Can you be normal-weight and metabolically unhealthy?

According to a study, 23.5% of U.S. adults who were normal weight according
to their BMIs had the same metabolic abnormalities that are common among the
overweight and obese. These abnormalities include reduced HDL cholesterol,
and increased triglycerides, fasting glucose, C-reactive protein, insulin resistance,
and blood pressure. Many, often older, individuals with metabolic abnormalities
have lost muscle mass. They have excessive body fat and visceral obesity as measured
by waistline girth, despite a normal BMI. A study of the results of weight
loss among normal-weight individuals found that even small losses of weight were
highly beneficial to multiple measures of their metabolic status.

Can you be obese and metabolically healthy?

Some obesity experts have considered that about 20% of obese people are metabolically
healthy (i.e., normal glucose, blood lipids, blood pressure) and may not have
increased health risks related to adiposity. Research has shown that their cardiovascular disease risk is considerably lower than those individuals who are obese and have unhealthy metabolic biomarkers. For example, the metabolically healthy but
obese participants in one study had a 38% lower risk of death from any cause than
those who were metabolically unhealthy and obese.

But some studies question the concept of healthy obesity. One such study found
that, compared to normal-weight individuals with no metabolic abnormalities, individuals
with metabolically healthy obesity had a 50% increased risk of coronary
heart disease; a 7% increased risk of cerebrovascular disease, a doubled risk of
heart failure, and excluding cigarette smokers, an 11% increased risk of developing
peripheral vascular disease. Dr. Caleyachetty, the study’s lead author, noted that
“Metabolically healthy obese individuals are at higher risk of coronary heart disease,
cerebrovascular disease and heart failure than normal-weight metabolically
healthy individuals. The priority of health professionals should be to promote and
facilitate weight loss among obese persons, regardless of the presence or absence of
metabolic abnormalities.”

This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.