Fat yet fit: Not all obese people get diabetes or heart disease, says study

Reduce obesity: Reducing visceral fat through diet, exercise, and stress management may lower metabolic disease risk (Image: Canva)

Have you ever noticed that despite being on the heavier side, some people are active, energetic, and full of life; challenging the long-held belief that obesity always leads to poor health. While obesity increases the risk of diabetes, high blood pressure, and high cholesterol, not all obese people develop these conditions. Many obese people remain healthy, encouraging researchers to investigate why some stay healthy while others don’t.

A new study reveals that not all obese people develop diabetes, heart disease, or other metabolic disorders. In fact, about one in four obese people remain perfectly healthy, defying conventional thoughts. Scientists have now uncovered the biological differences that separate healthy obesity from unhealthy obesity, sharing a fresh perspective on weight, metabolism, and long-term health.

This study, conducted by University of Zurich and Leipzig University, challenges the idea that all obesity is unhealthy. By identifying key differences in fat biology, researchers are paving the way for early detection, prevention, and targeted treatments, shifting the focus from weight alone to metabolic health at a cellular level.

Also read | How obesity can lead to another chronic diseases

Here’s what the researchers found.

The type of fat matters: Visceral fat (around internal organs) is more harmful than subcutaneous fat (under the skin). In unhealthy obesity, visceral fat burns fat inefficiently and releases pro-inflammatory molecules, increasing disease risk. Reducing visceral fat through diet, exercise, and stress management may lower metabolic disease risk.

Flexible cells: Healthy obese people have more mesothelial cells in visceral fat, which can transform into other cell types and allow fat tissue to expand without inflammation. Boosting your mesothelial cell activity could help manage obesity and metabolic health.

Unhealthy fat triggers immune response: In metabolically unhealthy obesity, fat cells release immune molecules that cause chronic inflammation, increasing the risk of diabetes and heart disease. Targeting inflammation in fat tissue could be a new approach to preventing obesity-related diseases.

Men and women store fat differently: A unique progenitor cell found only in women’s visceral fat may explain differences in obesity-related disease risks between genders. Understanding gender-specific fat storage could lead to more tailored obesity treatments for men and women.

Also read | Obesity paradox: Does being overweight really protect against heart disease? Here's the truth

Obesity and metabolic health: Scientists are still determining whether unhealthy fat causes metabolic disease, or if metabolic disease makes fat unhealthy. A new gene activity atlas may help predict disease risk. Early detection through biomarkers could enable better prevention and treatment strategies.

The findings are based on data from the DO-HEALTH study, Europe’s largest research initiative on healthy aging in adults over 70, conducted by the University of Zurich. Participants were closely monitored over three years through standardised health assessments, lifestyle evaluations, and follow-up calls every three months.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.