Can people be fat and fit at the same time? This old debate is kept alive by new research presented at the European Congress on Obesity.
They tracked people who were obese at the start of the study (defined as people with a body mass index of 30 or more) who had no evidence of heart disease, high blood pressure, high cholesterol or diabetes at this point.
They found these people who were obese but “metabolically healthy” were at higher risk of developing heart disease, strokes and heart failure than people of normal weight.
This led to some overstated headlines in the media:
- BBC News: ‘Fat but Fit Is a Big Fat Myth’
- The Guardian: No Such Thing as ‘Fat but Fit’, Major Study Finds
- EurekAlert! Study of 3.5 Million People Shows ‘Healthy’ Obese People Are Still at Higher Risk of Cardiovascular Disease Events Than the General Population
- The Telegraph: ‘Fat but Fit’ Idea Is a Medical Myth, Researchers Find
Not so fast
The problem is that this study, like earlier studies on the topic, are only observational. This means that they only track statistics and try to find correlations. This does not prove cause and effect. Thus, it’s certainly possible that there are plenty of “fat and fit” people. This study does in no way disprove that.
It’s just that obesity is a statistical risk factor that is hard ignore. What this study demonstrates is that, statistically, people with obesity tend to have a somewhat higher risk of disease, even if many other health markers are normal.
Slightly more people with obesity will get heart disease… but very far from everyone.
Obesity, in itself, is not a disease (unless it results in significant suffering or disability). Obesity is a risk factor for disease.