Diet Researchers Metabolically healthy overweight for the time being a good target

Metabolically healthy obesity as the first target
Heavily overweight people have hard-to-reach goals where failure is often inevitable. Scientists have now compared data from previous research and came to the conclusion that the "metabolic healthy obesity" as an important intermediate step would be a worthwhile goal. What that means exactly, you can read in the following article.

Almost every third person worldwide is obese. The result: more and more people are also suffering from diseases that are associated with morbid obesity such as diabetes, hypertension, heart attack or stroke. Despite the known health risks only a part of those affected tries to lose weight. Many people scare off the big required weight loss. Tübingen and Potsdam researchers at the German Center for Diabetes Research have now published in the journal "The Lancet Diabetes & Endocrinology" based on previously published and new data that metabolically healthy obesity * may be a worthwhile first target in the treatment of obesity.

The first goal is a healthy overweight. (Image: Kurhan / fotolia.com)

"Obesity makes you sick. You should lose weight. "Physicians repeatedly point out their overweight and obese patients. Through a lifestyle intervention, sufferers manage to reduce their weight in the short term, but in the long term, success is usually not achieved. Furthermore, the question arises as to whether the 5 to 8 percent weight loss proposed by the medical societies for all overweight and obese people is sufficient to significantly reduce the risk of secondary diseases. At a starting weight of e.g. 120 kg and a body height of 180 cm (BMI, body mass index 37.0 kg / m2), the BMI of the patient is 34.4 even after successful weight loss. He has not yet reached the desirable BMI of 25 and less, which is now considered by most people from a clear protection against obesity-related diseases.

Would not it make more sense to define achievable intermediate goals in order to achieve an individually healthy weight? Which parameters could describe this intermediate goal? Can smaller steps better motivate those affected to lose weight? These questions were investigated by scientists from the Medical Clinic IV of the University Hospital Tübingen and the Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Zentrum München and the German Institute for Nutritional Research (DIfE) in Potsdam. Both are partners in the German Center for Diabetes Research (DZD). In their current work, professors Norbert Stefan and Hans-Ulrich Häring from Tübingen and Professor Matthias Schulze from Potsdam show how the concept of metabolically healthy obesity can be integrated into the risk management of obesity therapy.

In doing so, they lay u.a. Based on own data from the Tübingen lifestyle intervention study, a weight loss of more than 10 percent with a mean starting BMI of 35 is probably sufficient to get from the "metabolically ill" to the "metabolically healthy" overweight. However, they emphasize that they can not be satisfied with this in the long term, since even with metabolically healthy obesity, the risk of disease is increased by 25 percent compared to the metabolically healthy normal weight. By comparison, for equally obese people who are considered metabolically ill, the risk is increased by 150 percent.

As an important milestone Stefan refers to the achievement of a proven protection against obesity-related metabolic diseases: "Consider this protection as a 'low-hanging fruit'. While not easy to harvest, it's easier to achieve than focusing on top fruit right from the start. "Doctor-patient communication is an important pillar in motivating the patient to achieve and, at least, achieve this condition hold.

At the Diabetes Conference of the European Association for the Study of Diabetes (EASD), which will take place from 11 to 15 September in Lisbon, the topic "The paradox of metabolically healthy obesity", headed by Nobert Stefan, is scheduled for Friday.

* People with metabolically healthy obesity have at most one of the following risk factors: high blood pressure (hypertension), impaired carbohydrate metabolism (insulin resistance), lipid metabolism disorders (dyslipidemia), abdominal obesity, elevated blood sugar levels (hyperglycemia) or fatty liver.

Original publication:

Stefan N, Haring H-U, Schulze MB. Metabolically healthy obesity: the low-hanging fruit in obesity treatment ?. Lancet Diabetes Endocrinol 2017.