‘Fat but fit’ people still at risk of heart problems 

Fat but Fit

People who are healthy but obese are at a higher risk of heart problems than those who are a normal weight, according to a British study.

The study, which looked at GP records of 3.5 million people in the UK, claims that the idea that people can be ‘fat but fit’ is a myth, and that obese people who currently have no health problems (‘metabolically healthy’) are still at a higher risk of suffering from heart conditions later in life than people who are a healthy weight.

Metabolically healthy obese

Being ‘metabolically healthy obese’ is when someone has a body mass index (BMI) of over 30, and is therefore classed as obese, but does not have any initial signs of associated health risk factors such as high blood pressure, diabetes or high cholesterol.

This study looked at whether it is possible to be ‘fat but fit’.

Researchers at the University of Birmingham used electronic GP health records from between 1995 and 2015. They analysed 3.5 million people aged 18 or over who were initially free from any heart problems, and looked at the BMI of these people, and whether they had conditions such as diabetes, high blood pressure or abnormal blood fats.

The researchers then looked at whether the risk of developing conditions such as heart disease, stroke or heart failure differed between people who were a healthy BMI and people who were classed as obese.

Risk factors

The study found that people who are ‘metabolically healthy obese’ were 50% more likely to get heart disease, 7% more likely to get cerebrovascular disease (including a stroke) and twice as likely to have heart failure.

The study also found that the risk of heart conditions in people who are obese increased with the number of metabolic abnormalities (for example diabetes or high blood pressure) they have.

Compared with people who are the recommended weight (a BMI of 18.5 to 24.9), those who are obese and have three metabolic abnormalities have a 2.6 times increased risk of heart disease, a 58% increased risk of cerebrovascular disease, a 3.8 times increased risk of heart failure and a 2.2 times increased risk of peripheral vascular disease (where blood vessels in the legs narrow).

The figures were adjusted to take into account factors that may influence the results, such as smoking, age and gender.

Not harmless

The research was presented at the European Congress on Obesity, but has not yet been published.

Dr Rishi Caleyachetty, the lead researcher, said: “At the population-level, so-called metabolically healthy obesity is not a harmless condition and perhaps it is better not to use this term to describe an obese person, regardless of how many metabolic complications they have.”


This article was written by a third party source and does not reflect the views or opinions of Ramsay Healthcare unless explicitly stated.

Additional comments on the page from individual Consultants do not necessarily reflect the views or opinions of other Consultants or Ramsay Healthcare.

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