Do Metabolically Healthy Obese Stay Healthy? Interview with:

Morgana Mongraw-Chaffin, PhD MPH Wake Forest School of Medicine North Carolina

Dr. Mongraw-Chaffin

Morgana Mongraw-Chaffin, PhD MPH
Wake Forest School of Medicine
North Carolina What is the background for this study? What are the main findings?

Response: While some large studies and meta-analyses of this topic suggest that metabolically healthy obesity (MHO) is not a benign condition, discrepancies persist in the results of individual studies. Lack of a clear explanation for these differences drives the continuing controversy over whether MHO is a useful tool for risk stratification or an intermediate condition on the pathway to cardiometabolic risk.

In the Multi-Ethnic Study of Atherosclerosis (MESA), we found that 48% of those with metabolically healthy obesity transitioned to unhealthy obesity by the end of follow-up. Those who transitioned had higher odds of developing cardiovascular disease compared to those who maintained normal weight. We further found that earlier transition from MHO to unhealthy obesity was associated with higher odds. What should clinicians and patients take away from your report?

Response: Individuals with metabolically healthy obesity are likely to develop cardiovascular risk factors and transition to unhealthy obesity over time. Weight management and the prevention of risk factors are important for this group to avoid cardiovascular disease. What recommendations do you have for future research as a result of this study?

Response: Additional work is needed to fully explore the relationship that physical activity and fitness play in the development and maintenance of metabolically healthy obesity. The association between MHO and all-cause mortality needs further investigation in large studies with sufficient follow-up time to determine if the risk involves a large lag-time between exposure and mortality or differs by cause of death. Is there anything else you would like to add?

Response: Our study reinforces the need to follow recommendations for prevention and treatment of cardiovascular risk factors for those with obesity even if they have not developed metabolic syndrome yet.

One author was previously employed by Merck, but the company played no role in any aspect of the research. The other authors have no conflicts of interest. Thank you for your contribution to the community.

Citation: JACC Volume 71, Issue 17, May 2018 DOI: 10.1016/j.jacc.2018.02.055

Metabolically Healthy Obesity, Transition to Metabolic Syndrome, and Cardiovascular Risk

Morgana Mongraw-Chaffin, Meredith C. Foster, Cheryl A.M. Anderson, Gregory L. Burke, Nowreen Haq, Rita R. Kalyani, Pamela Ouyang, Christopher T. Sibley, Russell Tracy, Mark Woodward and Dhananjay Vaidya

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.