Although there is no consensus on what criteria define metabolic health, people who seem pretty healthy despite being obese are considered to have what’s called “metabolically healthy obesity” (MHO). Commonly, these people are obese without the insulin resistance, low-grade inflammation, elevated blood lipids, or high levels of visceral fat.
This state is often used to facilitate the belief that obesity isn’t harmful to one’s health.
Yet, those with MHO are still at an increased risk for adverse cardiovascular events (e.g., heart attacks), subclinical atherosclerosis, nonalcoholic fatty liver disease, kidney dysfunction, and type II diabetes.
Plus, being obese is hard on the body outside of metabolic health. You could have perfect metabolic health while being obese, but that isn’t saving you from osteoarthritis and joint degeneration from carrying around excessive amounts of fat.
Moreover, the only reason you are metabolically healthy is because you haven’t passed your personal threshold. If you continue to engage in your obesogenic behaviors that cause weight gain, then it’s only a matter of time before that threshold is reached.
People can be obese and have different levels of health, but you simply can’t be obese and healthy. That’s not a knock against people currently struggling with their weight, it’s just a biological reality.
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