A reader writes:
I read with some consternation the reaction of one of your readers to the admonition by a physician that there is no “healthy obesity”. It is worth pointing out that contrary to your reader’s unsupported assertion, clinical data does not support the idea that obesity in the absence of metabolic abnormalities (high blood pressure, high cholesterol, diabetes, etc.) is as safe as being normal weight. Specifically, a recent systematic review and meta-analysis (that is, an analysis that looked to combine data from multiple independent studies) appeared in the Annals of Internal Medicine (here is the link to the abstract). The study combined eight studies that looked at 61,386 people in all and found that otherwise healthy obese individuals had about a 25% increased risk for death or cardiovascular events (heart attacks and strokes) compared to healthy normal weight individuals. To quote the conclusion: “ Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.” [emphasis mine] Here‘s a NYT blog entry on the study.
I am very sympathetic to your reader’s assertion that eating healthily and exercising regularly doesn’t always result in weight loss, and the reader is certainly correct that doing those things will result in health independent of whether it affects weight loss. I also cringed at the way the physician reader’s tone. But he is also correct; all else being equal, an obese person is at increased risk for bad health outcomes.
Another reader is much more blunt: