Can You Be Overweight and Healthy?

There is no advantage to being overweight. You can, however, improve your health even if you’re too heavy. Here’s what you should know and can do.

Can you be overweight and healthy?

The idea that you might be healthy even if you are overweight doesn’t track. You might be healthier than another overweight person, but your weight is still a problem.

Being overweight increases your risk of many problems, from heart disease and stroke to type 2 diabetes, and some cancers.

Some people carry extra pounds on their hips or rear. If you have visceral fat — which is stored around your stomach, close to your organs — your risk of disease is even higher. The best measure of the health risk of fat is your waist-to-hip ratio.

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For a time, people were excited about the idea that being overweight could be a health advantage after one study suggested they might live longer than someone who “could fit into a pair of jeans a size or two smaller.”

A separate meta-analysis backed up that idea, suggesting that people who were slightly overweight did better after heart surgery.

But it was too good to be true.

When it comes to heart disease, for example, obesity is bad for you. In one large study, researchers found that the top 20 percent of people with the most fat, measured by waist-to-hip ratio, had a 39 percent increased risk of being hospitalized for heart failure compared to people in the skinny bottom 20 percent.

There was no advantage in the study to being overweight measured by body mass index either. That is “is important because the underdiagnosis of heart failure in people living with obesity is a major issue in primary care,” says lead author John McMurray, professor of medical cardiology at the University of Glasgow (in the UK). “Patients’ symptoms of breathlessness are often dismissed as being due solely to obesity. Obesity is a risk factor and driver of heart failure.”

Will exercise help if you are still overweight?

It’s true that you can be strong and muscular if you exercise regularly. Exercise is good for everyone and helpful at any weight. But exercise won’t cancel the bad effects of fat, according to research based on data from nearly 528,000 working adults in Spain.

Compared to study participants who had a normal weight but were inactive, active obese participants:

• Had twice the risk of high cholesterol
• Were four times as likely to have diabetes
• Were five times as likely to have high blood pressure

A standard called the Fitness Fatness Index — which combines cardiorespiratory fitness and waist-to-hip ratio — may be useful for cardiologists and primary care doctors.

For every point increase in the index (indicating better health), participants were 11 percent less likely to die of heart conditions and 9 percent less likely to die from all causes.

The popularity of injectable medications designed to fight type 2 diabetes, which can also lead to weight loss, demonstrates that people coping with obesity in general would like to be thinner.

They’ll be healthier, too.

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