THE body positive movement’s mantra — “healthy comes in many sizes” — is being challenged by a groundbreaking new study.

Researchers at University of Birmingham’s Institute of Applied Health Research looked at public health records of 3.5 million Brits over a 20-year period, and compared weight and metabolic status to the risk cardiovascular disease.

The results were published this week in the Journal of the American College of Cardiology.

People who are “metabolically healthy obese” — those who are obese but not suffer from conditions such as diabetes, high blood pressure and high cholesterol — still have an increased risk of cardiovascular disease, compared to people who are of a “normal” weight, the study found.

“Three metabolic abnormalities were taken into consideration during the study — diabetes, hypertension [high blood pressure] and hyperlipidaemia [high cholesterol]. A metabolically healthy person was classified as having no metabolic abnormalities,” the study states.

The researchers found that the people who fell into the “metabolically healthy obese” category had a 49 per cent higher risk of having developed heart disease, a seven per cent higher risk of having had a stroke, and a 96 per cent higher risk of having suffered heart failure.

Lead author and epidemiologist Dr Rishi Caleyachetty, from the University of Birmingham, said obese people who were otherwise relatively fit and healthy were still at risk of developing serious heart problems.

“Obese individuals with no metabolic risk factors are still at a higher risk of coronary heart disease, cerebrovascular disease and heart failure than normal weight metabolically healthy individuals,” Dr Caleyachetty said.

“So-called ‘metabolically healthy’ obesity is clearly not a harmless condition and the term should no longer be used in order to prevent misleading individuals that obesity can be healthy.”

The study concluded that obese people should be encouraged to lose weight.

“We conclude that obese patients, irrespective of their metabolic status, should be encouraged to lose weight and that early detection and management of normal weight individuals with metabolic abnormalities will be beneficial in the prevention of CVD events,” said senior author Dr Krish Nirantharakumar.

The research was funded by The University of Birmingham.