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Published on: May 24, 2018
The metabolically obese, normal-weight individual revisited
N Ruderman1, D Chisholm, X Pi-Sunyer
1Evans Department of Medicine, Boston University Medical Center, Massachusetts 02118, USA. nruderman@med-med1.bu.edu
Diabetes
|May 20, 1998
Summary
Metabolically obese, normal-weight (MONW) individuals are common and predisposed to type 2 diabetes and heart disease. Early intervention with diet and exercise may prevent these conditions.
Area of Science:
- Metabolic health and disease prevention
- Endocrinology and cardiovascular research
Background:
- Metabolically obese, normal-weight (MONW) individuals exhibit insulin resistance and increased risk for type 2 diabetes and cardiovascular disease, despite normal BMI.
- MONW individuals are prevalent and may represent a significant portion of the insulin resistance syndrome spectrum.
- Adult-onset weight gain within a normal BMI range (20-27 kg/m2) is linked to increased disease risk in MONW individuals.
Purpose of the Study:
- To highlight the prevalence and risks associated with MONW individuals.
- To advocate for the early identification and intervention in MONW individuals to prevent metabolic diseases.
- To emphasize the potential of lifestyle interventions in preventing type 2 diabetes and other chronic conditions.
Main Methods:
- Review of existing evidence on MONW individuals and insulin resistance.
- Identification of predisposing factors such as central obesity, inactivity, and low cardiorespiratory fitness (VO2max).
- Consideration of data from studies demonstrating the efficacy of diet and exercise in preventing diabetes.
Main Results:
- MONW individuals share metabolic risk factors with overtly obese individuals, including hyperinsulinemia and insulin resistance.
- Factors like central fat distribution, physical inactivity, and low VO2max contribute to insulin resistance in both MONW and obese populations.
- Evidence suggests long-term diet and exercise interventions can reduce diabetes incidence in nonobese and minimally obese individuals with impaired glucose tolerance.
Conclusions:
- MONW individuals represent a critical, identifiable group at risk for serious metabolic and cardiovascular diseases.
- Early intervention strategies, including diet and exercise, are warranted for MONW individuals to prevent or delay disease onset.
- Further research is needed to evaluate the long-term effectiveness of interventions targeting young MONW individuals for disease prevention, potentially including obesity itself.
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