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Can one be overweight but fit and maintain a reduced risk of heart disease?

We've reported how U.S. obesity rates are increasing again. Of course, the trend puts urgency into the important efforts of well-run workplace wellness programs and other population health approaches.

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.”

One decade ago, 5.7 percent of American adults were severely obese and 33.7 percent were obese. Today the study notes that 7.7 percent of Americans are severely obese and 40 percent of U.S. adults are obese.

In addition to increased health concerns, obesity issues also drive up health costs. A  Cornell University study published in Science News that notes: “Obesity drives U.S. health care costs up by 29 percent, varies by state.”

Now MedPage Today reports that “Metabolically healthy obesity (MHO) is neither a stable nor reliable indicator of future risk for cardiovascular disease (CVD), despite having a risk similar to that of being normal weight at baseline, according to a longitudinal analysis of MESA (Multi-Ethnic Study of Atherosclerosis) participants.”

The study, published in Journal of the American College of Cardiology, is titled “Metabolically Healthy Obesity, Transition to Metabolic Syndrome, and Cardiovascular Risk.”

The results: “Compared with metabolically healthy normal weight, baseline MHO was not significantly associated with incident CVD; however, almost one-half of those participants developed MetS during follow-up (unstable MHO). Those who had unstable MHO had increased odds of CVD compared with those with stable MHO or healthy normal weight. Dose response for duration of MetS was significantly and linearly associated with CVD and MetS mediated approximately 62% of the relationship between obesity at any point during follow-up and CVD.”

In other words, as MedPage today notes: “Metabolically healthy obesity signals an opportunity for weight reduction, and prevention and management of existing metabolic syndrome components should be prioritized.”

For a well-run workplace wellness program, this means even more engagement with employees — particularly ones who are overweight — may be required.

The authors conclude: “Metabolically healthy obesity is not a stable or reliable indicator of future risk for CVD. Weight loss and lifestyle management for CVD risk factors should be recommended to all individuals with obesity.”