Ioanna Tzoulaki, of Imperial College London, and colleagues compared each person’s body mass index with whether they were metabolically “healthy” or “unhealthy”.
People were classed as the latter if they had three or more of a range of metabolic markers, such as high blood pressure, high blood sugar, low levels of “good” cholesterol, or a large waist circumference.
Taking a range of factors into account, the team found that, compared to healthy people of a normal weight, those classed as unhealthy had double the risk of coronary heart disease – regardless of whether they were a normal weight, overweight or obese.
“I think there is no longer this concept of healthy obese,” says Tzoulaki.
“Our study shows that, if anything, people with excess weight who might be classed as ‘healthy’ haven’t yet developed an unhealthy metabolic profile.
“That comes later.”