”Healthy obesity” is defined as obesity without metabolic risk factors, but in reality this concept is misleading – because most obese people eventually develop a variety of health problems. This finding comes from a 20-year study that examined the health of more than 2,500 people in total. The study was published online Jan. 6 in the Journal of the American College of Cardiology. Researchers from the Department of Epidemiology and Public Health at University College London looked at health data including body mass index (BMI), cholesterol, blood pressure, fasting blood sugar and insulin resistance in 2,521 men and women between the ages of 39 and 62. The purpose of the study is to examine whether people who start out healthy and obese remain metabolically healthy over time, or whether they develop health problems over time. This is by far the longest running study in this area. Of the 2,521 people, 181 were identified as obese at the start of the experiment, 66 of whom were in good health. And after 5 years, 32% of these healthy obese people had health problems; after 10 years this figure rose to 41%, and after 15 years it was 35%; and by the 20th year, this proportion finally developed to more than 51%. Of these people, only 11% became healthy and normal weight after losing weight, while the remaining 38% remained healthy and obese for the 20 years. At the same time, 6 percent of the study participants went from being healthy and normal weight to being unhealthy and obese. ”The core idea of the concept of healthy obesity is that this state is stable in people. But now we find that over longer periods of time, healthy obesity transforms into unhealthy obesity.” The first author of the paper, Joshua K. Bell talked about, “Healthy and obese adults are more likely to have health problems compared to adults of normal weight (healthy or not). This also suggests that healthy obesity is actually a high-risk condition, with a potential risk of other diseases.” In contrast, only 6 percent of healthy obese people returned to their normal weight and remained healthy after losing weight in the first five years of the study. The percentage of healthy and normal-weight people rose from 4.5 percent after 10 years to 6.1 percent after 15 years, and that percentage reached 10.6 percent after 20 years. Bell noted, “Although healthy obese people have a lower risk of cardiovascular disease than unhealthy obese people, they have a much higher risk of developing the disease compared to healthy and normal-weight people. Healthy obesity is only a relative health, just a little better than the worst case scenario. And as the experiment demonstrates, over time, healthy fat people tend to become unhealthy fat people, providing deeper evidence against the notion of healthy obesity.” “Unless the state of healthy obesity can be sustained over time, this claim is not valid. And our findings show that healthy and obesity coexist only over time. All forms of obesity need to be treated, even if those who are obese now appear healthy.”