Obesity has always been correlated with the development of numerous diseases and pro-inflammatory states. However as the extent and depth of research increases, the complex variability in the expression of obesity and its consequences for the overall health of an individual is being uncovered.
For decades, society has considered obesity as a serious health issue and obese people have been ridiculed and labelled as lazy and gluttonous. Moreover, with the “condition” going from rare to a pandemic, obesity has achieved the status of a “disease” by top medical organizations such as the WHO, AMA and CDC.
As the third most obese nation in the world only after the US and China, the first thing that we need to understand is, 'what is obesity?'. An obese person is someone whose Body Mass Index or BMI (body mass divided by the square of the body height) is greater than 30. However, BMIs do not portray a true picture of a person’s physical health - consider smokers with a normal BMI or athletes with an obese BMI due to muscle mass.
Obesity has always been considered as the primary cause of the major plagues of modern society including heart diseases and diabetes. But an important fact that many of us forget while making such assumptions is that these diseases also develop in so-called “normal” people, while not everyone who is categorized as “obese” develops such conditions. Therefore, even though obesity can be considered as a risk factor, it cannot be labelled as a disease.
“ However, BMIs do not portray a true picture of a person’s physical health - consider smokers with a normal BMI or athletes with an obese BMI due to muscle mass. ”
Recently, scientists have been working to study the relationship between obesity and metabolic health by examining genes, distribution of fat and its nature. Studies have shown that the excess visceral fat in the abdomen is associated with inflammation and fat buildup in some organs, in contrast to the subcutaneous fat which is stored under the skin and can even make you healthier than the people with “normal” BMI. Not only this, scientists have catalogued DNA stretches which are associated both with more fat (including a higher BMI and higher body fat percentage) and a lower risk of cardiac and metabolic diseases. It also included areas that control inflammation, energy expenditure and insulin signaling.
Many clinicians and researchers nowadays are also trying to focus more on the cardiac and metabolic markers of diseases such as triglyceride levels and blood pressure rather than just the BMI. It’s high time that the society also realizes that obese does not always mean unhealthy and that weight and health can be uncoupled.
FURTHER READINGS
https://theconversation.com/obese-does-not-necessarily-mean-unhealthy-72718
Huang, L.O., Rauch, A., Mazzaferro, E. et al. Genome-wide discovery of genetic loci that uncouple excess adiposity from its comorbidities. Nat Metab 3, 228–243 (2021).
Bosy-Westphal, A. & Müller, M. J. Diagnosis of obesity based on body composition-associated health risks—Time for a change in paradigm. Obes. Rev. 22, 1–7 (2021).
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