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Can you be overweight and still be healthy?

Bariatric Surgery News & Research | Adelaide Bariatric Centre

14 May 2018 2:01 PM

Obese Athlete

Over the years there has been a significant amount of research conducted by doctors worldwide focusing on issues affecting people who are obese or overweight, and for good reason. Obesity, and its associated conditions can have an extremely negative impact on a person's quality of life and eventually cut their life short if nothing is done in response.

With rising levels of obesity across the globe, the international health community has been tasked with asking and attempting to answer the toughest questions about the relationship between weight, diet, physical activity and emotional health.

One of the toughest questions to answer is: can a person diagnosed as overweight or obese still be considered healthy?

To answer that our first step will be to define what exactly being overweight or obese is. Secondly we will need to determine what we can consider a healthy lifestyle and the long term effects that lifestyle has on the human body.

Defining Obesity

The most common way the health community defines levels of obesity is with a mathematical system called the body mass index (BMI). To calculate a person's BMI we take their body mass in kilograms (their weight) and divide it by the square of their height in metres. A person with a body mass index that is over 30 is considered to be obese. Someone with a BMI over 40 is considered to be morbidly obese.

Although the BMI is a fairly accurate assessment tool for the most part it does have its limitations. For instance an athlete, who carries muscle mass which weighs more than fat, could potentially have a BMI over 30. In this case the BMI doesn’t give an accurate reading of their physical health.

There are factors present that the system is not designed to consider, however a physician could easily assess this particular persons reading. While an athlete rating above a 30 BMI may be defined as overweight based on that tool’s measurement, after factoring in their percentage of muscle mass compared to body fat and the lifestyle choices like diet and physical activity that are necessary to maintain that ratio, a physician would likely overrule the BMI reading and confirm that the athlete is very healthy.

There have also been cases reported where a person has a BMI over 30, with a higher percentage of body fat than muscle mass, but does not suffer from any of the negative health effects that typically are associated with obesity. These include:

  • Type 2 diabetes
  • Hypertension
  • High cholesterol
  • Heart problems
  • Obstructive Sleep Apnoea
  • Orthopaedic joint and back problems
  • Certain types of cancers

Although still physically overweight or obese, the person is metabolically healthy.

It is clear that obesity does not affect everyone in the same exact way and that the BMI system is not perfect. Genes, which control where fat is stored, can program fat to store in the hips and thighs which is less dangerous than fat that is stored around the abdomen.

The numerous factors that dictate how obesity affects the human body still require a large amount of research. Although cases of “healthy” obesity do exist, they are very rare and in many of these cases general health eventually deteriorates as the person begins to age. There are also the realities of social isolation, low self esteem and depression that may be harder to measure, but are very real conditions associated with obesity.

The general consensus amongst health professionals is to avoid obesity if possible and use effective medical intervention to manage it, like bariatric surgery, when other non invasive options have been exhausted.