A major study presented at the European Congress on Obesity has challenged the notion that people can be 'fat but fit', suggesting that obesity itself increases the risk of heart disease, stroke, and heart failure, even in the absence of metabolic abnormalities.
Researchers at the University of Birmingham analysed GP records of 3.5 million British patients between 1995 and 2015. They tracked individuals who were obese (BMI of 30 or more) but had no initial signs of heart disease, diabetes, high blood pressure, or high cholesterol. The findings showed that these 'metabolically healthy' obese individuals were still at higher risk of developing cardiovascular conditions compared to people of normal weight.
Dr Mike Knapton of the British Heart Foundation said: 'It's not often that research on this scale and magnitude is able to clarify an age-old myth. These findings should be taken extremely seriously.' He added that simply being overweight increases the risk of heart attack and stroke, even if other health markers are normal.
However, the study has not yet been published in a peer-reviewed journal, and some experts caution that factors such as diet, lifestyle, and smoking may not have been fully accounted for. Professor Tom Sanders of King's College London noted that using definite cut-offs for conditions like high blood pressure may oversimplify health assessment.
Despite these limitations, the researchers urge healthcare professionals to promote weight loss among obese individuals regardless of metabolic health. Dr Rishi Caleyachetty from the University of Birmingham stated: 'At the population level, so-called metabolically healthy obesity is not a harmless condition.'
The British Heart Foundation recommends standard heart health advice: not smoking, eating a balanced diet, exercising regularly, and limiting alcohol intake. Dr Knapton also called on policymakers and food manufacturers to make healthy choices more accessible.
