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A new study has revealed that many obese adults now have cholesterol and blood pressure levels "indistinguishable" from those of a healthy weight.
Researchers even found some obese people to be “better off” than their healthy-weight counterparts.
This marks a significant shift from the past, when obese adults typically had elevated blood pressure and higher levels of unhealthy cholesterol. The study found that these differences have "narrowed or disappeared" among those aged 40 and over.
Experts largely attribute the change to the increased use of cholesterol-busting medications, such as statins, and blood pressure-lowering drugs, both more commonly prescribed to people with obesity.
The findings are deemed crucial for understanding the "cardiovascular health" of people who are likely to be prescribed increasingly popular weight-loss medications. Experts caution against "losing sight" of these observations as the use of such treatments grows.
Professor Majid Ezzati, from the School of Public Health at Imperial College London, said: “Our study suggests that, in high-income countries, taking medication to lower blood pressure and cholesterol has helped middle-age and older adults lower their cardiovascular risk to levels that are similar to people with normal BMI.
“At a time that weight-loss medications are becoming more widely used, our results give a picture of the cardiovascular health of people likely to be prescribed them, which allows the healthcare system to understand how blood pressure and cholesterol treatments benefit the population alongside weight-loss medications.”
In the past, obese people typically had elevated blood pressurePA ArchiveThe study, published in The Lancet, saw researchers examine data from almost one million adults aged 20 to 79 from England, Japan, South Korea, Taiwan, Thailand, Finland and the USA.
They looked at data on blood pressure, cholesterol levels and body mass index (BMI) scores taken from 110 health surveys conducted from 1990 to 2024.
They also examined information on the use of cholesterol-busting drugs and blood pressure treatment – known as antihypertensives.
The team found that unhealthy cholesterol levels and blood pressure “declined over time”, especially among those age 40 and over.
The declines were larger among people with obesity “leading to a convergence of these risk factors between obesity and normal BMI in people older than 40 years”.
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“As a result of these trends, in England, the USA, Thailand, South Korea, and Japan, older people with obesity often became indistinguishable from, or better off than, those with normal BMI in terms of non-HDL cholesterol and SBP (systolic blood pressure),” they wrote.
The authors concluded: “We found that differences in non-HDL cholesterol and SBP between those with obesity and those with a normal BMI narrowed or disappeared, especially in older adults, in some cases making those with and without obesity indistinguishable in terms of these cardiometabolic traits.”
Experts largely attribute the change to the increased use of cholesterol-busting medications, such as statins, and blood pressure-lowering drugsPA ArchiveOne of the research team, Professor Edward Gregg from Imperial College London, stressed that “it doesn’t mean that obesity does not still increase your risk of of other outcomes”.
Meanwhile the study found that in adults under the age of 40, those who were obese still had higher levels of bad cholesterol and higher blood pressure.
Author Yse d’Ailhaud de Brisis, also from Imperial College London, said: “While good news for older adults with obesity, our results suggest that cardiovascular health risks remain higher for adults under 40 than for their counterparts with a normal BMI.
“Early lifestyle interventions, screening and, when appropriate, medication in this younger group should be considered to prevent long-term cardiovascular complications linked to obesity.”
Lakshya Jain, from the School of Public Health at Imperial College London, added: “This latest analysis suggests that the observed convergence in cholesterol and blood pressure levels between people aged over 40 with obesity and those with a normal BMI is largely due to statins and other widely accessible medications to reduce cardiovascular risk.
“That is a significant public health success story, and one we should not lose sight of as new weight-loss medications enter the picture.”
Commenting on the study, Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, said: “This study highlights a powerful public health success story – it shows just how effective modern treatments for blood pressure and cholesterol have become, with many people over 40 with obesity now reaching levels similar to those with a healthy weight.
“This is testament to the impact of cardiovascular disease prevention strategies, the use of widely available and highly effective medicines, and the importance of people taking them as prescribed.
“But we must not lose sight of the bigger picture.
“These medications are needed because of the adverse effects of obesity on cardiovascular disease risk.
“Moreover, obesity still affects the body in many other ways and increases the risk of other health problems, including diabetes, kidney disease and some cancers.
“So, while this progress is encouraging, preventing and reducing obesity would result in a range of health benefits, in many cases without the need for these additional medicines.”