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Healthy obesity is not safe obesity

International Journal of Obesity volume 40, page 1333 (2016)Cite this article

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Obesity is a touchy subject. At the centre of current debate is the idea of a ‘healthy’ type of obesity—one which occurs without metabolic dysfunction. This idea is based on the simple observation that at any given time, a minority of obese adults are free of metabolic risk factor clustering, displaying an incongruence between their body mass index (BMI) group and expected health profile. Tomiyama et al.1 recently made this observation once more, and argued that a single-point BMI measurement incorrectly attributes many obese adults who are healthy to a high-risk group. This ignores the full story.

When examining individual change over time, healthy obese adults show a strong tendency to progress to an unhealthy obese state;2 the healthy obese are far more likely to make this progression than healthy normal-weight adults. Indeed, metabolic dysfunction is often present at baseline. When defining healthy as having 0 or 1 metabolic abnormality as is most commonly done, about 1-in-3 obese adults fit this description; yet when defining healthy as having 0 abnormalities, only 1-in-10 do.3 A strictly healthy type of obesity is rare and its maintenance is even rarer; nearly 80% of these strictly healthy obese adults develop at least one metabolic risk factor after 20 years, again being more likely to do so than strictly healthy normal-weight adults.3

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References

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Acknowledgements

MK is supported by the Medical Research Council (MR/K013351/1), NordForsk, the Nordic Programme on Health and Welfare, and an Economic and Social Research Council professorial fellowship (ES/J023299/1).

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Authors and Affiliations

  1. Department of Epidemiology and Public Health, University College London, London, UK

    J A Bell, M J Shipley & M Kivimäki

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  1. J A Bell
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  2. M J Shipley
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  3. M Kivimäki
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Correspondence to J A Bell.

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Bell, J., Shipley, M. & Kivimäki, M. Healthy obesity is not safe obesity. Int J Obes 40, 1333 (2016). https://doi.org/10.1038/ijo.2016.77

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