People tend to assume that obesity is synonymous with ill health. It is a common belief that thin individuals are healthy, while people with obesity are not. It might be valid to some extent. However, someone with obesity needs not necessarily develop atherosclerosis, insulin resistance, or other metabolic complications. Such people have metabolically healthy obesity. However, the term, healthy obesity, can be misleading at times. Because while obese people can be healthy today, they might not be healthy tomorrow. Obesity on its own carries certain risk factors, thereby making “Healthy Obesity” medically an oxymoron.
What is Healthy Obesity?
You’re obese if your body mass index (BMI) is greater than or equal to 30. Obesity is often associated with metabolic abnormalities. Metabolic syndromes include increased inflammation, nonalcoholic fatty liver disease, hypertension, dyslipidemia, and type 2 diabetes. Unfortunately, metabolic syndromes are rising among men, women and children in development, due to changing lifestyles and urbanization.
Metabolically healthy obesity or MHO is a subset of obesity. It is known simply as healthy obesity. There is no universally acknowledged criterion for defining it. However, an obese person who lacks metabolic abnormalities such as metabolic syndrome, impaired glucose tolerance, and dyslipidemia is healthy obese. In contrast, metabolically unhealthy obesity increases the risk of adverse cardiometabolic outcomes.
What is the Possibility of Being Healthy and Obese?
In recent years, healthy obesity has been a critical part of clinical and epidemiological studies. According to a study based on the health records of 3.5 million people, about 14.8% were obese with no metabolic abnormalities. Therefore, these people were obese but healthy. Further, 25.7% of people from the observed pool were overweight with no significant signs of ill health. Interestingly, the prevalence of healthy obesity was more likely among younger individuals who never smoked. Moreover, it has been that around 10% to 25% of obese individuals, irrespective of gender and race, are initially healthy.
Over 5-10 years, individuals in the healthy obese category start showing signs of obesity-related disorders. For example, they become more likely to develop heart disease, have a stroke, high blood pressure, and diabetes. That’s because being healthy is usually brief. Metabolically healthy obesity can turn into metabolically unhealthy obesity gradually. The likelihood of obese people staying healthy is directly related to age, diet, lifestyle choices, and physical activity.
Health professionals conclude that in comparison to unhealthy obese patients, people with healthy obesity show favourable metabolic function and are less likely to acquire adverse outcomes. However, when compared to non-obese individuals, metabolically healthy obese people are at a higher risk of cardiovascular disease.
Why Does Healthy Obesity Happen?
Genetic factors might play a role in determining if you belong to the healthy obese or non-healthy obese category. Relative to unhealthy obese individuals, those with healthy obesity have reduced inflammation, smaller fat cells, and less visceral fat tissues. A study investigated if inflammation influences the division between healthy and unhealthy obese people. And as per the results, those with lower levels of inflammation had a greater likelihood of metabolically healthy obesity.
In addition to inflammation, the following factors can be why some people with obesity stay healthy.
Though there is limited scientific evidence, sleep duration and overall sleep quality may be indicators. It is important for an individual to have at least 7 to 8 hours of deep sleep. Sleep deprivation tends to disrupt metabolic processes in the body. Thus, getting uninterrupted and quality sleep is crucial in maintaining metabolic homeostasis. A good night’s sleep is one factor that keeps obese people metabolically healthy. Furthermore, a cross-sectional study shows that metabolically healthy obese individuals have slightly better overall sleep quality. However, this is in contrast to those with metabolically abnormal obesity.
Not all people with obesity lead a sedentary lifestyle paired with high-calorie intake. Some obese people choose healthy food options and stay physically active, making them healthy obese. Following a consistent exercise schedule and a balanced diet can improve overall health, regardless of whether they are obese or not. Some lifestyle habits that make an obese person healthy are:
- Eating five or more servings of fruits and veggies daily
- Exercising for a minimum of thirty minutes a day
- Avoiding or limiting alcohol intake
- Quit smoking
What Are the Risk Factors of Healthy Obesity?
