Obesity or being overweight can give light to several health complications such as heart disease, diabetes, high blood pressure and certain cancers, which are collectively known as metabolic syndrome. But did you know that some people can be obese, but not have these health problems at all? This type of obesity is called 'metabolically healthy obesity' (MHO).
According to Dr. Anurag Aggarwal, Sr. Consultant, internal medicine, Marengo QRG Hospital, obesity is a condition in which the body has excessive fat and is technically defined as Body Mass Index of more than 30, whereas metabolically healthy obesity is when an obese individual lacks the deranged metabolic parameters usually associated with metabolic syndrome.
"Such Individuals have lower visceral fat, higher subcutaneous leg fat, greater cardiorespiratory reserves and capacity to do physical exercise along with normal insulin sensitivity, lower levels of inflammatory markers associated with obesity and normal adipose tissue function compared to patients with metabolic syndrome," he explains.
While the doctor states that there is no specific clinical criteria to define MHO, he lays down parameters that have been proposed when a person is obese.
(BMI ≥30 kg/m2); HDL cholesterol serum concentrations >1.0 (>40 mg/dl) (in men) or >1.3 mmol/l (>50 mg/dl) (in women); fasted serum triglycerides ≤1.7 mmol/l (≤150 mg/dl), systolic blood pressure (SBP) ≤130 mmHg; diastolic blood pressure ≤85 mmHg; fasting blood glucos ≤ 100 mg/dl); not on medications to treat dyslipidemias, diabetes, or hypertension, no cardiovascular diseases like coronary artery disease or stroke.
'Healthy obesity is a misnomer as obesity is not healthy'
Dr. Vikas Singhal, Senior Consultant, GI Surgery, GI Oncology and Bariatric Surgery , Institute of Digestive and Hepatobiliary Sciences, Medanta Hospital, Gurugram, is of the opinion that being obese without any metabolic problems should not imply that this type of obesity is healthy.
"The word 'healthy' here should not be misunderstood as the patients are still at an increased risk of having heart problems, stroke etc.," he says. According to him, although as compared to someone with obesity and metabolic syndrome, they're at a lower risk of cardiovascular ailments, they carry an increased risk of heart attack, stroke, fatty liver, sleep apnea, back & joint pains, infertility, several cancers, mental health problems etc.
Sharing the same viewpoint, Dr Aggarwal says, "‘Healthy obesity’ is a misleading term as obesity continues to be associated with risk of development of hypertension, diabetes, cardiac issues and neurological issues. MHO is more of a transient state wherein the person just has obesity and no biochemical parameter to suggest any development of cardiovascular diseases associated with development of obesity."
Furthermore, the fact that obesity is associated with a lot many complications, not just limited to cardiovascular issues, but also with involvement of lungs, it can cause obstructive sleep apneas, weakening of bones and early joint diseases like osteoarthritis.
In addition, the doctor shares that obesity has also been linked with development of certain kinds of malignancies and studies have shown obesity to be associated with reduced overall survival.
Strategies to follow
Dr. Aggarwal recommends reducing the calorie intake, lowering the consumption of refined carbohydrates, increasing fibre in diet and regular exercise, all of which also help improve cardiovascular fitness.
"Regular exercise based on one’s physical capability is a must atleast 30 minutes 5 days a week. Other options to help with weight reduction include medication, and Bariatric surgery which is highly effective. It is important to get proper evaluation and treat obesity as a chronic disease!" says Dr Singhal.
