The notion of being “fat but fit” has been debunked by Germany researchers who opine that individuals with obesity, regardless of their outward appearance of good health, face elevated risks of developing both diabetes and heart disease.

Obese individuals looking healthy have 50% risk of heart disease

In a comprehensive study, researchers conducted a thorough analysis of the concept known as metabolically healthy obesity (MHO), often colloquially termed “fat but fit.” Their findings indicate that individuals who are obese, despite appearing to have favourable health conditions, still possess a 50% higher vulnerability to coronary heart disease.

University of Leipzig’s Professor Matthias Bluher said that approximately 15-20% of individuals who are afflicted by obesity do not manifest any of the typical metabolic issues linked to this condition. These commonly include irregular blood sugar regulation, elevated blood lipid levels, hypertension, Type 2 diabetes, and other indicators of cardiovascular illness.

Surprisingly, data reveals that overweight females exhibit a greater propensity for experiencing Metabolically Healthy Obesity (MHO), with prevalence rates ranging from 7% to 28%. Conversely, in males, MHO occurrence falls within the range of 2% to 19%. Moreover, approximately 50% of individuals classified as obese are estimated to suffer from a minimum of two obesity-related complications.

Overweight women more likely to experience MHO

The researchers argue that MHO classification should focus on the behaviour of adipose tissue in obese individuals instead of relying solely on BMI measurements. They found that people with normal-sized fat-storing cells (adipocytes) experience fewer obesity-related problems, whereas those with large and inflamed adipocytes are more likely to develop issues like insulin resistance and metabolic disorders.

In Dr. Blüher’s study, the notion that Metabolically Healthy Obesity (MHO) individuals are truly healthy was disproven. The research found that even when compared to people of standard weight without health issues, obese individuals without health conditions still had a 50% higher risk of coronary heart disease.

In the past, individuals with MHO were not given as much attention in obesity treatment, despite appearing to have good health. However, the team emphasizes the significance of providing treatment and weight loss advice for people with MHO.