Why ‘fit but fat’ may be a fable


If the dichotomy term of ‘healthy obese’ has always seemed to be a misnomer, new research is proving it to be most likely true.  An as yet unpublished British study presented at the European Congress on Obesity puts into question the ‘fit but fat’ campaign which surfaced about two years ago promoting the mantra that anyone can be fit since weight doesn’t discriminate.

Qualifications for someone falling into the category of healthy obese means that if people are obese but all their metabolic factors such as blood pressure, cholesterol levels and blood glucose are within recommended limits then the extra weight they carry will not be harmful.  The real question has always been were these same folks at an increased risk for developing heart disease or stroke?

It looks like this new research has an answer and it may surprise people.  For the research, scientists analyzed 1995-2015 electronic health records of 3.5 million people aged 18 and older in the United Kingdom who were initially free of heart disease.

Findings from the study showed that when these same people were compared to normal-weight participants with no metabolic problems, those dubbed as healthy obese (defined as people with a body mass index of 30 or higher) had a 50 percent higher risk of heart disease, a 7 percent risk of stroke, twice the risk of heart failure, and a greater risk of peripheral artery disease (PAD). 

At this time the study has not appeared in a scientific journal and has not yet been peer-reviewed.  This makes it difficult to assess how well other factors influencing the results such as diet, lifestyle, or smoking were taken into account.

The message from this study appears to be that it may be possible at some point for an obese person to be metabolically healthy.  Oftentimes these same people are ones who are making good attempts at eating healthier and exercising.  But if a healthier body weight is not achieved at some time during their life, their odds of developing chronic health conditions of heart disease, stroke or high blood pressure may be greater than someone in a healthier weight category.   Not only does excess weight put them at an increased risk of those conditions but also at a greater risk of developing osteoarthritis, joint problems of the knees and hips, fatty liver disease, type 2 diabetes, gout, and sleep apnea. 

Another factor to take into consideration is the way weight is distributed on the body.  For example, weight around the middle may be more damaging than weight distributed evenly throughout the body.  Past studies have suggested that it is not always the amount of fat that matters but where the excess fat is carried on the body that can influence and affect fitness and health.

However, medical professionals should still take seriously the findings from this study and to remember that exercise and healthy eating can promote and boost wellness, no matter how much a person weighs.

 As Dr. Rishi Caleyachetty, one of the study’s authors was quoted, “The priority of health professional should be to promote and facilitate weight loss among obese persons, regardless of the presence or absence of metabolic abnormalities.”