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It’s attainable to be “fat but fit,” new analysis introduced on the annual assembly of the European Affiliation for the Research of Diabetes (EASD) held in Vienna, Austria (15–19 September) suggests.
The research of tens of hundreds of individuals in Denmark discovered that these with a BMI within the chubby class—and even a few of these residing with weight problems—had been no extra more likely to die through the 5 years of follow-up than these with a BMI of twenty-two.5–25.0 kg/m2, which is on the high finish of the traditional weight vary.
People with a BMI within the center and decrease elements of the traditional weight vary, 18.5–22.5kg/m2, had been additionally extra more likely to die. As had been people with a BMI within the underweight vary.
“Both underweight and obesity are major global health challenges,” says Sigrid Bjerge Gribsholt, of the Steno Diabetes Middle Aarhus, Aarhus College Hospital, Aarhus, Denmark, who led the analysis.
“Weight problems could disrupt the physique’s metabolism, weaken the immune system and result in ailments like kind 2 diabetes, cardiovascular ailments and as much as 15 completely different cancers, whereas [being] underweight is tied to malnutrition, weakened immunity and nutrient deficiencies.
“There are conflicting findings about the BMI range linked to lowest mortality. It was once thought to be 20 to 25 but it may be shifting upward over time owing to medical advances and improvements in general health.”
To offer some readability, Dr. Gribsholt, Professor Jens Meldgaard Bruun, additionally of the Steno Diabetes Middle Aarhus, and colleagues used well being information to look at the connection between BMI and mortality in 85,761 people (81.4% feminine, median age at baseline 66.4 years).
BMI is a measure of weight to top and a rating of 18.5–25 kg/m2 is mostly thought-about to be of regular weight. A BMI of two is categorized as underweight, 25–30 kg/m2 is taken into account chubby and a BMI of 30 kg/m2 is described as weight problems.
A complete of seven,555 (8%) of the members died throughout follow-up. The evaluation discovered that people within the underweight class had been nearly thrice extra possible (2.73 occasions) to have died than people with a BMI in the direction of the highest of the wholesome vary (22.5–25.0 kg/m2, the reference inhabitants).
Equally, people with a BMI of 40 kg/m2 and above (categorized as extreme weight problems) had been greater than twice as possible (2.1 occasions) to have died in contrast with the reference inhabitants.
Nonetheless, greater mortality charges had been additionally discovered for BMIs which might be thought-about wholesome.
People with a BMI of 18.5–20.0 kg/m2, and so on the decrease finish of the wholesome weight vary, had been twice as more likely to have died as these within the reference inhabitants. Equally, these with a BMI of 20.0–22.5 kg/m2, and so in the midst of the wholesome weight vary, had been 27% extra more likely to have died than the reference inhabitants.
In contrast, people with a BMI within the chubby vary (25–30 kg/m2) and people with a BMI on the decrease a part of the overweight vary (30.0–35.0 kg/m2) had been no extra more likely to have died than these within the reference inhabitants—a phenomenon generally known as being metabolically wholesome or “fat but fit.”
These with a BMI of 35–40.0 kg/m2 did have an elevated threat of demise of 23%.
All the outcomes had been adjusted for intercourse, comorbidity degree and schooling degree.
An analogous sample was obtained when the researchers appeared on the relationship between BMI and weight problems in members of various ages, sexes and ranges of schooling.
The researchers had been shocked to search out that BMI was not related to a better mortality as much as a BMI of 35 kg/m2 and that even a BMI of 35–40 kg/m2 was solely related to a barely elevated threat.
Dr. Gribsholt says, “One attainable cause for the outcomes is reverse causation: some folks could drop extra pounds due to an underlying sickness. In these instances, it’s the sickness, not the low weight itself, that will increase the chance of demise, which might make it seem like having a better BMI is protecting.
“Since our information got here from individuals who had been having scans for well being causes, we can’t utterly rule this out.
“It’s also attainable that individuals with greater BMI who dwell longer—most people we studied had been aged—could have sure protecting traits that affect the outcomes.
“Still, in line with earlier research, we found that people who are in the underweight range face a much higher risk of death.”
Regardless of the rationalization, BMI is not the one indicator that a person is carrying unhealthy ranges of fats, says Professor Bruun.
He explains, “Different vital components embody how the fats is distributed. Visceral fats—fats that may be very metabolically lively and saved deep throughout the stomach, wrapped across the organs—secretes compounds that adversely have an effect on metabolic well being.
“Consequently, a person who has a BMI of 35 and is apple-shaped—the surplus fats is round their stomach—could have kind 2 diabetes or hypertension, whereas one other particular person with the identical BMI could also be free of those issues as a result of the surplus fats is on their hips, buttocks and thighs.
“It is clear that the treatment of obesity should be personalized to take into account factors such as fat distribution and the presence of conditions such as type 2 diabetes when setting a target weight.”
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European Affiliation for the Research of Diabetes
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Chubby and weight problems do not at all times improve the chance of an early demise, Danish research finds (2025, September 14)
retrieved 14 September 2025
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