Researchers have therefore been hard at work over the past few years to determine what constitutes MHO and how much protection against chronic disease MHO confers.
In order to fight the stigma and discrimination that people who are overweight or obese experience, a global movement known as body positivity is gaining ground. This stigma partly results from the idea that obese people are unhealthy. Weight is only one of the criteria used by medical professionals to evaluate general health.
Some studies have shown that a large proportion of obese persons have normal metabolisms, supporting the idea that people can be healthy at any weight. Metabolism-healthy obesity is the term used to describe this occurrence (MHO). The implications of this are currently the subject of research done by Stan Kubow, an associate professor at the school of human nutrition at McGill University, and Michele Iskandar, an associate research professor and lecturer there. The Conversation has republished this article.
A MHO person has healthy blood pressure, normal blood sugar, and normal levels of blood lipids (cholesterol and triglycerides). One’s risk of cardiovascular disease is greatly increased by having high values for one or more of these parameters. It has been suggested that fat people who are metabolically fit may be shielded from diseases linked to obesity. Because there is yet no accepted definition of MHO, the scope of this protection has generated debate within the scientific community.
To that purpose, a number of sizable population studies have been started. Results thus far indicate that stricter definitions of MHO are in fact required. This can be done by taking into account additional health indicators including insulin resistance and inflammatory blood markers.
Insulin resistance is a condition in which the body has poor response to the insulin hormone, which aids in absorbing blood sugar for use as an energy source. This causes high blood sugar levels and the ensuing health issues. MHO individuals appear to be much less protected from chronic disease than people who have healthy metabolisms and are not obese, according to an emerging consensus.
Some researchers have suggested that the term “metabolically healthy obesity” may be a misnomer due to the fact that patients with MHO still have a comparatively increased illness risk. Furthermore, after a period of years, the majority of the MHO population tends to advance toward “metabolically unhealthy obesity,” or MUO, which increases the risk of diabetes, cardiovascular disease, and other obesity-related illnesses. This raises the question of whether MHO is actually protective over the course of a lifetime or whether it is only a matter of time before MUO takes hold, making MHO a transitory condition.
How fat is distributed throughout the body may be a determining factor in determining whether obesity is metabolically healthy or unhealthy. Subcutaneous fat, which is a hereditary tendency for fat deposition under the skin, may serve a protective function. Most premenopausal women who have this propensity tend to build subcutaneous body fat in their hips rather than their waist (pear-shaped). Compared to those whose body fat is concentrated more in the abdomen, they are more resistant to diabetes and heart disease (apple-shaped). Contrarily, obese people with a large waist circumference exhibit excessive abdominal fat deposition as well as a pro-inflammatory state that can cause insulin resistance, which is a risk factor for Type 2 diabetes.
Researchers have also examined the lifestyle choices that set MHO persons apart from MUO people to determine whether metabolically unhealthy obesity may be avoided.
Exercise is one aspect. Compared to MUO people, those with MHO engage in more frequent physical exercise. Diet is the other. It appears that MHO persons eat healthier diets, such as the Mediterranean diet, which is high in fish, fruits, vegetables, whole grains, legumes, extra virgin olive oil, and nuts, despite the varied findings of dietary studies.
A healthy metabolic profile can be achieved thanks to the anti-inflammatory and antioxidant advantages of a nutritious diet. The MHO population does appear to have a decreased mortality rate among those who eat a Mediterranean-style diet. These wholesome lifestyle choices may help avoid MUO.
So, does MHO actually exist and offer disease protection? No yes or no response has yet been given. The idea that one can be completely healthy at any size is given additional subtlety as we understand more about it. According to the data we currently have, only a small subset of obese people are at low risk of developing chronic diseases linked to obesity.
Additionally, we have a lot more knowledge regarding their traits. They have more subcutaneous fat and less abdominal fat. They have a metabolically healthy cardiovascular profile, reduced inflammation, and less insulin resistance. Additionally, they practise healthy lifestyle practises like frequent exercise and a balanced diet. It appears that genetics also have an impact.
Parvathy Sukumaran 
