. Diets like gluten free, Cross-Fit, Atkins, South Beach or Paleo can be kept up for life. ** proteinpower.com/drmike/metabolism/oprahs-plight/

[john92021]

Why not show photos of obese 80 and 90 year old people. Oh yea, there aren't any. I guess you need a degree and a good paying job to ignore the obvious.

[StevenCharlapMD]

I'm sorry to break this news (because it is unfortunate) but there are far more overweight 80+ year olds in America than you think. My medical practice is geared to helping seniors lose weight and I see quite a few in their 80s. www.mdprevent.net

[MegaProcrastination]

Erm, I could show you a picture but it would mean scanning an image and uploading a picture of one of my relatives which I don't do. Yeah, it was my grandmother. She never weighed under 200 pounds at about 5'6" tall. She lived well into her eighties. Let's see now. There's also her sister who is still alive and healthy at almost ninety. Only one of the women in that family was thin and the rest would definitely have qualified as obese.

[liveloveforgod]

The food was changed in the USA, UK and Australia 30 years ago when dangerous food chemicals from the USA was allowed into Europe. The food today causes stubborn insulin If you have stubborn insulin you hold fat and have a hard time losing weight. You can eat very little and the weight still does not come off. Stubborn insulin will hold fat and diets won't work. When researchers used a specialized diabetes diet on overweight people all lost weight even those who did not have diabetes.

just google SPIRIT HAPPY DIET