Huge science bummer: 'Fat but fit' a myth

Obesity, still a considerable health risk.

Obesity, still a considerable health risk.

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I've clung to 'fat but fit' (read doughy but healthy) for a while now — learn more in my memoir: Diary of a Chubby Kid (work in progress). Sadly, science is asking me, and everyone else, to release our grip on "fat but fit" — because it's a myth. Irrefutable science bummer to follow below.

Science has no issues with self acceptance. But they do have some medical data that might be tough to swallow. If you're carrying around excess weight but have been resting easy on the merit that you're still pretty healthy, science is officially asking you to stop patting yourself on the back fat.   

Researchers at Imperial College London and the University of Cambridge have found strong data showing correlations between being overweight, albeit healthy by all other medical measures, and an increased risk of heart disease. That increase isn't slight either: coronary heart disease (CHD) shot up by 28 per cent when compared with subjects at a healthier body weight. The real cherry on the Sundae (the one you probably shouldn't eat), is that healthy blood pressure, blood sugar and cholesterol levels did nothing to lessen that risk. More fat meant less heart health in the long run - no matter what. Note to self: go for long run later.

The study, which is the largest to date, compounded data of over half a million people across 10 countries in Europe and was aptly named EPIC, or European Prospective Investigation into Cancer and Nutrition. Which would be cute if the evidence yielded wasn't such a scientific wet blanket. The salient finds support and add to research that suggests people deemed by medical science to be "metabolically healthy obese" ("fat but fit" in both media and lay speak) aren't truly healthy at all. At least not for long. When a 12 year follow-up was done, a total of 7,637 people in the EPIC study had experienced some kind of CHD event. That medical jargon seems a little sanitized - so consider that some of those "CHD events" were death by heart attack.    

What constitutes fat? Body weight in the study was classified according to definitions from the World Health Organization so they used BMI.  Anyone with a BMI over 30 got labeled obese, while those with a BMI of 25–30 classed as overweight. The tricky part for average folk is that BMI calculations are shoddy at best because they rely on height and weight only. If you're 5 feet tall, it's going to be tough to be at a "healthy" BMI unless you're very, very slender. Conversely, anyone with very high muscle mass is surely going to be overweight by BMI standards unless they're very, very tall (though don't convince yourself you're made of muscle if you're made of flubber, he told himself).

Compared to those at a "normal" weight, healthy but "overweight" subjects had a 26% greater risk of CHD, while the healthy but "obese" group had an increased risk of 28%. Researchers were careful to assert that the excess weight alone wasn't necessarily increasing the risk of heart disease directly. Instead, the weight may have had an indirect effect by dangerously boosting things like blood pressure and glucose levels. Medical professionals want to underline the real takeaway which is that people should aim to maintain a body weight within as healthy a range as possible. Sound advice, however common sense-y it may be.   

Still, in those deemed "fat but fit", the missing ingredient that put them at risk seemed to be time. "I think there is no longer this concept of healthy obese. If anything, our study shows that people with excess weight who might be classed as 'healthy' haven't yet developed an unhealthy metabolic profile", says Dr Ioanna Tzoulaki, from Imperial's School of Public Health. "That comes later in the timeline, then they have an event, such as a heart attack." Human mortality noted, doc.

We all have that Terminator uncle who smoked until he was 97 and died in a car accident. But Uncle Terminator and those like him are outliers. X-files really. And, we want to believe. Badly. Still, there are no free lunches (which you should only accept if it's a mixed-green salad with balsamic vinaigrette on the side) when it comes to health.  

Not that my opinion is worth a fat cell, but I'm of the ilk that big can truly be beautiful. And while that's splendid for a strong sense of self, it just may not be as healthy as we'd hoped. So, you know, go Google fun salads and workouts now. Jeez, science, thanks a bunch.

Marc Beaulieu is a writer, producer and host of the live Q&A show guyQ LIVE @AskMen