Normal weight obesity: a South Asian phenotype

Recent guidelines emphasize the significance of measuring adiposity rather than relying solely on BMI. This shift underscores the importance of normal-weight obesity (NWO), which is identified by assessing body fat percentage. This review presents recent advances in understanding NWO, including several substantial cohort studies that examine its prevalence, pathophysiology, and clinical implications.

The prevalence of NWO is notably high. Extensive cohort studies have established its association with increased cardiometabolic mortality, changes in microbiota diversity and composition, and alterations in body composition, including a reduction in brown adipose tissue. Body composition metrics, such as the android-gynoid ratio, have emerged as significant indicators of metabolic health. Additionally, the association with ultra-processed foods underscores the need to integrate nutrition and exercise regimens into treatment protocols.

NWO represents a clinically significant condition that requires early diagnosis to improve cardiometabolic outcomes.