Metabolically healthy obese people are not insulin resistant – so it isn’t obesity that causes insulin resistance. Skinny pepole be warned !
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Why your BMI is irrelevant and obesity is NOT the cause of insulin resistance
Metabolically healthy obese people are not insulin resistant – so it isn’t obesity that causes insulin resistance. Skinny pepole be warned !
I have a friend………….. she is rather big – let’s call her Mary. Since I am obsessed with body chemistry and understand, the problem with being overweight is not aesthetic, but biochemical, I find her fascinating.
You see – despite being morbidly obese, metabolically she is in perfect shape.
• Her blood pressure is normal.
• Her cholesterol is normal.
• Her sugar levels are normal.
• Her triglyceride levels are normal.
Now I won’t go so far as to say she is in PERFECT HEALTH.
She has a multitude of issues, but her health complaints revolve around aches and pains, brought on by the fact that she is carrying a seriously heavy load.
Mary is big ALL OVER.
This is so very different from my body, my legs look like I am an Olympic athlete, pretty much no butt to speak of – my bigness is all round my belly.
Metabolic madness
Officially I am NORMAL weight, with a BMI that comes in under the 25, the official cut off mark for FATNESS in white people.
NOTE : The numbers are a little lower for some ethnic groups.
Unfortunately despite my “perfect” BMI score, metabolically speaking, I teeter on the edge of metabolic derangement.
The only thing that keeps me from sliding off the precipice to serious health issues, is continued vigilance.
• I watch what I eat, when I eat, with whom I eat
• I exercised regularly
• I manage my light exposure
• I go to bed early and get enough sleep
• I regularly cook in the sauna
• I meditate/flow dream
You get the picture.
On the plus side, this is why I know SO MUCH ABOUT how to create BETTER BODY CHEMISTRY, and why I do what I do. I want to empower others to avoid metabolic mayhem.
But I must confess………
I am a little a lot jealous
Part of me thinks, those fat cells will eventually catch up to her – it is a matter of time. And this is what she believes too – so she is ALWAYS DIETING.
3 kg off, 4 kg on.
But as I’ve watched her expand and contract, over the years, I doubt this will happen – she has “some kind of magic”, that protects her. And I wish I knew what it was, so I could get a little.
Now most health gurus, admit there are metabolically healthy obese people, they’re pretty sure, the excess fat cells, will catch up with them………..sooner, rather than later.
Obesity ALWAYS a killer
So is this true ?
Does obesity ALWAYS result in metabolic mayhem ?
i.e. if you’re currently classified as metabolically healthy obese, will you eventually cross a line and become metabolically deranged ?
Curious about the metabolically healthy obese
A group of researchers from Washington University, decided to test the theory…
That too many fat cells, eventually catch up with you.
The team enrolled a group of heavy weights into their study. And instead of cutting calories, they fed them more, much much more – so they got heavier and heavier.
Now in the group of heavy weights they signed up for their study, they identified two distinct groupings.
• Heavy weights with metabolic troubles i.e. people showing signs of metabolic syndrome.
• 100 % metabolically healthy obese, just like my friend Mary
The metabolic line
The criteria the team used to decide whether, the heavy weights were normal or in metabolic trouble, was the presence/absence of fat inside the liver. Intrahepatic triglyceride content or IHTG for short, are a biomarker for insulin resistance – their presence signals excess fat, is no longer being stored exclusively in adipocytes.
Despite the differences, the two groups had similar BMIs at the start of the study.
And the heavy got heavier
The calorie loading saw all the heavy weights, get heavier. Believe it or not, this was not as easy as you would think. On average, they increased their weight by around 6 %.
Most of the weight gain was fat, fat mass increased by approx. 10 %.
The consequences of the weight gain – differed.
The metabolically unhealthy guys, became – MORE unhealthy. A variety of health parameters slipped, including fasting insulin levels, triglycerides and blood pressure.
The metabolically healthy obese, remained……………metabolically healthy. Their health parameters stayed within the normal ranges, actually they barely changed. So unfair !
