Can you be overweight and healthy?

New research suggests this is not a simple question to answer

People who are 'fit but fat' are considered to be obese by their body mass index score but have none of the complications associated with obesity. Getty Images
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France and other Mediterranean countries such as Italy and Israel have the highest number of people who are living with “metabolically healthy obesity”, researchers have said, as they called for more to be done to help people reduce their weight.

Almost one in 10 middle-aged men and more than a quarter of middle-aged women in the UK are “fit but fat”.

One study shows that 8 per cent of men and 27 per cent of women in the UK aged between 40 and 50 are metabolically healthy but obese.

The UK has similar levels seen in Sweden, Norway and Germany, experts told the Annual Meeting of the European Association for the Study of Diabetes.

People who are “fit but fat” are considered to be obese by their body mass index score but have none of the complications associated with obesity including abnormal blood sugar levels; high cholesterol, high blood pressures, type 2 diabetes or signs of heart disease.

Academics said that there are large regional differences over levels of “metabolically healthy obesity”, which could be down to different diets or other lifestyle factors as well as ethnic and genetic differences.

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“There are populations in Micronesia or Asian populations where it [metabolically healthy obesity] is down to 2 per cent to 5 per cent only,” said Matthias Bluher of the University of Leipzig and Helmholtz Centre Munich in Germany.

“Some populations may be, despite large amounts of adipose tissue, better protected against comorbidities and Caucasian populations belong to those.”

Prof Bluher said that healthy obesity is seen in a number of premenopausal women.

But he called for better weight management programmes for people who fit the profile.

He pointed to previous work which suggests people who are “healthy obese” have a higher risk of coronary heart disease, cerebrovascular disease and heart failure compared to those in a normal weight range.

“There will always be people living with obesity who seem to be protected against obesity-related cardiometabolic diseases,” he told the conference.

“The concept that metabolically healthy obesity affected people may not benefit from weight loss strategies has been challenged by recent data.

“A timely and personalised treatment of obesity should also be recommended to people living with healthier obesity.”

Updated: October 03, 2023, 10:31 PM