The amount of obese people in the United States continues to climb, and it’s estimated that nearly 37 percent of US citizens are now classified as obese. While most have accepted that obesity is an unhealthy condition that can lead to a shorter lifespan, there are many that have believed that it’s possible to both be healthy and obese. Some that are overweight can still have normal levels of blood pressure, cholesterol and other vital statistics, which has prompted a movement called “fat but fit.”

Around one-third of obese adults have numbers considered to be healthy, allowing them to prevent insulin resistance and avoid type 2 diabetes. Researchers were trying to find out why, with Dr. Jeffrey Horowitz of the University of Michigan saying “It sounds counterintuitive, but if we can better understand how to store fat more effectively, and why some people are better at this than others, perhaps we can design therapies and preventions that will improve some of these obesity-related metabolic conditions.”

Horowitz said that it’s possible to improve your health while gaining weight, saying “We believe that the regular exercise we do now may create a healthier fat-storing environment for those times when we do overeat and gain weight.” He added that “When people gain the same amount of body fat, those with adaptations to their fat tissue that can more healthfully accommodate the extra fat may be protected from developing insulin resistance and obesity-related diseases.”

However, a recent study is saying that even if you continue to exercise while gaining weight, you’re still putting yourself at a much higher risk of health issues, even if you’re exercising more than you did at a lower weight. You can avoid certain problems while obese by living a healthier lifestyle, but other risks are more present when carrying the extra weight.

This study was conducted by Dr. Rishi Caleyachetty and his team over the course of 20 years, and said that those who were obese increased their risk of stroke or heart disease by 50 percent, while those that were overweight increased their risk by 30 percent, even if their other vital signs were healthy overall. “The bottom line is that metabolically healthy obesity doesn’t exist,” Caleyachetty said. “Obesity is not a benign condition.”

This was not a small study, either, as it was not only conducted over two decades, but also included 3.5 million people. 21.9 percent of the participants were obese, of which 14.8 percent were metabolically healthy. Dr. Carl Lavie argued that certain aspects of the study couldn’t take everything into account, including using body mass index to calculate obesity instead of other factors, and that daily physical activities couldn’t be accurately measured.

“For the very large number of people who are overweight or mildly obese, I don’t think it’s doomsday if they can keep themselves out of the low fitness level,” Dr. Lavie said. Dr. Caleyachetty did agree with that aspect, saying “Those people who are metabolically healthy, obese and vigorously active may have a decreased risk of developing cardiovascular disease.”

Dr. Lavie added focusing on your physical activity was more important than tracking the numbers on the scale, saying “I do think that’s a better message than telling people ‘You better not gain weight.’ People aren’t trying to gain weight. They’re not trying to get to be obese. A better message would be to tell people that if they get themselves more physically active, they can improve their prognosis, despite carrying a few extra pounds. That’s a better message, and a more obtainable message.”

Other doctors supported Caleyachetty’s study, with Dr. Jennifer Bea saying “Obesity itself is a metabolic disorder,” and that being overweight or obese increases inflammation in the body, leading to heart disease and other complications. Caleyachetty said “The priority of health professionals should be to promote and facilitate weight loss among obese persons, regardless of the presence or absence of metabolic abnormalities.”

The study was summed up by saying “Metabolically healthy obese individuals had a higher risk of coronary heart disease, cerebrovascular disease and heart failure than normal weight metabolically healthy individuals. Even individuals who are normal weight can have metabolic abnormalities and similar risks for cardiovascular disease events.” The numbers certainly speak for themselves, though opponents maintain there aren’t enough factors taken into account.

Dr. Patrick Bradshaw is one of those opponents, saying those at a normal weight aren’t given a healthy guideline like obese patients are by most doctors. The message of the study, he said, “is that metabolic health is important regardless of your weight.” It’s suggested by most professionals that patients get at least 150 minutes of moderate aerobic exercise per week, or 75 minutes of vigorous exercise to maintain their health.