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There is No Such Thing as Healthy Obesity

Anne Foy

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Sept. 20k 2016

Obesity has long been touted one of America’s most worrisome epidemics. Approximately 35 per cent of all adults in the United States are obese, and that it bad news for the healthcare system, which is already overburdened. Obesity (which is related to heart disease, stroke Type 2 diabetes and some cancers) costs the nation anywhere from $147 billion to $210 billion annually, while employers lose around $506 per obese worker every year. Obesity related diseases are not only costly to treat, they also significantly reduce both our quality of life and shorten our lifespan. Up until recently, it was thought that an individual could be obese yet still healthy, leading scientists to coin the term, ‘healthy obesity’. New research indicates, however, that there is no way that one can be obese and healthy at once, suggesting that obesity should be addressed in all individuals, even those showing no sign of illness.

The research, published in the journal, Cell Reports, showed that white fat tissue obtained from obese individuals classified as either ‘healthy obese’ or ‘unhealthy obese’, showed practically the same abnormal gene changes following insulin stimulation. This contrasts with studies carried out in the 1990s and 2000s, which suggested that some people who were obese were still relatively healthy in so far as metabolic and cardiovascular profiles were concerned.

One way to test metabolic health is to see if individuals are sensitive to insulin, which permits blood glucose to be used by the cells for energy. In the study, the scientists tested the insulin response of 15 persons who had never been obese, as well as 50 obese patients who were taking part in a clinical study of gastric bypass surgery. The scientists took samples of white fat tissue (obtained from the abdominal area) before and after the 65 participants were administered insulin and glucose intravenously. The glucose uptake rate showed that 21 of the obese subjects were insulin sensitive (i.e. they metabolised blood sugar well), while 29 were insulin resistant (insulin resistance is characteristic of diabetes).

The scientists were surprised to find that the white tissue samples showed a clear difference between participants who had never been obese, and both groups of obese persons. The gene expression in those who were obese (regardless of whether or not they were insulin resistant) was nearly identical. Abnormal gene expression was found in the obese group, as opposed to the group who had never had weight issues. This was true regardless of whether or not risk factors (such as heart rate, blood pressure or waist-to-hip ratio) were present. This shows that the main factor in metabolic health – is the presence or absence of obesity itself!

Scientists are excited about their discovery and are currently conducting new research – for instance, the question remains as to whether or not gene expression will change in obese patients following bariatric surgery. They are also working to find specific genes which are linked to better metabolic health in this group.

The findings suggest that for now, those who are overweight should immediately work on keeping their weight down. Other new research published this year indicates that obesity also affects memory, and is linked to cognitive decline. Mice with diet-induced obesity fared worse at memory tests, for instance, than their noinduced obesity fared worse at memory tests, for instance, than their none-obese counterparts. They also showed impaired plasticity in the hippocampus are of the brain. The research indicates that memory is impaired in those battling obesity over time; for instance, the mice’s memory grew worse the longer they were obese.

Meanwhile, studies carried out on people show similar results. Those aged between 40 and 45 who are obese, for instance, have a 75 per cent higher risk of dementia in their old age. Additional research shows that metabolic syndrome (which is related to obesity) in persons aged 60 was linked to significant impairment in the ability to recall and in overall intellectual functioning. One interesting study (carried out on over 8,000 twins) showed that those who were overweight or obese in their 40s had a greater dementia risk in old age.

To reduce the obesity epidemic, scientists recommend regular physical activity and a nutritious diet following Mediterranean tenets (i.e. comprising lean proteins, healthy nuts and legumes, and seasonal fruit and vegetables, with a focus on foods with a low glycaemic index). Obesity is a battle that can be beaten, though consistency and perseverance.

 anne@arialblack.org