No Such Thing As “Healthy Obese”?

Even though it totally baffles my mind that such a term even exists, the classification of being “heathy obese” is currently used in the medical world. But if obesity itself is considered to be a medical condition (it has a diagnosis code after all!), how can someone who has a medical condition be considered truly healthy? Let alone a condition that is almost guaranteed to eventually lead to several other health issues?

People can be considered healthy obese if they don’t have the metabolic problems (dare I say “yet”…), that are commonly associated with obesity, such as diabetes or high blood pressure or cholesterol. Even though we know that unhealthy changes are occurring in the body due to the disproportionate amount of fat cells, some people are not yet at the stage where they are exhibiting the symptoms of that imbalance. But would they still be considered “healthy” if it was shown that they were at greater risk for other major issues like cardiovascular disease? If some preliminary research from England holds up to be valid, then the term healthy obese may be gone as quickly as it came about.

Let’s Not Try To Sugar Coat It Please

Obesity is a serious issue in our country. It costs our healthcare system millions of dollars even though it is generally considered a preventable “disease”, with overeating being the primary cause. Unfortunately, if some people are given this title, it may lead to a false sense of security of the true nature of their health status. Obesity without “symptoms” is like a time bomb ticking away – the danger may not be immediately imminent, but rest assured, it’s coming!

The British team behind the research looked at 20 years of electronic health records of 3.5 million people aged 18 and older who were initially free of heart disease. When comparing them to people of normal weight (who also had no metabolic problems), the healthy obese had:

  • Twice the risk of heart failure
  • 50% greater risk of heart disease
  • 7% higher risk of suffering a stroke
  • A greater chance of developing peripheral artery disease (PAD)

It was also found that the risk of heart disease in obese people rose with the number of metabolic problems. For example, compared to a normal-weight person with no metabolic abnormalities, an obese person with three metabolic abnormalities had almost three times the risk of coronary heart disease and nearly four times the risk for heart failure. Odds of PAD more than doubled, and risk of stroke was 58 percent higher. Now, explain to me how that translates into “healthy”.

People dealing with obesity need to be educated about the reality of their condition so that they can have the chance to improve their health and longevity, not just be given a sugar-coated title that makes the condition seem less serious than it really is. Carrying an unhealthy level of bodyfat not only puts structural stress on the body, leading to joint aches and pains and mobility issues, but it also leads to hormonal changes as well. Insulin, leptin (which affects appetite and weight control) and even your testosterone and estrogen can be negatively affected when you fall into the obese category.

Proper weight management should be at the foundation of any health maintenance program. If it really wasn’t viewed as a health concern, then losing weight wouldn’t be the most common goal of people seeking help at our office. Our programs are centered around helping people learn how to achieve a healthier weight by guiding them on building a proper diet and educating them about the impact of food on their health. The great thing about doing this foundational work is that, in the process, they also see energy improve, digestive issues clear up, and blood sugars/cholesterol/blood pressure numbers come back to normal.

As doctors, we have dedicated our life’s work to helping improve the health status of those seeking our care. Addressing the issues, instead of covering up their seriousness with nonsense titles, is our obligation and the only way to truly help these individuals. We choose to be honest and proactive with their health, and in the end, hope to give them the best chance to lead a long, healthy, enjoyable life!

The study quoted was presented in May at the European Congress on Obesity in Portugal and is awaiting approval for publication.