Fat But Fit: Metabolically Healthy Obesity


Photo: Suzanne Tucker/Shutterstock

Can you be fat and healthy at the same time? Apparently so, according to a new study by University of Pennsylvania physicians and obesity researchers who say that there are people with "metabolically healthy obesity."

Many obese people are classified as such when their body mass index or BMI reaches a certain value. BMI, a formula based on a person's weight and height, was invented by Belgian mathematician Adolphe Quetelet in the early 19 century and has garnered wide acceptance as a simple way to measure "fatness." It's quick and easy to administer - requiring only a scale and a ruler - and allows for comparison for broad populations, taking in age and country-by-country variations. Indeed, BMI is a good statistical measure of the obesity of a whole population of people.

Doctors have noted, however, that some people with BMI in the obese range are actually quite healthy and that in many cases, fat people fare better than thin ones with the same ailments. In the "obesity paradox," researchers noted that diabetic patient of normal weight are twice as likely to die than those who are obese. Others have pointed out that thin dialysis patients are more likely to die than heavier ones.

In recent years, the medical field has began to accept that BMI is not a reliable measure of health in individuals, and that some people who are obese do not have nor are they in any danger of developing obesity-related diseases.

But how many people are actually "fat but fit" and "not fat but not fit"? The answer may surprise you. For 1 in 5 Americans, BMI may actually tell the wrong story:

- 8% of normal-weight adults in the United States are actually metabolically unhealthy
This translates to 19.2 million people whom doctors may not currently worry about but should.

- 10% of obese adults are actually metabolically healthy
This means that 24 million chubby Americans are not in any danger of dying because of obesity-related illnesses, but are probably badgered by their family, friends and employers to lose weight.


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BMI was invented in 1850 as a statistical measure of the "fatness" of population, and in that terms, BMI was and still is a very effective tool.

The problem is when they apply BMI to individuals, where the margin of error approaches 20%. (i.e. 10% of skinny people and 10% of fat people do not conform to the picture of health that BMI purports to show).
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BMI is a made up term. A term invented by insurance companies to fraudulently screen clients to supply them with coverage. It is not in the best interest of the medical industry to keep you healthy. There's no profit to be made from this. BMI is an excuse to make skinny people feel unhealthy and to prescribe ineffective unnecessary drugs. Do not pay mind to their ruse. People will believe any published piece as the source of truth. "Thou who cureth can maketh ill".
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Same, I'm 6'4" and around 280. But I don't look it. I have a bit of a tummy, but it get's smaller all the time. My moms nephews were all huge men, easily my height, and my weight and above, and they were all fit as hell. The bmi says my healthy weight is under 200 pounds. What a crock. I haven't weighed that much since I was a teen, I have no major health issues, and if anything I will probably add weight as I add muscle.
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Canuckle Head 6'1, 235 lbs.
Artor 6'1" 250 lbs
032125 6'1" 240 lbs

Am I detecting a trend? My dad swears there is a specific danger of heart attack for men who are large framed and muscular everywhere but specifically carry all of their fat in the belly. I believe this would be mesomorphic.
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I don't know what group I fit into. My BMI is in the "normal" range according to the CDC, but I look like a little fat woman.

Of course I'm in shape! "Round" is a shape!
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