We argue that despite inconsistencies in the definition , patterns across studies clearly show that healthy obesity is a state of intermediate disease risk .
Expert commentary : Given the current state of population -level evidence , we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health .
INTRODUCTION Obesity is a top public health priority but interventions to reverse the condition have had limited success .
About one-in-three obese adults are free of metabolic risk factor clustering and are considered ' healthy ' , and much attention has focused on the implication s of this state for obesity management .
Body-mass index and mortality among 1.46 million white adults.
BACKGROUND A high body-mass index ( BMI , the weight in kilograms divided by the square of the height in meters ) is associated with increased mortality from cardiovascular disease and certain cancers , but the precise relationship between BMI and all-cause mortality remains uncertain . METHODS We used Cox regression to estimate hazard ratios and 95 % confidence intervals for an association between BMI and all-cause mortality , adjusting for age , study , physical activity , alcohol consumption , education , and marital status in pooled data from 19 prospect i ve studies encompassing 1.46 million white adults , 19 to 84 years of age ( median , 58 ) . RESULTS The median baseline BMI was 26.2 . During a median follow-up period of 10 years ( range , 5 to 28 ) , 160,087  deaths were identified . Among healthy participants who never smoked , there was a J-shaped relationship between BMI and all-cause mortality . With a BMI of 22.5 to 24.9 as the reference category , hazard ratios among women were 1.47 ( 95 percent confidence interval [ CI ] , 1.33 to 1.62 ) for a BMI of 15.0 to 18.4 ; 1.14 ( 95 % CI , 1.07 to 1.22 ) for a BMI of 18.5 to 19.9 ; 1.00 ( 95 % CI , 0.96 to 1.04 ) for a BMI of 20.0 to 22.4 ; 1.13 ( 95 % CI , 1.09 to 1.17 ) for a BMI of 25.0 to 29.9 ; 1.44 ( 95 % CI , 1.38 to 1.50 ) for a BMI of 30.0 to 34.9 ; 1.88 ( 95 % CI , 1.77 to 2.00 ) for a BMI of 35.0 to 39.9 ; and 2.51 ( 95 % CI , 2.30 to 2.73 ) for a BMI of 40.0 to 49.9 . In general , the hazard ratios for the men were similar . Hazard ratios for a BMI below 20.0 were attenuated with longer-term follow-up . CONCLUSIONS In white adults , overweight and obesity ( and possibly underweight ) are associated with increased all-cause mortality . All-cause mortality is generally lowest with a BMI of 20.0 to 24.9
We argue that despite inconsistencies in the definition , patterns across studies clearly show that healthy obesity is a state of intermediate disease risk .
Expert commentary : Given the current state of population -level evidence , we conclude that obesity and metabolic dysfunction are inseparable and that healthy obesity is best viewed only as a state of relative health but not of absolute health .
INTRODUCTION Obesity is a top public health priority but interventions to reverse the condition have had limited success .
About one-in-three obese adults are free of metabolic risk factor clustering and are considered ' healthy ' , and much attention has focused on the implication s of this state for obesity management .