It just goes to show, you really can’t tell by someone’s size whether they’re healthy or not. Someone who looks fabulous in a swimsuit might be a heart attack waiting to happen, while an overweight person may be otherwise healthy.

A new study from the University of Michigan finds a surprising number of overweight people — about half — have normal blood pressure and cholesterol levels, while about a fourth of normal-weight people (16 million adults!) have some of the health problems associated with obesity.

Part of the problem may come from the way we determine whether someone is overweight. There’s growing debate about the accuracy of using Body Mass Index (BMI) as the standard measurement. It’s a weight-height ratio that does not distinguish between fat and lean tissue. A few years ago, a report showed the BMI system would put nearly half of NBA players in the overweight category. That should tell you something!

Many experts say waist size is a more accurate way of determining health risks and that bigger bellies are linked with heart problems. This new study supports that argument.

The research also shows in all weight categories, risk factors for heart problems were generally more common in older people, smokers and those who were inactive.

The study authors stress the results do not mean we don’t need to worry about weight. Rather, we should all realize how important exercise is for staying healthy, no matter what we weigh.

The study is in the Archives of Internal Medicine.

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