Is there such a thing as “healthy” obesity?

Not so long ago, I told you to put down that celery stick and relax. Stop obsessing about losing those last 10 pounds. You might actually live longer–much longer–by never reaching that “ideal” weight. And now, a new study shows there may be such a thing as “healthy obesity,” as I’ll explain in a moment.

Now, I know this advice is the exact opposite from what the so-called medical experts on all the TV talk shows tell you. Especially at this time of year.

But the science couldn’t be clearer.

Last year, researchers analyzed data for more than 3 million people in 100 different countries. They found that obesity increased “all-cause mortality.” However, men and women who were slightly overweight “significantly reduced” their all-cause mortality. This means they were less likely to die from any cause.

Overall, the findings suggest that being a little overweight and remaining so might offer health advantages. Real danger seems to occur when someone who is slightly overweight becomes severely obese. Dr. David Katz, the director of the Yale University Medical School Prevention Research Center, says we need to clarify the threshold “at which weight poses a threat of premature death” and concentrate our efforts there.

Unfortunately, that threshold can be about as clear as mud. Sure, there’s the body mass index (BMI). But during my research at the National Institutes of Health in the 1980s, I found that this one-size-fits-all approach doesn’t accurately reflect overall health.

The BMI index measures weight independently of height. It uses a simple formula: weight (in kilograms) divided by height (in meters) squared. But it does not tell us about someone’s overall health. It may tell us that you weigh more than another person of the same height does. But it doesn’t tell us why. For example, are those extra pounds fat or lean muscle? Did the extra weight come from a healthy diet containing whole foods? Or did it come from junk food and “empty” calories?

An interesting new Finnish study illustrates the limitations of using BMI. And it even shows that there may be such a thing as “healthy” obesity…

For the study, scientists reviewed health data for the entire population of Finland. They found 16 pairs of identical twins in which one of the pair was obese and the other had an average weight. The average difference between the twins was 40 lbs.

Now, here’s where it gets interesting…

Eight of the obese twins had higher BP, worse cholesterol, and poorer measures of blood sugar and insulin function than their average weight co-twin. They also had seven times the amount of fat in their livers.

Yet, the other eight obese twins had measurements similar to their average weight co-twin. In fact, they had normal blood pressure, normal cholesterol, and normal blood sugar readings…all as good as their co-twins. The Finnish scientists called these subjects “metabolically healthy obese.” And they estimated that one-third of all obese adults might have these normal health markers.

The healthy obese actually had 11 percent more fat cells than their average co-twin. And the unhealthy obese actually had 8 percent fewer fat cells than their average weight co-twin. But their fat cells were larger, swollen, and riddled with inflammation.

You see, in healthy bodies, fat tissues generate new fat cells to help store fat as it accumulates. In unhealthy bodies, the fat cells swell to the breaking point and ultimately die off.

Why do they die off?

Turns out, their mitochondria stop functioning. And mitochondria are your cells’ energy and hydration factories. So, unhealthy obese have difficulty burning calories and producing energy. Their cells also stop producing water for cellular hydration.

As fat cells die off, the fat must go somewhere. So, in unhealthy obese men and women, the excess fat goes to the liver, heart, and skeletal muscles. And these tissues are the last places where you want fat. A fatty liver often coincides with metabolic abnormalities, which leads to insulin resistance. We also associate a fatty liver with high blood pressure and heart disease.

In healthy obese, fat stays where it should–right under the skin. Interestingly, when it stays put, just under the skin, fat doesn’t appear to cause much harm. It doesn’t cause inflammation. And it doesn’t harm the organs. And it even protects the body from exposure and injury.

Clearly, unhealthy obesity is still a real problem. And these findings help explain why unhealthy obese really do have more difficulty burning calories. And it may also help explain why they become dehydrated.

But, as these findings suggest, I believe we need to start thinking about obesity as a spectrum. Place metabolically healthy obesity on one side. And place unhealthy obesity on the other.

The study’s authors theorize that even “healthy” obese can become “unhealthy” with age or by gaining more weight. But you can thwart these factors by keeping inflammation under control. And by keeping your mitochondria healthy.

When it comes to combatting inflammation, omega-3s are your best weapons. As I often report, omega-3 fatty acids help keep down inflammation throughout the body. So, if you do carry excess weight, look for ways to “up” your omega-3s. Eat wild-caught fatty fish three times a week. Eat plenty of nuts, whole grains, and take 1 to 2 grams of fish oil each day.

And if you want to keep your mitochondria firing, take a Co-Q10 supplement and drink Red Joe brand red bush. And go ahead and indulge in a little dark chocolate once in a while, especially with all the holiday treats around. As I’ll explain tomorrow, this “decadent” treat may be just what you need to keep your cells’ energy factories pumping.


1. “Identical twins with significant weight differences shed light on the phenomenon of metabolically healthy obesity,” Diabetologia, 2013