Fat but Fit: Fact or Myth?

January 23, 2018

No metabolic derangement, insulin sensitivity preserved; fat on the macrometabolic level can look fit. Now, let's look deeper.

Fat may look fit on the metabolic surface, but the 2 studies summarized here look deeper.

Among the epidemic numbers of the obese found worldwide is a subgroup referred to, paradoxically, as the metabolically healthy obese, or MHO. These individuals are unique in that the increased abdominal adiposity that otherwise would qualify them as "unhealthy," they have no metabolic abnormalities and have preserved insulin sensitivity.

Overt cardiovascular events and other end organ injury related to obesity may take decades to present. Assessment of subclinical atherosclerosis, eg, coronary artery calcification and abnormal carotid intima-media thickness, have been used to evaluate the impact of obesity related factors in a far shorter window.

The slide show above highlights two recent studies that have done that and found that fat indeed is not always as fit as it may seem.

Metabolically Healthy Obesity: Truly Benign?

2014 Korean Study Links Healthy Obese to Subclinical Atherosclerosis

CAC Scores Higher for Metabolically Healthy Obese vs Normal Weight Subjects

Prospective Cohort Study Takes Another Look at Metabolically Healthy Obesity²

Metabolically Healthy Obesity is Not So Healthy After All

Study Authors Recommend Caution

Take Home Points on Studies of Metabolically Healthy Obese

References

1. Chang Y, Kim BK, Yun KE, et al. Metabolically-healthy obesity and coronary artery calcification. J Am Coll Cardiol. 2014; 24;63:2679-86.

2. Kim TJ, Shin HY, Chang Y, et al. Metabolically healthy obesity and the risk for subclinical atherosclerosis. Atherosclerosis. 2017;262:191-197.