Obesity-associated disorders in normal-weight individuals: some speculations

A number of disorders including maturity-onset (Type II) diabetes, hypertension and hypertriglyceridemia are frequently associated with adult-onset obesity and improve with energy restriction. It is the premise of this brief review that there are patients with these disorders who are not obese according to standard criteria; but who would also respond favorably to energy restriction. It is proposed that these 'metabolically-obese, normal weight' individuals might be characterized by hyperinsulinism and possibly an increase in fat cell size, compared to patients of similar age, height and weight and/or to themselves at an earlier time. It is also proposed that in some of these individuals inactivity and diet composition might be important contributing factors, and that for them, the appropriate therapy would include exercise and altered diet composition.