Sorry, but there’s no such thing as ‘fat but fit’ according to doctors

A doctor has come out against the so-called 'fat but fit' claim and says that 'healthy obesity' is not a harmless condition.

New research, presented last week at the European Congress on Obesity in Portugal, has shown that so called 'fat but fit' or 'metabolically healthy' obese people are still at higher risk of cardiovascular disease events such as heart failure and stroke than slimmer people. The study, by Dr Rishi Caleyachetty and his colleagues from The Institute of Applied Health Research at Birmingham University, examined whether the risk of developing four heart conditions (coronary heart disease, stroke, heart failure, and peripheral vascular disease) was different for ideal weight people with no metabolic conditions or people with metabolically healthy obesity (MHO). People with MHO are clinically obese in terms of their body mass index, but do not have the complications that usually come with obesity, such as abnormal blood fats, poor blood sugar control or diabetes, and high blood pressure. The researchers found that, when compared to individuals with a normal BMI and no metabolic abnormalities, individuals with MHO had a 50 percent increased risk of coronary heart disease; a 7 percent increased risk of cerebrovascular disease and a doubled risk of heart failure, after taking into account demographics and smoking behaviour. Dr Caleyachetty says that the misnomer 'fat but fit' isn't helpful:

"This is the largest prospective study of the association between metabolically health obesity and cardiovascular disease events. Metabolically healthy obese individuals are at higher risk of coronary heart disease, cerebrovascular disease and heart failure than normal weight metabolically healthy individuals. The priority of health professionals should be to promote and facilitate weight loss among obese persons, regardless of the presence or absence of metabolic abnormalities. At the population-level, so-called metabolically healthy obesity is not a harmless condition and perhaps it is better not to use this term to describe an obese person, regardless of how many metabolic complications they have."