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Obese but healthy? You’re still at risk for heart disease

Do you know anyone who is pretty significantly overweight but says their doctor is happy with their cholesterol, blood pressure and general health?

They could be right. There are people whose Body Mass Index qualifies them as obese, but they don’t have any of the metabolic risk factors associated with being overweight: high blood pressure, high cholesterol, insulin resistance.

But a long term study of people who qualify as “healthy obese” showed that the majority of them don’t maintain their good numbers: Researchers from the Department of Epidemiology and Public Health at University College London studied 2,521 men and women between the ages of 39 and 62 for 20 years, and found more than 50 percent of those who started out extremely overweight but without signs of heart disease eventually increased their cholesterol, blood pressure and other factors. The study was published Monday in the Journal of the American College of Cardiology.

In general, the study found that the majority of obese adults end up with health problems related to their weight — including people who may be overweight but otherwise healthy. The percentage of healthy obese people who became unhealthy increased pretty steadily over the course of the 20 year study.

And perhaps unsurprisingly, these healthy overweight people are more likely to end up like the sick obese, with heart disease. Healthy obese people were much more likely to become unhealthy obese than people who have a healthy weight, even if they already have some metabolic risk factors.

About 11 percent of the healthy obese people lost weight and stopped being obese over the course of the study — but about six percent of the people who had good labs and were a healthy weight became unhealthy obese.

As the researchers concluded, obesity increases your risk for heart disease, period. Your risk is lower if you have normal blood pressure and cholesterol, but if you are obese there’s a strong chance that those numbers are going to get worse.