The risk factors of healthy obesity are not different from unhealthy obesity. Both are functions of your diet and exercise habits. Still, they can also get influenced by medical conditions, medications, and injuries. For example, some medical conditions lead to unexpected weight gain, which causes obesity. A few of the diseases that can serve as obesity risk factors are:
- Insulin resistance
- Polycystic ovary syndrome (PCOS)
- Prader-Willi syndrome
- Cushing’s syndrome
The following medications lead to weight gain:
- Anticonvulsants or seizure treating medicines such as valproate and carbamazepine
- Prednisone and other corticosteroids
- Sulfonylureas, Insulin and thiazolidinedione are examples of diabetes medications.
- Beta-blockers, for example, are used to treat high blood pressure.
The Transition of Healthy Obesity to Unhealthy Obesity
Compared to metabolically unhealthy obese persons, a person with healthy obesity leads a better lifestyle and is less severely obese. However, when a person with healthy obesity becomes metabolically unhealthy, it simultaneously increases bodily dysfunctions and health issues. Thus, healthy obesity is a temporary phase leading to metabolic syndrome and insulin resistance.
Some of the health risks that accompany the transition are:
- Bone and cartilage damage or degeneration
- Gallbladder disease
- Sleep apnea
- Respiratory Problems
- Coronary artery disease
- High blood pressure
- Type 2 Diabetes
- Colorectal cancer
Should Someone With Healthy Obesity Seek Treatment?
Obesity is a worldwide health concern. It is bound to cause mild, moderate, or severe health complications. For this reason, it is essential to go for professional consultation, irrespective of healthy obesity or unhealthy obesity. An easy way to do it is by downloading the HealthifyMe app.
Obesity Friendly Diets
There are numerous kinds of diet and meal plans available for obesity. The most straightforward and most effective approach is to choose a calorie deficit plan. To lose weight, you need to burn more calories than you eat. Avoid processed foods and sugary snacks while increasing your whole grains, fruits, vegetables, and lean protein intake.
You might not find the ideal diet plan on the first try. It can be a process of trial and error. Find what works best for you and your fitness goals. Any diet or meal plan will only be effective when you do it consistently and strictly adhere to it.
Calorie counting is vital in obesity management. However, do not obsess over it. You can use calorie tracking and fitness apps like HealthifyMe to count calories accurately and simplify the process.
Staying active promotes healthy living. It can help you lose weight and prevent the transition from healthy obesity to unhealthy. In the beginning, aim for thirty minutes of brisk walking or jogging. Then, work your way up, including resistance training and cardiovascular activities to your exercise schedule.
While dieting, obese people lose muscle mass with fat which is absolutely normal since in later stages of weight management it is recommended to gain some muscle mass.. Incorporating bodyweight exercises can help combat muscle loss.
Healthy or not, obesity requires medications to subside the side effects. Sometimes, doctors prescribe medicines for weight loss. Qsymia, liraglutide, and orlistat are some common examples. However, a medication that works for one person might not work for you. Ask your doctor for the medication that suits your lifestyle and diet.
Surgery is the recommended approach for people with a BMI range of 30 to 35. However, before opting for a surgical procedure, the doctors look at several other parameters. BMI is an indicator and not an absolute measure. Some start healthy but are vulnerable to extreme health fluctuations. Weight loss surgery makes your stomach smaller, thereby reducing the food intake. Doctors recommend them for those at risk of developing weight-related severe problems. However, people with healthy obesity must try a non-surgical approach as the first-line treatment. Even small dietary and lifestyle changes offer considerable benefits. These options include liposuction, and bariatric surgery (Roux-en-Y gastric bypass, adjustable gastric banding, and sleeve gastrectomy).
The risk of adverse metabolic complications in healthy obesity is substantially lower than those with metabolically unhealthy obesity. However, the concept of metabolically healthy obesity is debatable. It can be misleading since people assume that obesity can be healthy. Furthermore, the period of healthy obesity is temporary. A person can transition from healthy obesity to metabolically unhealthy obesity. On that account, obese people certainly face health problems down the road. Therefore, every person with obesity must work to achieve an average weight in the long term. If they do not lose weight, they can have metabolic disorders and other health issues.
