This research simply demonstrates that we don't really understand 'healthy' and the tools we currently use to measure health are very poor.
Meta-Analysis Dispels Myth of "Healthy" Obese — Physician’s First Watch
Meta-Analysis Dispels Myth of "Healthy" Obese
By Amy Orciari Herman
Having a healthy metabolic profile — for example, normal blood pressure, triglycerides, and blood glucose — does not appear to protect obese adults from increased risks for cardiovascular events or death, according to a meta-analysis in the Annals of Internal Medicine.
The analysis included eight observational studies comprising over 60,000 adults whose BMIs and metabolic profiles were assessed. Participants were defined as metabolically healthy if they did not meet criteria for the metabolic syndrome. (The syndrome was usually defined as having at least three of the following: increased waist circumference, high triglycerides, low HDL cholesterol, hypertension, and elevated blood glucose.)
In the four studies with at least 10 years' follow-up, metabolically healthy obese adults had a significant, 24% increased risk for the combined endpoint of cardiovascular events or death, relative to metabolically healthy normal-weight adults. Similarly, metabolically healthy overweight participants had a 21% increase in risk, but this did not reach statistical significance.