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There's more evidence — we may want to be wary of the idea of “healthy obesity.”

As we recently reported, the Journal of the American Medical Association published a study titled “Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007-2008 to 2015-2016.”

The approach: “Obesity prevalence has been increasing since the 1980s among adults, but among youth, prevalence plateaued between 2005-2006 and 2013-2014. We analyzed trends in obesity prevalence among US youth and adults between 2007-2008 and 2015-2016 in order to determine recent changes.”

The new findings provide new information for well-run workplace wellness programs to share with employees — and for businesses who seek ways to manage overall health costs.

The information comes from a study published in The Lancet titled “Transition from metabolic healthy to unhealthy phenotypes and association with cardiovascular disease risk across BMI categories in 90 257 women (the Nurses' Health Study): 30 year follow-up from a prospective cohort study.”

The background: “Cardiovascular disease risk among individuals across different categories of BMI might depend on their metabolic health. It remains unclear to what extent metabolic health status changes over time and whether this affects cardiovascular disease risk. In this study, we aimed to examine the association between metabolic health and its change over time and cardiovascular disease risk across BMI categories.”

The results were telling.

MedPage Today reports: “Metabolically healthy obese women — that is, those without diabetes, hypertension, or high cholesterol — had a nearly 40% increase in the risk of cardiovascular disease compared with metabolically healthy women of normal weight, said researchers led by Nathalie Eckel, MSc, of the German Center for Diabetes Research in Neuherberg.”

Other findings, according to MedPage:

• “A substantial majority of metabolically healthy obese women (84%) became metabolically unhealthy during the course of the study. Surprisingly, so did more than two-thirds (68%) of metabolically healthy normal-weight women.”
• “Cardiovascular disease risk was highest in metabolically unhealthy women regardless of their weight. Compared with healthy women of normal weight, the risk was significantly higher in metabolically unhealthy normal-weight women, overweight women, and obese women.

The study reports its important conclusions:

“Even when metabolic health is maintained during long periods of time, obesity remains a risk factor for cardiovascular disease. However, risks are highest for metabolically unhealthy women across all BMI categories. A large proportion of metabolically healthy women converted to an unhealthy phenotype over time across all BMI categories, which is associated with an increased cardiovascular disease risk.”

Said Matthias Schulze, DrPH, of the German Institute of Human Nutrition Potsdam-Rehbruecke in Nuthetal and the study's senior author in a statement: “Our large cohort study confirms that metabolically healthy obesity is not a harmless condition, and even women who remain free of metabolic diseases for decades face an increased risk of cardiovascular events. What's more, we observed that most healthy women are likely to develop type 2 diabetes, high blood pressure, or high cholesterol over time, irrespective of their BMI [body-mass index], putting them at much higher risk for cardiovascular disease.”