Metabolic Health Versus Weight

by Natalie Digate Muth, MD, MPH, RDN, FAAP

Despite more than a decade of intensive efforts to reverse the adult and childhood obesity crises, obesity remains widespread. Generally, the first treatment recommendation is to lose weight, but losing large amounts of weight and keeping it off is difficult, and possibly not even the best reflection of health improvements. After all, the number on a scale is just one measure of health.

Perhaps, as researchers in a 2017 Lancet Diabetes & Endocrinology paper suggest, we should spend more effort looking at other markers that may help promote metabolically healthy obesity, such as attaining or maintaining normal cholesterol levels, blood sugar, and blood pressure. Improvements in these measures result from healthful eating patterns, increased physical activity, and/or moderate weight loss (about 5%–10%).

While people with metabolically healthy obesity face a greater risk of cardiovascular events than their counterparts at normal weights, their risk is substantially lower than that of people with metabolically unhealthy obesity.

Health and fitness professionals could collaborate with clients and their healthcare providers to monitor improvements in markers of metabolic health with the adoption of a healthier lifestyle.

What do you think: should metabolic health—and not weight—be a key target?

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