Postmenopausal women, who are not obese, but have excessive abdominal fat reflected in large waist circumferences face a heightened risk of cardiovascular disease, cancer, and death, according to a new study. This phenomenon is termed normal-weight central obesity.
Published in the Journal of the American Medical Association, the study shows that women with this kind of central obesity have an equally high mortality risk compared to women diagnosed with obesity — traditionally measured through the calculation of body mass index (BMI).
Current public health guidelines for obesity prevention focus on promoting a healthy BMI that measures only for weight-based obesity. They don’t take factors such as body shape or fat distribution in an individual into consideration that determine if they are centrally obese.
“People with normal weight based on BMI, regardless of central obesity status [are] generally considered normal in clinical practice according to current guidelines and policymakers. This could lead to a missed opportunity for risk evaluation and intervention programs for a high-risk but neglected subgroup (ie, those with normal-weight central obesity),” the study states.
Lead study author Wel Bao and her team tracked the health of more than 156,000 women between the ages of 50 and 79 from 1993 to 2017 and linked mortality rates to the respondents’ BMI as well as their central obesity.
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Women with normal-weight central obesity (that is, having a healthy BMI between 18.5-24.9 but a waist circumference greater than 88 cms) were found to be 31% more likely to die within the two-decade observation period. That’s comparable to the 30% increased likelihood that an obese person with central obesity (that is, having a BMI greater than or equal to 30 and a waist circumference greater than 88 cms) will die within the same period. The two major causes of death in people with normal-weight central obesity were cardiovascular disease and obesity-related cancer.
The study highlights the underrepresentation of central obesity in the discourse on healthy weight management. “The results suggest we should encourage physicians to look not only at bodyweight but also body shape when assessing a patient’s health risk,” said Bao.
