'Fat but fit is a big fat myth'

The idea that people can be fat but medically fit is a myth, say experts speaking in Portugal.

Their early work, as yet unpublished, involved looking at the GP records of 3.5 million people in the UK.

They say people who were obese but who had no initial signs of heart disease, diabetes or high cholesterol were not protected from ill health in later life, contradicting previous research.

A summary of their study was discussed at the European Congress on Obesity.

The term "fat but fit" refers to the alluring theory that if people are obese but all their other metabolic factors such as blood pressure and blood sugar are within recommended limits then the extra weight will not be harmful.

In this study, researchers at the University of Birmingham analysed data of millions of British patients between 1995 and 2015 to see if this claim held true.

They tracked people who were obese at the start of the study (defined as people with a body mass index of 30 or more) who had no evidence of heart disease, high blood pressure, high cholesterol or diabetes at this point.

They found these people who were obese but "metabolically healthy" were at higher risk of developing heart disease, strokes and heart failure than people of normal weight.

Is the 'fat but fit' theory well and truly busted?

Dr Mike Knapton, from the British Heart Foundation, said: "It's not often that research on this scale and magnitude is able to clarify an age-old myth.

"These findings should be taken extremely seriously and I'd urge healthcare professionals to take heed."

He added: "Previously we used to think that being overweight led to an increase in heart attacks and stroke because it raised your blood pressure or cholesterol.

"What was new from this study for me is that it showed that people who were overweight or obese were at increased risk of heart disease even though they may have been healthy in every other respect.

"Just being overweight puts you at increased risk of heart attack and stroke."

But the study has not appeared in a scientific journal and, as such, it will not have gone through a number of checks by other academics to judge whether it is scientifically sound.

Fitness and fatness: tricky things to measure?

But other experts point out that the way scientists measure fatness and fitness makes this a tricky area to study and could make some of the more tantalising results invalid.

Tom Sanders, emeritus professor of nutrition and dietetics, King's College London, says a major weakness of the Birmingham study is that it uses definite cut-offs to decide when someone has high blood pressure or high cholesterol for example.

Instead, he argues that it is too simple and not accurate to use such definite values to decide whether someone is healthy.

And other studies have suggested that it is not always the amount of fat that matters but where the excess fat is carried on the body that can affect fitness and health.

For example, weight around the middle may be more damaging than weight distributed evenly around the body.

Overall, experts say it is important to not just focus on what you see in the mirror or on the scales - exercise and healthy eating can help boost wellness, no matter how much a person weighs.

Originally published on BBC