A new study published in The Lancet reveals that many obese adults now have cholesterol and blood pressure levels that are "indistinguishable" from those of a healthy weight. Researchers even found some obese individuals to be "better off" than their healthy-weight counterparts, marking a significant shift from past decades when obesity was strongly linked to elevated cardiovascular risk factors.
Key Findings from the Study
The study, which analyzed data from nearly one million adults aged 20 to 79 across England, Japan, South Korea, Taiwan, Thailand, Finland, and the USA, examined blood pressure, cholesterol levels, and body mass index (BMI) from 110 health surveys conducted between 1990 and 2024. The team found that unhealthy cholesterol levels and blood pressure "declined over time," especially among those aged 40 and over. The declines were larger among people with obesity, "leading to a convergence of these risk factors between obesity and normal BMI in people older than 40 years."
In England, the USA, Thailand, South Korea, and Japan, older people with obesity often became "indistinguishable from, or better off than, those with normal BMI in terms of non-HDL cholesterol and SBP (systolic blood pressure)," the authors wrote. They concluded that differences in these cardiometabolic traits "narrowed or disappeared," especially in older adults.
Role of Medications
Experts largely attribute this change to the increased use of cholesterol-busting medications, such as statins, and blood pressure-lowering drugs, which are more commonly prescribed to people with obesity. Professor Majid Ezzati from Imperial College London said: "Our study suggests that, in high-income countries, taking medication to lower blood pressure and cholesterol has helped middle-age and older adults lower their cardiovascular risk to levels that are similar to people with normal BMI."
Lakshya Jain, also from Imperial College, added: "This latest analysis suggests that the observed convergence in cholesterol and blood pressure levels between people aged over 40 with obesity and those with a normal BMI is largely due to statins and other widely accessible medications to reduce cardiovascular risk. That is a significant public health success story, and one we should not lose sight of as new weight-loss medications enter the picture."
Implications for Younger Adults
However, the study found that in adults under 40, those with obesity still had higher levels of bad cholesterol and higher blood pressure compared to their normal-weight peers. Author Yse d'Ailhaud de Brisis from Imperial College London said: "While good news for older adults with obesity, our results suggest that cardiovascular health risks remain higher for adults under 40 than for their counterparts with a normal BMI. Early lifestyle interventions, screening and, when appropriate, medication in this younger group should be considered to prevent long-term cardiovascular complications linked to obesity."
Cautions and Broader Health Context
Professor Edward Gregg from Imperial College stressed that "it doesn't mean that obesity does not still increase your risk of other outcomes." Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, commented: "This study highlights a powerful public health success story – it shows just how effective modern treatments for blood pressure and cholesterol have become... But we must not lose sight of the bigger picture. These medications are needed because of the adverse effects of obesity on cardiovascular disease risk. Moreover, obesity still affects the body in many other ways and increases the risk of other health problems, including diabetes, kidney disease and some cancers."
