"No such thing as 'fat but fit', major study finds" The Guardian 17 May 2017

[Mike_W_Ellwood]

No such thing as 'fat but fit', major study finds

For what it’s worth …

[AnnaLeeMI]

Interesting

[Kirkor]

[Chris_W]

"divided them into groups according to their BMI and whether they had diabetes, high blood pressure [hypertension], and abnormal blood fats [hyperlipidemia], which are all classed as metabolic abnormalities. Anyone who had none of those was classed as “metabolically healthy obese”.

My guess is that these so-called ‘metabolically healthy obese’ were not really such, because the idiotic medically community still refuses to recognize hyperinsulinemia as a metabolic disorder that is worth checking. Most likely, they did the standard blood sugar tests (fasting & HbA1C) and declared them non-diabetic if still in normal range.

[cashfoley]

[devhammer]

My guess is that these so-called ‘metabolically healthy obese’ were not really such, because the idiotic medically community still refuses to recognize hyperinsulinemia as a metabolic disorder that is worth checking. Most likely, they did the standard blood sugar tests (fasting & HbA1C) and declared them non-diabetic if still in normal range.

Precisely this.

I’ve read several things that suggest that the damage done by insulin resistance starts occurring well before the A1c and glucose ranges that are currently considered diabetic range. So there could be many in the group that was classified as “metabolically healthy” who were anything but.

And given the size of the sample (3 million +), it’s guaranteed this was observational, rather than control, with all of the issues that go with that.

Are there people who are obese and not yet showing signs of metabolic disorder, but who aren’t “metabolically healthy”? I’m sure there are. And there are others who may still be heavier than “normal” BMI, but who do not share the metabolic issues of those eating the SAD diet. Speaking of which, I saw no mention of diet at all in the report on the study, which means that it would be impossible to know whether any subsequent coronary or other issues are a result of obesity, or a result of something else.

[Mike_W_Ellwood]

ISTR that Ivor Cummins, in some of his talks, does refer to the “fat but fit” group of obese folk. However, I think he usually qualifies it by saying that they may appear to be fit now, but that doesn’t mean they’ll remain fit.

Dr Rishi Caleyachetty, who led the study, said it was true that weightlifters could be healthy and yet have a BMI that suggested they were obese. “I understand that argument. BMI is crude … but it is the only measure we have in the clinic to get a proxy for body fat. It is not realistic [to use anything else] in a GP setting or in the normal hospital clinic. We have to rely on BMI measurements, however crude they may be,” he said.

hmm…couldn’t they use waist to height ratio, and/or waist to hip ratio?
I don’t know any weightlifters, but I imagine their WTHtRs or WTHpRs are better than the average obese person.

Or does a GP get struck off if he/she uses a tape measure (and some common sense…)…?

[Chris_W]

Are there people who are obese and not yet showing signs of metabolic disorder

Yes, there definitely are some folks who are overfat but still insulin sensitive (by our current measures). I suspect these are the ones that are also able to “eat less and move more” with success, thereby poisoning the well for the vast majority.

[devhammer]

I suspect these are the ones that are also able to “eat less and move more” with success, thereby poisoning the well for the vast majority.

All depends on whether their insulin sensitivity is a result of having been through the looking glass and coming out the other side (i.e. shifting from SAD to LCHF/Keto).