LONDON — A major study is challenging the idea that a person carrying extra pounds can still be “fat, but fit.”

Researchers from Imperial College London and the University of Cambridge found that overweight or obese people with healthy cholesterol and blood sugar levels along with a normal blood pressure reading are still at a much greater risk of suffering from heart disease.

“Overall, our findings challenge the concept of the ‘healthy obese’. The research shows that those overweight individuals who appear to be otherwise healthy are still at increased risk of heart disease,” says lead author Dr. Camille Lassale, from Imperial’s School of Public Health, in a news release.

Weight loss, scale
Myth-buster? A new study finds that people who are considered “fat, but fit” are at a greater risk of suffering from coronary heart disease.

Many scientists and health experts have debated whether being “fat, but fit,” or “metabolically healthy obese” in medical-speak, is comparable to thinner people who have similar health characteristics. So many studies often point to high cholesterol or high blood pressure as a precursor to potentially deadly conditions — so would weight matter if a person is otherwise perfectly healthy?

The authors examined data of more than 521,000 European people who took part in the annual European Prospective Investigation into Cancer and Nutrition, one of the largest cohort studies in the world. Participants, who come from 10 different countries, are monitored for 15 years to see how diet, lifestyle, environment, and other daily health habits and factors weigh into the risk of cancer and other chronic conditions.

Data was used for this particular project to find a correlation between people who were fat, but fit and heart disease.

The researchers noted individuals as being “unhealthy” if they were found to have at least three harmful metabolic markers such as high blood pressure, high blood sugar levels, and a larger waist size (37″ for men and 31″ for women). Meanwhile, those with a body mass index (BMI) of over 30 were considered “obese,” while participants with a BMI of 25-30 were viewed as overweight. Anyone with a BMI of 18.5-25 was listed as normal.

They also found more than than 7,600 participants reported suffering from “events” linked to heart disease, such as a fatal heart attack.

While participants who made the “unhealthy” list were more than twice as likely to suffer from coronary heart disease regardless of weight, people considered “healthy” under the formula who were overweight still had a 26 percent greater risk of battling the condition. Obese “healthy” participants were found to have a 28 percent increase risk.

“Our findings suggest that if a patient is overweight or obese, all efforts should be made to help them get back to a healthy weight, regardless of other factors. Even if their blood pressure, blood sugar and cholesterol appear within the normal range, excess weight is still a risk factor,” says Lassale.

More than 10,000 people served as a control group for the study and factors such as exercise level, smoking history, and socio-economic status were taken into account for the research.

The authors believe that “the excess weight itself may not be increasing the risk of heart disease directly, but rather indirectly through mechanisms such as increased blood pressure and high glucose.” They agree that stronger awareness and prevention measures, along with treatment of obesity, be offered by doctors so that those who “fat, but fit” don’t lose sight of losing weight.

“I think there is no longer this concept of healthy obese,” says Dr. Ioanna Tzoulaki, from Imperial’s School of Public Health. If anything, our study shows that people with excess weight who might be classed as ‘healthy’ haven’t yet developed an unhealthy metabolic profile. That comes later in the timeline, then they have an event, such as a heart attack.”

The study’s findings were published Monday in the European Heart Journal.

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