New research further undermined the idea of “healthy obesity.”

There is an ongoing scientific controversy over whether obese individuals with no metabolic abnormalities, such as diabetes, high cholesterol, or hypertension, should be treated as higher risk.

A new study of 157,000 people over 13 years found that obese people, especially women, with no such conditions were at higher risk of cardiovascular disease, death, and other negative outcomes than people of normal weight.

The finding supports those of previous research, and is incremental rather than groundbreaking, but boosts calls for the roughly 300 million people worldwide in the “obese but metabolically healthy” category to be offered earlier risk assessments and other potential interventions.