Trump is obese, but his doctor says he’s in ‘good health’ — can you be both? – MarketWatch

This is a weighty debate.

Trump’s doctor declared Thursday that the President was in “good health” despite gaining four pounds. The commander-in-chief now stands at 6-foot-3 and weighs in at 243 pounds, according to a memorandum released by the White House.

This weight gain tips Trump’s body mass index over 30,^[1] which is the threshold for obesity^[2]. Despite this, Sean P. Conley, the president’s doctor, wrote that his health was solid.

“After taking into account all the laboratory results, examinations and specialist recommendations, it is my determination that the President remains in very good health overall,” Conley wrote.

Trump has plenty of company on the weight front. More than one-third of U.S. adults are obese, according to the Centers for Disease Control and Prevention^[3]. And though residents of some states are slimmer than others, there is not a single state in America that has obesity rates lower than 20%.

But some research suggests that obesity may not be all that bad for everyone. In a 2012 study published in the European Heart Journal, researchers determined that some people can be obese yet healthy and fit. Those who were what’s called “metabolically fit” — which means, like Trump, they didn’t have high cholesterol, blood pressure or blood sugars; and they exercised — weren’t more likely than others to get heart disease or cancer. “Looking at data from over 43,000 US people they found that being overweight per se did not pose a big health risk,” the BBC wrote at the time.^[4]

But this “fit but fat” finding doesn’t carry weight with other researchers. Researchers from the University of Birmingham^[5] have found that people who are obese have a higher risk of stroke, heart disease and heart failure — even when they don’t have traditional warning signs of such things like high blood pressure or diabetes. The study examined 3.5 million subjects, 61,000 of whom got heart disease, from 1995 to 2015.

These findings fly in the face of the notion that you can be fat but still medically fit, or the idea that the extra weight won’t hurt you if you’re metabolically healthy. “This is the largest prospective study of the association between metabolically health obesity and cardiovascular disease events. Metabolically healthy obese individuals are at higher risk of coronary heart disease, cerebrovascular disease and heart failure than normal weight metabolically healthy individuals,” Rishi Caleyachetty, one of the study authors, says.^[6]

Whatever the answer, for many of us, obesity comes not just with a health cost, but also with a financial one. Obese people face medical costs that are $1,429 higher each year^[7] than those who are normal weight.

What’s more, there are a number of indirect costs as well. Overweight people tend to earn less^[8] in their careers than those who are normal weight — a problem that is even worse for women. Another study found^[9] that roughly half of employers were “unlikely” to hire someone who is overweight.

This story was originally published in 2017 and has been updated with Trump’s health report.