Metabolic Health Versus Weight

Despite more than a decade of intensive efforts to reverse the adult and childhood obesity crises, obesity remains widespread. Generally, the first treatment recommendation is to lose weight, but losing large amounts of weight and keeping it off is difficult, and possibly not even the best reflection of health improvements. After all, the number on a scale is just one measure of health. Perhaps, as researchers in a 2017 Lancet Diabetes & Endocrinology paper suggest, we should spend more efforts looking at other markers that may help promote metabolically healthy obesity, such as attaining or maintaining normal cholesterol levels, blood sugar and blood pressure. Improvements in these measures result from healthful eating patterns, increased physical activity and/or moderate weight loss (about 5%–10%).

While people with metabolically healthy obesity face a greater risk of cardiovascular
events than their counterparts at normal weights, their risk is substantially lower than that of people with metabolically unhealthy obesity.

Health and fitness professionals could collaborate with clients and their healthcare providers to monitor improvements in markers of metabolic health with adoption of a healthier lifestyle.

What do you think? As clients make their New Year’s resolutions, should metabolic health—and not weight—be a key target?

Natalie Digate Muth, MD, MPH, RD

Natalie Digate Muth, MD, MPH, RD

"Natalie Digate Muth, MD, MPH, RDN, FAAP, is a board-certified pediatrician and obesity medicine physician, registered dietitian and health coach. She practices general pediatrics with a focus on healthy family routines, nutrition, physical activity and behavior change in North County, San Diego. She also serves as the senior advisor for healthcare solutions at the American Council on Exercise. Natalie is the author of five books and is committed to helping every child and family thrive. She is a strong advocate for systems and communities that support prevention and wellness across the lifespan, beginning at 9 months of age."

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