Does metabolically healthy obesity exist or is it just a matter of time?

  • Date 12 May 2021
  • Category Cohorts

Can we talk about metabolically healthy obesity or is it just a matter of time before complications appear? A study by the Instituto de Saúde Pública da Universidade do Porto (ISPUP) concluded that, although some individuals with obesity do not present metabolic changes, it only seems to be a matter of time before the changes normally resulting from the accumulation of fat develop. Obesity is not harmless, even though it may seem to be so in the early years of the disease.

According to Vanda Craveiro, first author of the study, coordinated by Joana Araújo, “although obesity usually increases the risk of developing metabolic changes – such as high blood pressure, lipids and glucose levels – some people with the disease present these indicators at levels considered normal. For this reason, the concept of metabolically healthy obesity has emerged in recent years”.

“But this is a controversial term. To better understand this issue, individuals with obesity need to be monitored over time, to assess the evolution of their weight and metabolic parameters. We need to find out if this apparently healthy metabolic profile is just an occasional situation or if these people have characteristics that allow them to reduce the risk associated with obesity”, the researcher says.

Using data from the EPITeen cohort – a longitudinal study that has followed, since 2003, a group of individuals born in 1990 – the authors studied the evolution of weight and the metabolic status of 1040 people from adolescence to adulthood.

Data related to the health of these participants, at the age of 13 and 24, were analyzed and their body mass index (BMI) was assessed over 11 years. Young people were categorized according to their weight – “normal” or “overweight” – and the state of their metabolic health.

22% of overweight individuals developed metabolic changes

About 22% of the individuals in the sample who, at 13 years of age, were overweight, but did not have metabolic changes, developed, during the 11 years of follow-up, at least one metabolic alteration, when maintaining their excessive weight.

According to the authors of the study published in the journal Nutrition, Metabolism & Cardiovascular Diseases, “our results have shown that obesity is not harmless. Although some individuals with obesity have normal levels of metabolic parameters in early adolescence, the results suggest that it is only a matter of time before they develop complications in adulthood, such as high cholesterol and triglycerides, diabetes or hypertension”.

In addition to the duration of obesity, the distribution of body fat, such as a greater accumulation of fat in the abdomen, has been shown to contribute to these metabolic changes.

Along with Vanda Craveiro and Joana Araújo, Elisabete Ramos also participated in the investigation entitled Metabolically healthy overweight in young adulthood: is it a matter of duration and degree of overweight?.

Image: Unsplash/i yunmai

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