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The 'healthy obese' may not stay healthy for long.


The phenomenon of "healthy obesity"--having a body mass index over 30 kg/[m.sup.2] but without significant metabolic risk factors--is most often a transitive phase toward unhealthiness, and not a stable physiologic stage, a report suggested.

"Healthy obese" adults were nearly eight times more likely to progress to an unhealthy obese state after 20 years than were healthy nonobese adults. After 20 years, roughly 50% of healthy obese adults were unhealthy obese, and 10% were healthy nonobese, lead author Joshua A. Bell wrote in a research letter published in the Journal of the American College of Cardiology (doi: 10.1016/j.jacc.2014.09.077).

Mr. Bell and his colleagues at the department of epidemiology and public health at University College London examined data from 2,521 British government workers between the ages of 39 and 62 years. Each participant's body mass index, cholesterol level, blood pressure, fasting plasma glucose level, and insulin resistance was measured over a period of 5 years, 10 years, and 20 years. Three-quarters of the participants were male.

The sample included 66 healthy obese adults at baseline, or about a third of all obese participants. Of these subjects, 21 (32%) were unhealthy obese after 5 years, and 27 (41%), 23 (35%), and 34 (52%) were unhealthy obese after 10, 15, and 20 years, respectively.

"Our results, which were obtained with a longer, more detailed follow-up than any previous study, suggest that long-term stability is the exception, not the norm. The natural course of healthy obesity is progression to metabolic deterioration," the authors wrote.


Key clinical point: Obese patients without metabolic risk factors will likely develop complications over time.

Major finding: Of "healthy obese" participants, 51% became "unhealthy obese" over a period of 20 years, while 11% lost weight and became healthy.

Data source: An analysis of 5,521 men and women from the Whitehall II cohort study of British government workers.

Disclosures: There were no relevant disclosures to report.

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Author:Bock, Mike
Publication:Clinical Psychiatry News
Date:Apr 1, 2015
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