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The Obesity Paradox

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We all know that carrying too much extra weight can lead to a host of health issues, from sore knees to high risk heart issues. But there are those, maybe even you, who feel good and have no symptoms or diseases related to weight. In the medical community, this is called the obesity paradox.

Because obesity is strongly connected to so many diseases and conditions, it seems like everyone with obesity should be experiencing some type of problem, but that’s not the case. When people are “metabolically healthy but obese” (MHO), they fall into the obesity paradox category. This happens to both adults and adolescents, and while genetics and birth weight are thought to play a role, a clear reason why remains a mystery.

About one-third of people with obesity are metabolically healthy, and they are 50 percent less likely to develop type 2 diabetes or cardiovascular disease than others with obesity. This is why some people who, despite their weight, don’t become diabetics, maintain good heart health fitness, have healthy cholesterol, blood pressure and liver readings, don’t experience inflammation, or have other symptoms associated with obesity.

Sounds like great news, right? Yes and no. Certainly being healthy is a big deal and at the top of the list. There is also some evidence that losing weight may not offer the same benefits to those who are MHO versus those who aren’t. Before you toss your diet out the window and start celebrating, however, the picture isn’t as rosy as it might seem. While people who are MHO are healthier than others with obesity, they still are at much higher risk — in the range of 300 percent — than those who maintain a healthy weight. Also, some health issues, such as kidney disease, affect all levels of overweight and obesity so being otherwise healthy doesn’t provide a free pass.

Most importantly, being MHO right now does not assure continued health over time. In fact, about half of those with MHO will become unhealthy within a six to 10 year timeframe. Because of this, doctors wonder if this paradox actually exists, or if it really is just a temporary period from healthy to disease. While this may sound gloomy, it can be a great opportunity! Starting from a stronger, healthier position changes the requirement of “You must lose weight now!” and instead becomes “Let’s figure out something that will work for you so that you can lose weight and keep it off before it’s a serious issue.”

Let’s face it: It will still be a challenge. But starting from a healthy foundation allows you more control and gives you some time to get your head, heart and body on the same page to face the effort. So, start collecting recipes and thinking about what physical activity you can commit to and make a plan! You’ve got this!

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