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Research: ‘metabolically healthy’ obese people still at risk

obesity and Covid


People with metabolically healthy obesity are still at a higher risk of diabetes, heart disease, stroke and respiratory disease, research has found.

The study, published this month by scientists from the University of Glasgow, found weight management should be recommended to all people with obesity (with a BMI of 30 or greater). This is regardless of whether clinicians had categorised them as ‘metabolically unhealthy’ or ‘healthy’.

It divided 381,363 participants into four categories depending on their weight and other risk factors, such as high cholesterol and blood pressure. These categories were metabolically healthy non-obesity, metabolically unhealthy non-obesity, metabolically healthy obesity and metabolically unhealthy obesity.

Those with metabolically healthy obesity, where the typical metabolic problems do not occur in people with obesity, were still found to be 4.3 times more likely to have type 2 diabetes, compared to healthy participants who were not obese.    

They were also 18% more likely to have had a heart attack or stroke, had a 76% higher risk of heart failure and 28% more likely to have respiratory disease. Compared to metabolically unhealthy people who were not obese, they were 28% more likely to have heart failure.

The study authors concluded: ‘People with metabolically healthy obesity are not ‘healthy’, as they are at higher risk of heart attack and stroke, heart failure, and respiratory diseases compared with people without obesity who have a normal metabolic profile.

‘Particularly worth noting is that people with metabolically healthy obesity had a higher risk of heart failure and respiratory disease than metabolically unhealthy participants without obesity.’

The term ‘metabolically healthy obesity’ should be avoided by clinicians as it is ‘misleading’, they added.

Metabolically healthy obese people make up an estimated 2% to 22% of the population, the research highlighted. It also found these individuals were likely to be younger, female and white. Metabolically healthy obese people also appeared to watch less television, exercise more, had a higher education level, a lower deprivation index and a higher red and processed meat intake.

A recent study from the University of Cambridge suggested one in 340 people in the UK carry a genetic mutation linked to weight gain, making the mutation more common than previously thought.

Nursing in Practice also took an in-depth look this month at whether lessons from the Covid crisis will help the latest obesity strategy succeed where others have failed.