EXPOSED! The most dangerous medical myth of the 21st century

How to tell if you’re a victim—and the simple solution that can save your life


“You can do as bad as you want, but never for as long as you want.”

That’s what my mother used to say. And while I realize I’m biased, I can’t imagine a more sensible (or accurate) nugget of wisdom to live by.

Still, that hasn’t stopped people from trying to find ways to have their cake and eat it too—literally. And when they find a quick fix, they’re not likely to let it go without a fight. Even if the logic behind it defies the science of our bodies.

I’m a recovering obese person myself. So I’m very familiar with the kind of stories we tell ourselves in an effort to avoid necessary change… And I’m here to tell you that the idea that you can be “fat but fit” is one of those myths.

It’s a dangerous one, too. Which is why I feel obligated to set the record straight on this issue (without sugarcoating it).

Today, I’ll reveal how much of a lethal lie it really is. And I’ll give you the simple solution that can save your life.

More on that in just a moment. But first, let’s take a closer look at some disturbing new research.

International study shows being “fat but fit” greatly increases heart disease risk

According to one recent study, “metabolically healthy obesity” (the technical term for being “fat but fit”) can raise your risk of heart disease by more than 25 percent.

This study was the largest of its kind—using data from roughly half a million people across 10 different European countries, spanning a period over 12 years.

Using Body Mass Index (BMI) designations, researchers classified participants as:

  • Normal weight: with a BMI between 18.5 – 25 percent
  • Overweight: with a BMI between 25 – 30 percent
  • Obese: with a BMI over 30 percent

They defined “unhealthy” subjects as those with three or more metabolic red flags, including:

  • High blood pressure
  • High triglycerides
  • High blood sugar
  • Low HDL cholesterol
  • Increased waist size

Results appeared in the European Heart Journal. And they showed that even after adjusting for factors such as smoking, diet, and exercise habits, the “unhealthy” participants faced more than double the risk of heart disease, regardless of weight.1

But here’s where things get interesting: Results also showed that, among the supposedly “healthy” subjects, those in the “fat but fit” group had up to a 28 percent increase in heart disease risk compared to those with a normal weight.

Sorry, but there’s just nothing “fit” about a 28 percent increased heart disease risk.

Look, I’m a doctor—my job is to keep my patients healthy in the midst of a booming diabesity crisis. If being “fat but fit” were really possible, it would make my job a whole lot easier. But unfortunately, that’s just not the case.

As they say, the proof is in the pudding. This is only one study exposing just how deadly the “fat but fit” myth is. And there are plenty more where that came from…

“Metabolically healthy” obesity—just the lesser of two evils

Another recent analysis looked at data from more than 90,000 women from the 1980 Nurses’ Health Study. And it determined that being “metabolically healthy” lowered risk of heart disease, regardless of BMI.

But I beg to differ. When you look at the actual numbers, being overweight or obese still significantly raises the risk of heart disease.

Researchers looked at risk of fatal and non-fatal heart attacks and stroke, as well as total heart disease risk. They divided the women up into the same standard BMI categories I mentioned earlier. Subjects without diabetes, high blood pressure, or high cholesterol were deemed “metabolically healthy.” Those who met the criteria with a BMI higher than the normal range fell into the “fat but fit” category.

Unsurprisingly, subjects who didn’t make it into the metabolically healthy group had a sky high risk of heart disease, regardless of their weight. (More than double that of normal weight women who were metabolically healthy.) But the “fat but fit” women still faced a nearly 40 percent higher risk of heart disease.

It’s also worth noting that more than 80 percent of the obese women who started off metabolically healthy didn’t end up that way 20 years down the line. (And to be fair, neither did 68 percent of the metabolically healthy women with normal weight.) So being “fat but fit” isn’t a given. And chances are, you won’t stay that way for long. And as your metabolic status snowballs, so does your heart disease risk.

If this isn’t a slam dunk case for making weight management your No. 1 priority, I really don’t know what is.

But while we’re on the subject, there’s one more misconception I want to clear up…

Even borderline weight takes a toll on your heart

You know what else I’d like to put an end to? The mistaken belief that “a little extra padding” might actually protect you against heart disease.

This absurd notion is known as the “obesity paradox.” And it’s based on the results from a 2013 JAMA study that claimed being overweight might actually help you live longer.3

But another recent study, which appeared in the European Heart Journal within the past year, has tossed this misleading theory to the top of the trash heap where it belongs. And with a subject pool upwards of 300,000 people, its results are worth paying attention to…

Using data from the UK Biobank study, researchers found that subjects with BMIs between 22 and 23 had the lowest risk of heart disease. (This is directly in the middle of the normal range—you’re not considered “overweight” until you exceed a BMI of 25.)

But for every significant BMI increase above 22—specifically, a 5.2 rise for women and a 4.3 rise for men (which is enough to push you into a new weight category)—the risk of heart disease rose by 13 percent.4

And that’s not all. Results also showed that heart disease risk rose with increases in waist circumference. In fact, every 4.5-inch to 5-inch increase in waist size elevated cardiovascular risk anywhere from 10 to 16 percent. (That’s compared to men with 33 inch waists and women with 29 inch waists.)

The researchers identified similar trends when they looked at waist-to-hip and waist-to-height ratios, as well as body fat percentages.

These results put a finer point on the issue—showing that fat around the waist is particularly dangerous. (I’ve spoken before about the specific risks posed by visceral fat—which not only envelops internal organs, but also churns out pro-inflammatory signals.)

But it’s clear that every extra pound places a significant burden on your health, wherever your body happens to store it. And even if your weight is on the upper end of normal, your heart might still be at risk.

Ditch the delusion that high BMI numbers are harmless

The bottom line: There’s no upside to being overweight—it’s never healthy, no matter how good your other numbers look on paper.

The sooner doctors and patients ditch this delusion, the sooner we can all roll our sleeves up and start actually doing something to put an end to this modern health crisis.

In the meantime, you know what else I wish people would stop believing? The idea that shedding pounds and getting healthy has to be a miserable, tasteless, torturous affair.

If you’re familiar with my new book, The A-List Diet, then you know this couldn’t be further from the truth. (To pick up a copy, visit or

Now we just need to wait for the ill-informed “experts” over at the American Diabetes Association and the American Heart Association to catch up.

Because if more people knew how easy and delicious it is to get healthy, they wouldn’t need to cling to narratives like “fat but fit” to feel good about their choices. They would simply be making the right ones, every single day.

How you can add six years to your life—starting today

Obviously, reining in your BMI is key to a healthy, heart-attack-free future. But in a recent study published in JAMA Cardiology, researchers found that losing weight doesn’t just help protect your heart—it can also help you live longer.5

This study reviewed data from more than 190,000 patients. And researchers found normal-weight subjects lived up to six years longer than their obese peers.

That’s six extra years you can spend with your family, doing the things you love. I can’t think of a better incentive for taking control of the scale once and for all—starting today.


  1. Lassale C, et al. Eur Heart J. 2018 Feb 1;39(5):397-406.
  2. Eckel N, et al. Lancet Diabetes Endocrinol. 2018 May 30.
  3. Flegal KM, et al. JAMA. 2013 Jan 2;309(1):71-82.
  4. Iliodromiti S, et al. Eur Heart J. 2018 May 1;39(17):1514-1520.
  5. Khan SS, et al. JAMA Cardiol. 2018 Apr 1;3(4):280-287.