As we round the corner on the beginning of 2022, it seems everyone is trying to lose weight gained during the COVID-19 pandemic. Fat is fat, right? Getting rid of it seems to make sense to ensure a healthier weight. However, research has shown that some people with a BMI that is considered unhealthy may still have lower risk of diabetes and other complications compared with someone else with the same BMI but with fat stored in more risky locations in the body. A study published late January 2022 in the journal eLife, funded by Diabetes UK in collaboration with the University of Winchester, reveals what researchers are describing as favorable or unfavorable adiposity.

Lead researcher, Dr. Hanieh Yaghootkar, a lecturer in biosciences at Brunel University London, and colleagues set out to explore why there is a subset of obese individuals who exhibit a relatively healthy life while other peers experience consequences of the adverse metabolic component that contributes to diabetes and other serious illnesses. To do so, they evaluated specific genetic variants to determine potential associations of higher adiposity with and without negative metabolic impact on diseases.

According to Dr. Yaghootkar, "Some people have unlucky fat genes, meaning they store higher levels of fat everywhere, including under the skin, liver and pancreas. That's associated with a higher risk of diseases such as type 2 diabetes," she continued, adding "Others are luckier and have genes that mean higher fat under the skin but lower liver fat and a lower risk of diseases like type 2 diabetes."

The researchers identified 37 chronic diseases associated with obesity and genetic variants associated with different aspects of excess weight and included those associated with metabolically "favorable adiposity" and "unfavorable adiposity."

The team was then able to identify two different groups of diseases. One group were those in which the adiposity was the likely culprit in the development of metabolic disease, such as coronary artery disease, peripheral artery disease, hypertension, stroke, type 2 diabetes, polycystic ovary syndrome, heart failure, and atrial fibrillation.

The second group were those in which obesity played a nonmetabolic role but resulted in "mechanical" consequences such as osteoarthritis, rheumatoid arthritis, osteoporosis, gastro-esophageal reflux disease, gallstones, adult-onset asthma, and psoriasis.

The authors concluded that their study results will enhance knowledge and understanding of why some individuals with a high BMI may be metabolically healthy while others exhibit consequences of both a high BMI and the adverse metabolic effects of obesity.

"To better prevent and measure risk of disease, it is important to understand if obesity is a casual risk factor and if it is causal, which consequences of it—be they metabolic, mechanical or psychological—are deriving the risk," said Dr. Yaghootkar, who elaborated further, "Our results also provide evidence that everyone will benefit from losing their extra fat even if they are metabolically healthy."

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