Does Metabolically Healthy Obesity Even Exist?

SPEAKER_1 (0:03)

Welcome to the Docs Who Lift Podcast, where we distill and simplify the complexities of a healthy lifestyle, exercise, medicine, and weight loss.

We're excited to bring you a podcast that's a prescription for clinical practice, scientific recommendations, and just real life. This is the Docs Who Lift Podcast.

Spencer Nadolsky (0:29)

Hey, hey, welcome back to the Docs Who Lift Podcast. I'm your host, Dr. Spencer Nadolsky, with my co-host, Mr. Doctor No-Myostatin Gene Nadolsky, Karl Nadolsky Jr. We have a really special guest today. They're all special, but this guy came from my chief scientific officer's lab. His name is Dr. Christian Rodriguez. He's at Pennington, one of our favorite places down in Baton Rouge, right? But down in Louisiana, one of the biggest research centers for understanding obesity and metabolism, and he is working with Dr. Steve Heymsfield, who people may remember.

We talked about the BELIEF trial with Bamagrimab with some agglutide, and he's also working with Dr. Eric Ravussin, who is one of the big time metabolism researchers who has oftentimes worked with Dr. Kevin Hall, who is also on our podcast. Today we're inviting him on because he has a new review talking about whether metabolically healthy obesity exists or not and using some of these newer guidelines and clinical definitions of obesity. We have a podcast on this from a few years ago, but it'll be fun to have a nice little update with someone who's studying this directly. So welcome to the podcast, Dr. Rodriguez.

Christian Rodriguez (1:53)

Thank you. Thank you. I appreciate you all having me.

Spencer Nadolsky (1:56)

Yeah. Okay. So a little bit of background. You did a master's and PhD with Dr. Grant Tinsley, and what were you studying with him?

Christian Rodriguez (2:05)

Let's see. Yeah, he's actually the reason I got into research.

He was my first year of my master's. I had no idea what research was, what it entailed, and he was my advisor and then he just asked if I wanted to help out in the lab. I almost said no to this day. I tell him all the time. I was this close to saying no. I just didn't know what it was. I said yes, and then for, let's see, two years master's, four years PhD, so six years, I just started learning all about body composition, metabolism as well, and for the most part, we did a lot of, let's say, methodological work looking at how accurate are these devices? How valid are they? How reliable are they?

Standardization, is it important? Like if we let these people drink water, is that important if we let them exercise? But my dissertation, so I have this interest, and I guess you could say, physique, sports, bodybuilding. I've always had that interest for a while. Dr. Tenzi knew about that.

And my dissertation was in muscular resistance trained adults, which is like the scientific way, I guess, for saying these people were jacked. We wanted to try to get the most jacked people in. And we tried to use as strict of a criteria, as we have seen. Like, I haven't seen anyone use this strict of a criteria, because we wanted to actually be able to say these people were over resistance training. And Dr. Tenzi was in my study. I don't know if I can say that. I don't know if that's a violation of HIPAA or something.

Spencer Nadolsky (3:58)

He's fine, I don't care.

Christian Rodriguez (4:00)

And he was in my study. He had the lowest amount of fat-free mass, the highest body fat shortage, just everything. I'm just kidding, he didn't. But so to qualify, to qualify, because I'm pretty proud of these criteria. The manuscripts are in review right now, but to qualify, they had to have resistance trained three times per week for the past five years. No layoffs greater than a month within the last five years. No layoffs greater than two weeks within the last year. Males had to be below 20% body fat on Dexa, greater than 21.5 fat free mass index. Females had to be below 27.5% on Dexa and greater than 17 fat free mass index.

And trained like major body parts once weekly.

So we got a lot of cool, and it was natural and enhanced. So if they were enhanced, we didn't care. So we got some pretty cool people in that study. We were essentially just trying to evaluate how accurate all these devices were in estimating body composition as compared to a multi-compartment, four-compartment model. So we had like 12 devices and it was our first time doing deuterium dilution as well. So we had a criteria on metal model for total body water assessment. We did RMR as well. So hopefully those results will be coming out pretty soon.