We have been traditionally taught that excess body weight correlates with an increased risk for heart problems. However, the latest studies show that not every overweight/obese individuals develop health issues. These individuals have been referred to as “fit fat” or “metabolically healthy”.

The existence of these so called “healthy obese” have shaken the very foundation of our perception about obesity. At first, there was no explanation for such a phenomenon. The reason remained unclear until such a time when CT scan and MRI findings revealed a particular pattern on how these “fit fat” stored the fats in their body.

It was revealed that these individuals have lower deposition of adipose tissue in the abdominal area. Later studies show that this pattern of fat distribution correlates with a much lower risk for heart disease. This is in contrast to those individuals who have excessive fats deposited in the abdomen. They eventually develop the so-called “metabolic syndrome” which is a constellation of metabolic problem that ultimately culminates in diabetes and atherosclerosis

Now why is this important?

This poses a new challenge to doctors who specialize in preventive cardiology. They must decide whether to reduce the risk for heart disease by targeting weight loss, or to simply focus on controlling other factors like lowering BP, lipids/cholesterol and blood sugar levels.

It is important to know, that even until today, no weight loss drug which targets obesity has been proven to reduce deaths from heart disease. Perhaps the only exception to this are new diabetes drugs, but their main purpose is not weight loss per se.

Adding to this challenge, are contradictory findings from various researches. One large study concluded that markers of increase body fat such as body mass index (BMI) or waist circumference are not related to the risk of having a heart problem. While other studies have shown a strong relationship between being obese and having a heart disease.

This new finding about obesity shows us that we cannot generalize everyone. We cannot conclude that because a person is obese based on BMI, that he is at risk for having a heart disease. Many factors come in to play such as the environment, genetics, lifestyle, nutrition and others. This paradigm shift is important because it drives to field of medicine to focus on other risk factors for developing a heart disease and other means of preventing heart disease.

Important: This is not fake news or false advertisement. Everything written here are based on published scientific articles and cardiology textbooks. Please click on the link to see the references https://dbgcardiology.home.blog/references/