The idea of “healthy obesity” is a myth, a study of 3.5 million Britons suggests.

Having excess fat increases the risk of suffering heart disease by half even when blood pressure and cholesterol levels are normal, according to the research.

People regarded as obese but healthy also have an increased risk of stroke and almost double the risk of heart failure, researchers found.

Person on scales
A body mass index of 30 or more is considered obese (Chris Radburn/PA)

Experts have long debated whether people can truly be “healthy obese” or “fat but fit”, characterised by having normal markers of metabolic health despite having a body mass index (BMI) of 30 or more.

While most obese people have an increased risk of developing conditions such as heart disease, stroke and Type 2 diabetes compared to those of a normal weight, some seem to buck that trend and remain “healthy”.

Previous research has suggested up to one in three obese people are healthy despite carrying extra fat.

A team from the Institute of Applied Health Research at the University of Birmingham has now cast doubt on this idea in the biggest study of its kind.

Their study, presented at the European Congress on Obesity in Porto, Portugal, analysed health records from 1995 to 2015 for 3.5 million adults who were initially free from heart disease.

The team looked for markers of being metabolically healthy, having normal blood pressure and cholesterol and no diabetes, while also being obese.

They then tracked how many people suffered one of four cardiovascular conditions, coronary heart disease (CHD), cerebrovascular disease (including stroke), heart failure and peripheral vascular disease (a disorder of blood circulation).

The result showed, compared to healthy people of a normal weight, those regarded as healthy and obese had a 49% increased risk of coronary heart disease. They also had a 7% higher risk of stroke and a 96% increased risk of heart failure.

A jogger
Being a health weight can cut the risk of coronary heart disease (PA)

Lead author, Dr Rishi Caleyachetty, told the Press Association: “The idea of being healthily obese is a myth and there is much that health professionals and people who are obese can do to reduce their risk of disease.”

He added: “What we have shown in this study of 3.5 million people is that metabolically healthy obese individuals, compared to those of normal weight, are at higher risk of conditions such as heart disease, stroke and heart failure.

“Metabolically healthy obesity is not a harmless condition, and it would be incorrect to think so.”

Tam Fry, chairman of the National Obesity Forum, said: “Can you be fat and fit? Ask any group of rugby forwards who shift their bulk up and down a 100m field for 80 minutes and you’ll get a ‘yes’. Ask scientists stuck in a lab and you might not.

Rugby front-rowers are known for their bulk (PA)
Rugby front-rowers are known for their bulk (PA)

“Unfortunately, the Birmingham researchers appear not to have factored in recent genetic evidence that goes a long way to explaining why so many fat people appear not to suffer ill health.

“These people have the ability to store large amounts of fat around their bodies yet remain fit. And so the debate rages on. “