5 min read
Some people don’t want to admit to a problem and will latch onto anything that makes them feel comfortable about their uncomfortable situation. When Tess Holliday an obese model was on the front cover of Cosmopolitan recently, I saw people claiming that being obese doesn’t necessarily mean you are unhealthy, people posted pictures of pages from books on Instagram claiming that obesity doesn’t lead to other health issues, and that the health warnings about obesity are just a way for big pharma and the food industry to make money. Cancer Research UK recently launched a campaign stating how obesity is the second biggest cause of cancer after smoking. Predictably it wasn’t received well, and despite this statement being backed by many scientific studies and researchers who have dedicated their lives to investigating this very subject, denial flooded Cancer Research UK’s Facebook post. Many people became defensive and started to blame things or even people for their weight gain, and many took to pointing the finger at other likely causes of cancer. Cancer Research UK were accused of fat shaming, when all they did was promote a scientifically proven message.
Being obese is not healthy.
The internet and social media has helped science communication a great deal, in the sense that information is readily available. However, its success has also been its downfall as the general public don’t always understand what a credible source is, let alone how to interpret data. Instead of being able to look at all the evidence available, it only takes one buzz word or phrase from a single source, regardless of the credibility that supports their own world view to solidify their bias and cognitive dissonance. One such buzz phrase is ‘metabolically healthy obesity.’ Metabolically healthy obesity (MHO) individuals may be without one or more of the following: inflammatory profile, dyslipidaemia, insulin resistance, or hypertension. However, studies can’t agree on what defines the criteria that qualifies an individual as being MHO. In some studies, even if two of the unhealthy characteristics are present, they can still be categorised as MHO. Not many studies look at inflammation markers such as C-Reactive Protein when categorising metabolic health in obese participants. In one study, if you have high C-Reactive Protein levels without any other markers for metabolically unhealthy obese (MUO), then you can still be classified as MHO. Whilst scientists try to figure out how to diagnose someone’s metabolic health status, what we do know for certain is that obesity causes low grade chronic inflammation, which occurs in MHO as well as MUO individuals.
Metabolically healthy obese is not the same as being healthy and obese.
This criterion needs to be clearly defined, as without this, researchers cannot investigate the transition from MHO to MUO. This is the key point here. There is a transition. There is a causal pathway from healthy to unhealthy even if this is not yet fully understood. People may hang onto the fact that it is possible to be metabolically healthy and obese, but they fail to acknowledge that studies show that 30-40% of MHO individuals converted to MUO individuals after follow-up periods ranging from 5.5 years to 10 years. There are factors that appear to prevent or slow this transition, which incidentally also have the potential to aid fat loss: frequent exercise, consumption of healthier foods, good mental health, no smoking or the cessation of smoking, and lower levels of markers of metabolic dysfunction. Gender, ethnicity and gender are also influencing factors. The extent of the protection that these factors confer is unknown. Even if you are metabolically healthy obese and living a healthy lifestyle, on a molecular and systemic level, things are amiss. Increased fat deposition occurs due to an imbalance between energy intake and energy expenditure, and whilst the human body will try and maintain equilibrium, chronic excess fat deposition leads to hormonal and immunological disruption. This disruption creates an environment where the scales are tipped towards the development of a metabolic disorder, and only if the right protective factors are present could this prevent you from switching to a metabolically unhealthy profile. Even then, there’s no guarantee.
The definition of health as defined by the World Health Organization is:
"State of complete physical, mental, and social well being, and not merely the absence of disease or infirmity."
Obesity can also impact mental health, cause issues with joints, and being overweight and pregnant, increases the risk for complications for you and your baby. Again, for the people at the back – not healthy.
On a more positive note, as this can read like it’s all doom and gloom, people who are metabolically unhealthy can transition to being metabolically healthy if there is no permanent metabolic damage. If you fall into the metabolic healthy obese category, and you are adhering to a healthy lifestyle, that is awesome. It should encourage you that only small tweaks to your diet could help you lose weight. No one is fat shaming you by saying being obese is unhealthy, this is simply a fact. But, if you want to be truly healthy, you need to address your calorie balance. Obese individuals should seek specialised help from a dietitian, but if you are overweight or looking to lose some fat you have gained over the years a registered nutritionist will be able to help you with your goals.