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Healthy obesity as an intermediate state of risk: a critical review

Bell, JA; Hamer, M; (2016) Healthy obesity as an intermediate state of risk: a critical review. Expert Review of Endocrinology & Metabolism , 11 (5) pp. 403-413. 10.1080/17446651.2016.1220298. Green open access

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Abstract

Introduction: Obesity is a top public health priority but interventions to reverse the condition have had limited success. About 1-in-3 obese adults are free of metabolic risk factor clustering and are considered ‘healthy', and much attention has focused on the implications of this state for obesity management. Areas covered: We searched for individual studies, systematic reviews, and meta-analyses which examined correlates and outcomes of metabolically healthy obesity. We discuss the key roles of fat distribution and physical activity in determining healthy vs. unhealthy obesity and report a greatly increased risk of incident type 2 diabetes associated with healthy obesity vs. healthy normal-weight, among other outcomes. We argue that despite inconsistencies in the definition, patterns across studies clearly show that healthy obesity is a state of intermediate disease risk. Expert commentary: Given the current state of population-level evidence, we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health. We recommend that weight loss through energy restriction be a stand-alone target in addition to increased physical activity for minimising risk of future disease

Type: Article
Title: Healthy obesity as an intermediate state of risk: a critical review
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/17446651.2016.1220298
Publisher version: https://doi.org/10.1080/17446651.2016.1220298
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Obesity; Body mass index; Metabolic health; Physical activity; Cardiorespiratory fitness; Type 2 diabetes; Cardiovascular disease; Mortality; Epidemiology; Review
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
URI: https://discovery.ucl.ac.uk/id/eprint/10085733
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