So how then to explain the outcomes from a paper published yesterday in Obesity Reviews? The paper, Metabolically healthy obesity and risk of incident type 2 diabetes: a meta-analysis of prospective cohort studies, was a meta-analysis using data from the English Longitudinal Study of Aging and it concluded that those with what they defined as "metabolically healthy obesity" had a 4 fold higher risk of developing type 2 diabetes over a 6 year period than individuals with "metabolically healthy normal weight". The authors then conclude,
"Prospective evidence does not indicate that healthy obesity is a harmless condition."But before you agree with them there's something important you need to know. Whereas Arya (rightly as far as I'm concerned) defines metabolically healthy obesity (EOSS 0) as an individual who has ZERO weight-relatable conditions, the authors here considered a person to have "metabolically healthy obesity" even if they had one of the following issues: hypertension, impaired glycaemic control, systemic inflammation, adverse high-density lipoprotein cholesterol or adverse triglycerides.
Rather disingenuous don't you think, to describe the increased relative risk of developing type 2 diabetes in individuals who are most assuredly not metabolically healthy as purely consequent to their weight?
Regardless of your weight, if you have hypertension, impaired glycaemic control, systemic inflammation, adverse high-density lipoprotein cholesterol or adverse triglycerides then you are not metabolically healthy, and studies that explicitly suggest otherwise aren't doing anyone any favours, nor answering any questions about risks in those with truly metabolically healthy obesity.