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Summaries for Patients |3 December 2013

Is Obesity Harmful If Metabolic Factors Are Normal? Free

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  • The full report is titled “Are Metabolically Healthy Overweight and Obesity Benign Conditions? A Systematic Review and Meta-analysis.” It is in the 3 December 2013 issue of Annals of Internal Medicine (volume 159, pages 758-769). The authors are C.K. Kramer, B. Zinman, and R. Retnakaran.


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    • What is the problem and what is known about it so far?
    • Why did the researchers do this particular study?
    • Who was studied?
    • How was the study done?
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What is the problem and what is known about it so far?

Being overweight or obese increases the risk for heart disease as well as death. But some studies have suggested that being obese might not increase risk if no metabolic problems exist. Such problems include high blood pressure, high lipids, high blood sugar, and a pattern of obesity involving a large waist (together called the “metabolic syndrome”).

Why did the researchers do this particular study?

To find out if the risk for heart disease and death differed among people who are obese depending on whether they also had the metabolic syndrome.

Who was studied?

Altogether, the researchers were able to gather information on 61,386 individuals.

How was the study done?

Information from 8 prior studies of the interaction of weight, heart disease, death, and the metabolic syndrome were collected and “pooled.” The researchers analyzed the data to see if the risks for heart disease and death differed according to whether individuals were normal weight, overweight, or obese and whether they had the metabolic syndrome. Overweight was defined as having a body mass index (BMI, the ratio of weight to height in meters squared) of 25 to 30 kg/m2 or less, and obesity was defined as a BMI of 30 kg/m2 or greater.

What did the researchers find?

The risk for heart disease or death was increased among individuals who were obese, even if they did not have the metabolic syndrome. In addition, individuals with the metabolic syndrome had increased risk regardless of whether they were normal weight, overweight, or obese.

What were the limitations of the study?

The researchers could not determine how long the individuals studied were overweight or obese or how long they had had the metabolic syndrome.

What are the implications of the study?

Being obese is associated with an increased risk for heart disease, even if an individual is otherwise “metabolically healthy” and does not have the metabolic syndrome. There does not seem to be a “healthy pattern” of increased weight.

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Is Obesity Harmful If Metabolic Factors Are Normal?. Ann Intern Med. 2013;159:I–26. doi: 10.7326/0003-4819-159-11-201312030-00002

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Published: Ann Intern Med. 2013;159(11):I-26.

DOI: 10.7326/0003-4819-159-11-201312030-00002

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