Metabolically healthy obesity: definitions, determinants and clinical implications

Area of Science:

• Endocrinology
• Metabolic Health
• Obesity Research

Background:

• Obesity is linked to metabolic syndrome, type 2 diabetes, cardiovascular disease, and mortality.
• The metabolically healthy obese (MHO) phenotype suggests some obese individuals may not have metabolic abnormalities.
• Lack of standardized criteria for metabolic health impedes accurate MHO prevalence estimation and study comparability.

Purpose of the Study:

• To review the current understanding of the MHO phenotype.
• To discuss the epidemiology, definitions, and determinants of MHO.
• To explore the implications of MHO for obesity diagnosis, interventions, and treatment.

Main Methods:

• Literature review of existing studies on obesity and metabolic health.
• Analysis of epidemiological data regarding MHO prevalence.
• Synthesis of research on dietary and lifestyle factors influencing metabolic health in obesity.

Main Results:

• Conflicting results exist regarding the long-term cardiometabolic disease risk and mortality in MHO individuals.
• Limited data is available on the specific dietary and lifestyle behaviors that determine the MHO phenotype.
• Current 'one-size-fits-all' obesity interventions are largely unsuccessful.

Conclusions:

• Standardized criteria are needed to define and identify the MHO phenotype accurately.
• Understanding MHO determinants is crucial for personalized obesity management.
• Stratifying obese individuals by metabolic phenotype may lead to more effective interventions.