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Sep 24, 2013

Healthy Obesity: An Oxymoron?

Being more physically fit, having a smaller waistline and having normal blood sugar may help protect some obese individuals from chronic diseases.

With such worry about the global obesity epidemic, it’s hard to imagine that there’s such a thing as “healthy obesity”—when an individual is obese but does not appear to have any increased risk of health complications. Although the idea of healthy obesity is relatively new to the medical field, it could be the key to managing the one-third of Americans that are obese, according to a paper recently published in The Lancet.

This paper reviewed everything we know about healthy obesity and how we can use it to help keep people healthier, longer. While we lack exact criteria to define healthy obesity, there are a few factors that may play a deciding role in whether excess weight will result in health complications. Being more physically fit, having a smaller waist circumference and having normal blood sugar may help protect obese individuals from chronic diseases, such as heart disease and type 2 diabetes. Also, having fewer cardiovascular risk factors like high blood pressure and high cholesterol may help further differentiate between healthy and unhealthy obesity.

As the authors point out, we have much more to learn about this concept but it has the potential to help improve outcomes for obese patients. If we can identify which patients have the highest risk for serious health complications, we can then tailor treatments to help address risk factors more effectively. Many treatment strategies are expensive and time consuming, so identifying which patients will benefit the most from certain treatments is important. For example, it’s possible that weight loss surgery should be reserved for those with greatest risk and the less-intensive interventions should be used in those with seemingly healthy obesity.

But that’s not to say that obesity prevention strategies are no longer needed. Preventing obesity and helping obese individuals achieve a healthy weight is paramount in fighting heart disease—the No. 1 killer of Americans. For most individuals, obesity does not protect them from serious health complications. Instead, it drastically increases risk for chronic disease and death. The concept of healthy obesity may help us better manage the health of millions of obese Americans, but preventing obesity is always the best strategy for promoting better health.

Questions for You to Consider

  • What is a healthy weight?

  • A few important tools can be used to determine if an individual is underweight, normal weight or overweight. The easiest tool is a Body Mass Index, which is calculated using height and weight to estimate levels of body fat. However, Body Mass Index is not always accurate, particularly among individuals with extremely high or low amounts of muscle. In these cases, measuring waist circumference is helpful in assessing weight, as a waist circumference greater than 35 inches for a woman or 40 inches for a man is considered unhealthy.
  • How important is maintaining a healthy weight?

  • Overweight and obesity greatly increase risk for diabetes, heart disease and a number of cancers — all of which can be life threatening. Therefore, it is important to take action toward maintaining a healthy weight, as losing just 5-10% of your weight can help reduce blood pressure and cholesterol, and reduce risk for heart disease.

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