A lot of fat people claim that they don’t have any ailments—so that must mean they're perfectly healthy and in shape!—or that you can still be obese but be fit and hold the same risk for chronic diseases as healthy-weight people. But recent research from the University of Birmingham in the U.K. found that obese people who seem to be healthy on paper have a higher risk for cardiovascular disease.

The study, which was presented at the European Congress on Obesity, looked at the health records of around 3.5 million people in the U.K. from 1995 to 2015 who didn’t have heart disease at the start of the survey, and then grouped them according to BMI and if they had diabetes, high blood pressure, or blood fat levels out of the ordinary. Those subjects who had a high BMI but none of the other aliments were classified as the “metabolically healthy obese,” but they were shown to be 50% more likely to have heart disease, 7% more likely to have a stroke or heart attack, and 11% more at risk to develop poor circulation to the limbs.

"This is the largest prospective study of the association between metabolically health obesity and cardiovascular disease events,” said study co-author Rishi Caleyachetty, Ph.D., an epidemiologist at the university. “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. At the population level, so-called metabolically healthy obesity is not a harmless condition, and perhaps it is better not to use this term to describe an obese person, regardless of how many metabolic complications they have."

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