Even in metabolically healthy obese people, the risks of cardiovascular disease are real, according to a study. Through their research, the authors seek to put an end to this very controversial concept.
Are there really healthy obese people? This concept of “healthy obesity” is very popular in the United States. It refers to obese people who show no signs of cardiovascular disease or pathology that can cause heart problems. This apparent good health is referred to as metabolically healthy obesity. But this notion has lead in the wing if we are to believe the results of a study published in The Journal of the American College of Cardiology. According to their results, these apparently healthy obese people are still more likely than the “non-obese” to have blocked arteries.
Obese people who are not so healthy
Dr Yoosoo Chang and his team studied 14,828 Koreans between the ages of 30 and 59 and in good health. None of the participants had a history of cardiovascular disease. After a complete work-up with imaging examination, it turned out that many of them presented a significant calcification score which testifies to the formation of plaques. This score was actually increased by 67% compared to healthy non-obese adults.
However, everyone agrees on this point: untreated atherosclerosis is a risk factor for cardiovascular disease. In other words, for the authors of this study, a healthy obese is a myth. Even if the metabolic disturbances are not yet noticeable, it does exist.
A Finnish study, dating from October 2013, tried to show that there were obese people without any health problem. To do so, the researchers observed monozygotic twins, one is thin and the other is obese. In 50% of cases, the obese twins were as healthy as their thin twin. Liver fat, insulin sensitivity, lipid level, blood pressure, and subcutaneous fatty tissue characteristics match that of a thin person.
A concept that “undermines the mission” of doctors
Conversely, this new study shows that there is no such thing as healthy obesity. Using their results, the researchers warn against this claim. Associated with Dr. Chang’s study, one of his colleagues, Dr. Rishi Puri, published an editorial attacking this notion of metabolically healthy obesity head-on. He blames the inventors of the concept he accuses of “undermining the mission that doctors and health organizations face, which is to reduce the obesity curve and prevent future generations from becoming obese.” . Continuing to only treat obese patients with cardiovascular problems would be “futile and pointless.” For him, these results “highlight the fact that obesity is a real disease. “
The author of the study sees, through the results of his study, a way to end the impunity enjoyed by obese in good health. “Obese people, considered healthy because they don’t have an aggravating risk for heart disease, shouldn’t be seen as in good shape by their doctors,” warns Dr. Chang. According to him, “it is important that people learn this quickly so that they can effectively change their diet and habits to avoid any stroke in the future.” Concretely, this means that the disease does not progress at the same speed in everyone and that the advice on diet and physical activity must be the same for all people with obesity, regardless of the metabolic impact. .
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