Obesity is the condition of having excessive fat tissue in the body. The World Health Organization expects that there will be 1 billion diagnosed obese people in the world in 2030.
Although there are many methods used in the diagnosis of obesity, body mass index (BMI) measurement is recommended for diagnosis and classification today. BMI is calculated by dividing body weight in kilograms by height in square metres.
Obesity Classification
• Underweight BMI < 18.6
• Normal Weight BMI = 18.6 ~ 24.9
• Overweight BMI = 25 ~ 29.9
• I. Degree OBESE BMI = 30 ~ 34.9
• II. Degree OBESE BMI = 35 ~ 39.9
• III. Degree OBESE BMI > 40
Obesity is a risk factor for diabetes mellitus and cardiovascular diseases. Obesity is rapidly increasing all over the world due to unbalanced diet and decreased physical activity. Obesity; It is associated with diabetes, hypertension, heart diseases, fatty liver, sleep disorders, musculoskeletal diseases and increased cancer risk.
A group of patients diagnosed with obesity are protected from many obesity-related complications. shown. Despite the increased body fat rate of these individuals compared to normal; It was observed that values such as insulin sensitivity, blood cholesterol levels and blood pressure were less deteriorated than expected or did not deteriorate, and these individuals were named as metabolically healthy obese individuals.
The definition of metabolically healthy and obese refers to a group of patients whose body mass index is over 30 kg/m2 and who do not have insulin resistance, diabetes or hypertension at the time of diagnosis. This concept was defined in the early 1980s, but its definition could not be made clearly. Approximately 20-30% of the obese population is called metabolically healthy obese.
If there is really obesity and normal metabolic values, will there be a decrease in risk factors?
The concept of metabolically healthy obese has long-term metabolic effects. The main obstacle to understanding their effects is the inconsistent definition of metabolic health and obesity across studies. These individuals are really To answer the question of whether they are healthy or not, it is important to recognize that the criteria used for classification purposes vary from study to study. A previous study has shown that the prevalence of this group of diseases varies depending on the definition used, contributing to inconsistencies in the relationship between health outcomes. In addition, not all definitions of metabolic healthy obese include insulin resistance, blood pressure, fasting sugar level and cholesterol values. For this reason, it is necessary to standardize the definition first.
Is the Definition of Metabolic Healthy Obese a Temporary Condition?
Is the definition of metabolically healthy obese a temporary condition? The condition may change from metabolically healthy to metabolically unhealthy or from metabolically unhealthy to metabolically healthy. A study conducted in 2013 showed that 30% to 40% of these individuals returned to a metabolically unhealthy state after 6 years of follow-up.
The concept of metabolically healthy obesity is not a static condition. Since there is evidence, attention has focused on the variables that enable the transition to unhealthy obesity in these individuals. According to a study conducted in Spain, the factors that predicted the transition to unhealthy obesity were an increase in body mass index, waist circumference, and waist-hip ratio.
In a similar study, Japanese-Americans found that approximately two-thirds developed into unhealthy obesity over a 10-year follow-up and showed that this was associated with abdominal circumference, female gender, higher fasting insulin levels and lower levels of good cholesterol.
Although the risk of type 2 diabetes among metabolically healthy obese individuals is controversial, studies have shown that the risk of these individuals developing type 2 diabetes over time is 4 times that of healthy normal weight adults.
Hypertension is one of the most important causes of cardiovascular diseases. In studies, metabolic healthy is also defined as obese. The identified individuals were observed to have a 1.5-fold increased risk of high blood pressure in a relatively short time (median follow-up period of 35.0 months).
Obesity is known to be associated with progressive loss of kidney function. is a risk factor. Even in mild kidney failure, the risk of cardiovascular disease increases. It has been shown that a healthy metabolic profile does not protect obese adults from chronic renal failure. It has been determined that obesity puts an extra burden on the nephrons, the number of which is determined at birth, and therefore contributes to the progression of kidney failure.
Obesity also plays a role in the progression of cardiovascular diseases. An increased risk of heart disease and death has been observed in individuals who are observed as metabolically healthy and obese. Hypertension, heart failure and heart rhythm disorders are the main diseases related to obesity.
As a result; According to the World Health Organization, "overweight and obesity" is defined as abnormal or excessive fat accumulation that can impair health. Health is a state of complete physical, mental and social well-being. Therefore, these people with normal metabolic values do not necessarily mean "healthy obese". Body mass index alone is not a prognostic value that can guide the management of quality of life or clinical risk. Even if metabolic values are normal, the risk of obesity-related complications and mortality continues.
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