Battle of the Bulge: Bigger Can't Be Better

The New York Times, "Idea of Healthy Obesity is Tested" by Nicholas Bakalar: 

The idea that there are obese people who are nonetheless healthy may be a myth.

Although some overweight or obese people have normal cholesterol, glucose levels and blood pressure — elements of so-called metabolic health — a new study suggests that obesity by itself increases the risk for heart disease, stroke, diabetes and death.

Researchers analyzed 12 studies that had together followed more than 61,000 adults, most for at least 10 years. About 9 percent of the subjects were obese and metabolically healthy — that is, they had normal LDL, HDL and total cholesterol, along with healthy blood pressure and blood sugar levels. The report was published online last week in Annals of Internal Medicine.

Compared with metabolically healthy people of normal weight, the obese group had a 24 percent increased risk for fatal and nonfatal cardiovascular events like heart attack and stroke, and for death by any cause.

Increasing body mass went along with decreasingly healthy waist circumference, blood pressure and insulin resistance. It was not associated with increases in triglycerides, glucose or LDL cholesterol levels, which are also risk factors for cardiovascular disease.

“The message here is pretty clear,” said the lead author, Dr. Caroline K. Kramer, a researcher at the University of Toronto. “The results are very consistent. It’s not O.K. to be obese. There is no such thing as healthy obesity.”