Hormonal
Insulin resistance is a primary driver of cardiovascular risk in obesity, whereas obesity itself (without insulin resistance) does not significantly increase mortality or cardiovascular risk.
Having excess body fat does not automatically mean you have a high risk of heart disease or early death. The critical factor is insulin resistance. If you are obese but metabolically healthy (normal insulin sensitivity), your cardiovascular risk may not be significantly elevated. Focus on improving metabolic health through activity and diet rather than just weight loss.
Metabolically healthy obese individuals are not at increased risks of all-cause mortality, cancer mortality or CVD mortality in a 15-year follow-up [59] suggesting that obesity per se is not sufficient to determine CV risk. On the contrary, insulin resistance is a key driver of CV risk in obesity.
Why this rating
Cites a 15-year follow-up study and general consensus in the review.
Source
Metabolic flexibility and insulin resistance
José E. Galgani et al. · American Journal of Physiology-Endocrinology and Metabolism · 2008
DOI 10.1152/ajpendo.90558.2008
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