Metabolically healthy obesity as the first goal
Very overweight people pursue goals that are difficult to reach and where failure is often preprogrammed. Scientists have now compared data from previous research and came to the conclusion that “metabolically healthy obesity” as an important intermediate step would be a worthwhile goal. You can read exactly what that means in the following article.
Almost every third person in the world is obese. The result: An increasing number of people also suffer from diseases that are associated with pathological obesity, such as diabetes, high blood pressure, heart attack or stroke. Despite the known health risks, only some of those affected try to lose weight. Many people put off the large weight loss required. Researchers from the German Center for Diabetes Research in Tübingen and Potsdam are now showing in the journal "The Lancet Diabetes & Endocrinology" based on published and new data that metabolically healthy obesity * could be a worthwhile first goal in the treatment of obesity.
"Being overweight makes you sick. You should lose weight. ”This is what doctors keep pointing out to their overweight and obese patients. Through a lifestyle intervention, those affected manage to reduce their weight in the short term, but in the long term, success is usually absent. There is also the question of whether the 5-8 percent weight loss proposed by the medical associations is sufficient for all overweight and obese people to significantly reduce the risk of complications. With an initial weight of e.g. 120 kg and a height of 180 cm (BMI, Body Mass Index 37.0 kg / m2), the patient's BMI is 34.4 even after successful weight loss. He has by no means achieved the desirable BMI of 25 and below, which is nowadays assumed to provide clear protection against obesity-related diseases in most people.
Wouldn't 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 examined 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 Center Munich 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.
Among other things, they based on own data from the Tübingen lifestyle intervention study, that a weight loss of more than 10 percent with a mean baseline BMI of 35 is probably sufficient to get from “metabolically ill” to “metabolically healthy” obesity. However, they also emphasize that one should not be satisfied with this in the long term, since even with metabolically healthy obesity the risk of illness is increased by 25 percent compared to the metabolically healthy normal weight. For comparison: the risk is increased by 150 percent for equally weighty obese people who are considered to be metabolically ill.
Stefan describes the achievement of verifiable protection against obesity-related metabolic diseases as an important milestone: "Look at this protection as a 'low hanging fruit'. Although it is not easy to harvest, it is easier to achieve than to concentrate on the top fruits right from the start. ”The doctor / patient communication is an important support to motivate the patient to achieve this condition and at least to hold.
At the diabetes conference of the EASD (European Association for the Study of Diabetes), which takes place in Lisbon from September 11th to 15th, the topic “The paradox of metabolically healthy obesity” under the direction of Nobert Stefan will be on the program on Friday.
* People with metabolically healthy obesity have a maximum of one of the following risk factors: high blood pressure (hypertension), disturbed carbohydrate metabolism (insulin resistance), fat metabolism disorders (dyslipidemia), abdominal obesity, increased blood sugar (hyperglycaemia) or fatty liver.
Stefan N, Häring H-U, Schulze MB. Metabolically healthy obesity: the low-hanging fruit in obesity treatment ?. Lancet Diabetes Endocrinol 2017.