Being skinny doesn’t mean you’re fit—or even healthy. A recent study in the Annals of Internal Medicine found that men and women of normal weight but with high blood pressure and cholesterol levels are at risk for heart events just as dire as the obese.
The reason a thin waist is no saving grace, explains the Mayo Clinic’s Dr. Francisco Lopez-Jimenez, is that people can register a normal weight, but still hold excess fat—more than 25 percent body weight in men, 35 percent for women.
Essentially, fat matters even if you don’t appear fat, says Dr. Lopez-Jimenez, whose main area of study is in what he calls the “skinny obese.”
“Excess fat affects metabolism in ways that make it harder to use insulin and other hormones effectively,” explains James O. Hill, Ph.D. Executive Director, of the University of Colorado’s Anschutz Health and Wellness Center. “This leads to metabolic diseases such as diabetes, heart disease, and kidney disease.”
The study also dispelled any myths of being both obese and healthy. At first, there appeared to be a group of obese subjects who were at low risk of cardiac event and death—statistically similar to the healthy and normal weight folks. But when the researchers dug deeper, only looking at data with 10 years of follow up, all overweight and obese subjects appeared to have greater health risks.
It’s possible for an obese person to appear metabolically healthy and at low risk for heart disease, but being overweight and healthy isn’t a permanent station, says Hill.
What’s more, even if an obese patient registered low blood pressure and healthy cholesterol, there are more risks than heart disease; for starters, degenerative joint disease. The health of your hips, ankles, and, especially, knees, are imperiled by excess pounds.
And though the first response to turn your health around—whether you’re normal weight or obese—would seem to be weight loss, that’s actually secondary by doctor’s order.
“Your first priority is to become active,” says Lopez-Jimenez. “If somebody is obese but very active, the risk for heart attacks is same or lower than sedentary skinny person.”