Managing obesity is a combination of exercise, diet, and lifestyle changes. In extreme cases, medications get added too. However, following a disciplined approach is necessary for weight loss. Obesity management takes commitment, patience, effort, and time. At times it is also recommended to reduce weight surgically but liposuction, bariatric surgery etc. But it is always recommended that one should try to reduce weight naturally first.
Frequently Asked Questions (FAQs)
Q. Can an obese person be healthy?
A. Yes, an obese person can be healthy. It is possible when a person is metabolically active. Metabolically active means the person does not have degenerative diseases. Examples are diabetes, atherosclerosis, and cardiovascular diseases. Despite being obese, following a consistent exercise schedule can keep you in a better state of health. In addition, an active lifestyle helps to keep obesity at bay as it burns excess calories and fat.
Q. What are the benefits of obesity?
A. Fat offers some benefits. Some excess fat reserves help in energy storage, and energy reserve utilisation for bodily processes occurs. Fat can help you stay warm during chilly weather, and it shields the vital organs from trauma and injury. Moreover, your body’s fat tissue absorbs fat-soluble vitamins. Examples are A, E, D and K. However, by no means are we encouraging you to get fat.
Q. Can you be 300 lbs. and healthy?
A. If a person is 300 pounds and does not have any other diseases or health complications, then that person is considered healthy. However, the chances of staying healthy with 300 pounds weight are low. Around 99% of individuals weighing this heavy suffer from several other health complications. On that account, try to have a healthy and active lifestyle and consult a certified nutritionist to lose weight and live a healthy life.
Q. Is obesity always unhealthy?
A. No, obesity is not always unhealthy. It is particularly true if you exercise and eat a balanced diet. For example, an obese high BMI person who exercises could be healthier than a low BMI person who doesn’t exercise. But the chances of being healthy and obese are not high. You might not face any health complications during the initial stages of obesity. However, if you do not address it, the situation worsens over time.
Q. What are the three benefits of fat?
A. Fat offers some benefits, but only the healthy kind of fats. It serves a chief role in storing energy. In cold weather, an overweight person has an advantage over a skinny person due to the ability of fats to keep the body warm. Further, fat helps absorb vitamin A, vitamin D and vitamin E.
Q. Why is it important to not be obese?
A. Obesity is a leading cause of many diseases. It can cause diabetes, various cardiovascular complications, fatty liver, and Gastrointestinal tract problems. Many of these problems are degenerative. It means there is no complete cure. Hence, it is crucial to maintain your weight within the range advised for your weight and height.
Q. How can you tell if you are fat?
A. The BMI or body mass index is a common determinant of obesity and fat composition. The BMI gets calculated by dividing weight (in kilograms) by doing a whole square of their height (in metres). A high level of BMI will indicate high body fat composition, indicating obesity. A BMI value between 25 and 29.9 indicates the overweight range. If the BMI is over 30, then it is considered obese. However, several other parameters are popular. BMI is easy to calculate, but it is not an absolute measure of obesity.
Q. What is skinny fat?
A. It means that the person has a relatively high percentage of body fat and a low muscle mass. People with skinny fat body composition show a normal BMI range. However, they are at a heightened risk of developing hypertension and diabetes.
Q. Can you be fat and have abs?
A. Yes, it is possible to have abs when you are working out and trying to lose weight. You may have abs hidden under the layer of subcutaneous fat. You’ll need to cut out junk food and stay away from sugars to reduce the fats covering the abs.
Q. Can fat be athletic?
A. Yes, fat and obese people can be athletic, but the type of sport will be different. They can play sumo wrestling, rugby or American football, and weight lifting. But excess fat comes with health troubles, even in athletes. Moreover, around 65% of obese athletes are metabolically healthy. It means that they have healthy obesity. Fat can be fit, but only if you don’t have blood pressure, diabetes, cholesterol or other metabolic disturbances.
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