UPDATING THE CONCEPT OF METABOLICALLY HEALTHY OBESITY

Area of Science:

• Endocrinology
• Metabolic Health
• Obesity Medicine

Background:

• Obesity is a major risk factor for type 2 diabetes, cardiovascular disease, and cancer.
• Metabolically healthy obesity (MHO) is a subtype characterized by reduced metabolic complications despite high BMI.
• Diagnostic criteria for MHO are not universally established, leading to variable prevalence estimates.

Discussion:

• MHO is broadly defined by lower visceral fat, a better inflammatory profile, and less insulin resistance than metabolically unhealthy obesity.
• Controversy exists regarding the long-term cardiovascular event risk and all-cause mortality associated with MHO.
• Further research is required to precisely identify the MHO phenotype and its health trajectory.

Key Insights:

• MHO presents a paradox: obesity without typical metabolic dysfunction.
• Understanding MHO mechanisms is crucial for personalized health strategies.
• Distinguishing MHO from metabolically unhealthy obesity is key for risk stratification.

Outlook:

• Future research should focus on refining MHO diagnostic criteria.
• Investigating the transition from MHO to metabolically unhealthy obesity is essential.
• Longitudinal studies are needed to clarify the long-term prognosis of MHO.