“Metabolically Healthy Obesity”: What's the Risk?

Overweight and obese individuals can be “metabolically healthy” (i.e., without hypertension, diabetes, or hyperlipidemia), but does this protect them from cardiovascular events? In an analysis of approximately 3.5 million patients in the U.K., investigators sought to understand the interplay of body-mass index (BMI) and metabolic dysfunction.

Over a mean follow-up of 5 years, metabolically healthy obese individuals (BMI, ≥30 kg/m²), compared with metabolically healthy normal-weight individuals, had significantly higher risks for coronary heart disease (hazard ratio, 1.49), cerebrovascular disease (HR, 1.07), and heart failure (HR, 1.96) but not peripheral vascular disease after adjustment for confounders. In contrast, approximately 10% of th…