Health at Every Size


  • You can engage in health seeking behaviours at any size
  • A high BMI does not make you unhealthy
  • A high body % fat does not necessarily make you unhealthy
  • Think of the other components of health such as Cardiorespiratory Fitness

The Metabolically Healthy Obese (MHO) phenotype is a condition in which obesity co-exists with a fully healthy metabolic profile.

Is it luck of the draw that some people with obesity are healthy while some aren’t?

There are some previously identified common factors at play in the MHO phenotype found in the research that such as:

  • lower visceral fat accumulation
  • higher birth weight (perhaps some people aren’t supposed to be small)
  • adipose cell size
  • gene expression for fat cell differentiation

But cardio-respiratory fitness (CRF) accounts for another small to moderate effect size in the factors amounting to a MHO phenotype. HIgh CRF and the process of improving CRF bring a multitude of benefits that may lead to some of those commonalities mentioned above… not birth weight though.

This is a health component everyone can engage with. If you are currently a person with obesity but do not fully engaging with your health because you feel stigmatised, marginalised and even hopeless, this is something you can engage with. You can find any method of improving your fitness that you enjoy, and you can improve your health and wellbeing by doing it.

Not sold yet? Here’s more…

What’s the prognosis for the MHO phenotype?

Well, obesity whether it be MHO or Metabolically Abnormal Obesity (MAO) is associated with an increased risk of all cause mortality, cancer and CVD.

However, when CRF is accounted for in the analysis; no difference is seen between MHO and people with normal body fatness.

When CRF and accurate measures of obesity (body fat) are used ie not BMI, MHO carries a 30-50% lower risk than MAO for morbidities.

So, MHO is associated with a low risk of myocardial infarction, but obesity per se is associated with an increased risk of heart failure – Some other factors are at play beyond just CRF.

No doubt, if healthy eating patterns such as food variety, lower saturated fatty acid intake and higher fibre intake were included in the MHO phenotype’s lifestyle we would see even better outcomes.

Might you start with a lifestyle intervention this time? A weight-neutral, health positive approach that improves the quality of your life?

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