So……….. not all obese people are metabolically IN TROUBLE.
And extra fat cells does not always equate with metabolic troubles.
It is an inconvenient TRUTH.
BMI tells you NOTHING
BMI (body mass index) is currently the number that carries an awful lot of weight, when it comes to classifying people. A normal BMI is between 18 and 25. Anything above this is considered abnormal and problematic. The higher the number, the more trouble you’re in.
So a BMI above 30, puts you in the category of obese.
A BMI above 35, makes you morbidly obese.
But………… being overweight/obese does not automatically mean you’re metabolically UNHEALTHY. It just means, your doctor is expecting TROUBLE. Heart disease, diabetes are on his radar…….
And if you visit with a problem, his/her first response will be to tell you to lose weight.
Skinny people missing out
We all have heard the stories…………
Jo Soap was skinny. He ate “right”. Worked out. And last week he dropped down dead from a heart attack. How could this be ?
His BMI betrayed him.
The “this guy could have metabolic troubles” radar didn’t go off, because his doctor assumed, he must be OKAY, since obesity causes insulin resistance.
This study, hints it’s more complicated…
What if………..
Obesity is not the cause of insulin resistance.
Instead, insulin resistance is the cause of obesity.
The implications of this………………… are mind boggling and far reaching, because it raises the question – what causes insulin resistance ?
Genes are only part of the story, is it…
• Bad bugs ?
• Circadian disruption ?
• Specific chemicals ? Maybe endocrine disruptors, linoleic acid, vitamin B3 ?
• Air pollution ?
• The way food is being processed and/or cooked ?
• Cell phone radiation ?
All of the above. Something else ?
Ditch the BMI
The reality is, a percentage of skinny people have seriously defective metabolism. The exact percentage probably varies according to where in the world you live, but it’s generally around 30 %.
Let that sink in………
30 % of “normal” weight adults are insulin resistant
i.e. they have metabolic syndrome.
On the flip side, a percentage of overweight/obese people have excellent metabolism. Again the exact number varies and often depends on your “definition”, but 30 % of people who are considered to be heart attack’s waiting to happen, in fact have happy healthy hearts and blood vessels.
NOTE : Now to be fair, if you look at the official criteria for metabolic syndrome, BMI is not there, waist circumference is…………. but this detail is often, LOST IN TRANSLATION.
Fat cells are not actually the health risk
They are needed and necessary.
Granted you don’t want to many, being overweight/obese – it’s not a fun experience. But when it comes to creating BETTER BODY CHEMISTRY and enjoying BETTER HEALTH, it important to remember.
The problem is not fat cells per se, it’s the inability to respond to insulin appropriately.
You need to know your metabolic status, not your weight.
Unfortunately, at this stage at least, there isn’t one number that tells you whether you are or are not insulin resistant, so you have to “read the tea leaves” a little, and look for clues.
NOTE : There are quite a few surrogate markers for insulin resistance, each has it’s pros and cons. My favourite is the TyG index, click here to learn more about it.
The take home message, no matter what you weigh, you must know your metabolic status.
Insulin resistance KILLS
Need a little help, figuring out your metabolic status, let me take a look…. BUY A BODY AUDIT.
NOTE : If you already know you are insulin resistant, there are tons of resources on the BETTER BODY CHEMISTRY blog. The Willpower Report (it’s free) is a good place to start – click here to download it. If you’re ready to dive a little deeper, take a look at the Ups and Downs of Insulin Resistance series – click here.
Further reading
To be healthy, you need MORE fat cells, not less
You can be fat, with lots of fat cells (hyperplasia) or you can be fat with fewer fat cells (hypoplasia). More fat cells is better from a health perspective
All I want for Christmas is a fat transplant
Mice who receive a FAT transplant become OBESITY RESISTANT – this means, the little critters can eat what they like and never get fat. I want that….
Is a shortage of bubble wrap causing the trouble in obesity ?
Each droplet of fat, is carefully wrapped in bubble wrap so that the high energy fat molecules don’t cause a fire, but in obesity adipose tissue is on fire. Why ?