Occasionally my obese patients challenge my suggestion that they lose weight on the
grounds that they do not suffer from arthritis, hypertension, diabetes or heart
disease. Therefore, is there such a thing as being healthy and overweight? Here
is a paper recently published in the Annals of Internal Medicine that suggests otherwise.
In this systematic review, eight
studies (n = 61 386; 3988
events) evaluated participants for all-cause mortality and/or cardiovascular
events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95%
CI, 1.02 to 1.55) had increased risk for events compared with metabolically
healthy normal-weight individuals when only studies with 10 or more years of
follow-up were considered. All metabolically unhealthy groups had a similarly
elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR,
2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).
Compared with metabolically healthy normal-weight individuals,
obese persons are at increased risk of death by all causes and for
cardiovascular events even in the absence of metabolic abnormalities.