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British scientists dispel myths about metabolically healthy obesity

Scientists at the University of Birmingham’s Institute of Applied Health Research have published new findings that discredit myths around the so-called metabolically healthy obesity phenotype.
This controversial theory says that it is possible to have a high Body Mass Index (BMI) while having relatively normal metabolic parameters and a low risk of developing conditions such as heart disease, stroke and type 2 diabetes.
The BMI is currently the recommended fat-related biomarker for identifying high risk individuals. Last year, however, it emerged that relying solely on BMI for predicting heart disease, in particular, was misguided.
The study, published at the time in the Journal of the American College of Cardiology, suggested that a high volume of visceral fat in the abdominal region was far more reflective of risks than BMI or waist circumference.
This past research already casted doubt about assuming that an overweight or obese person is not predisposed to disease without knowing if he or she does not have a dangerously high amount of fat spilling into the liver, pancreas, heart or other vital organs.
This may also explain why this new study of 3.5 million Britons has found that obese participants otherwise regarded as healthy had a 49 per cent increased risk of coronary heart disease and a 96 per cent higher risk of heart failure.
According to the findings, presented at the European Congress on Obesity, in Portugal, this held true even when blood pressure was normal and cholesterol levels were in balance, as well as in non-smokers.
On the basis of these results, obtained after analysing 20 years worth of health records for adults initially free of heart disease, it is now suggested that there is no such thing as “metabolically healthy” obesity.
Researchers emphasised that obesity is not a harmless condition and that it raises risks for a lot of silent killers, like peripheral vascular disease. People who are obese also have a two-fold increased risk for multiple cancers and live about ten years less than lean individuals.
In addition to that, and as discussed earlier, the accumulation of fat in the liver and pancreas in obese individuals is the main driver of dysregulated insulin signaling and consequent elevated blood sugars, which raises risks for type 2 diabetes.
Controversy will continue to rage regarding the benign obesity paradox, but these findings should be taken seriously as they suggest obesity remains one of the primary risk factors for heart conditions and type 2 diabetes.

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