Reviews in Endocrine and Metabolic Disorders

, Volume 14, Issue 3, pp 219–227 | Cite as

Metabolically healthy obesity: Definitions, determinants and clinical implications

  • Catherine M. PhillipsEmail author


Obesity is associated with increased risk of developing metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) leading to higher all-cause mortality. However accumulating evidence suggests that not all obese subjects are at increased cardiometabolic risk and that the “metabolically healthy obese” (MHO) phenotype may exist in the absence of metabolic abnormalities. Despite the knowledge of the existence of obese metabolic phenotypes for some time now there is no standard set of criteria to define metabolic health, thus impacting on the accurate estimation of the prevalence of the MHO phenotype and making comparability between studies difficult. Furthermore prospective studies tracking the development of cardiometabolic disease and mortality in MHO have also produced conflicting results. Limited data regards the determinants of the MHO phenotype exist, particularly in relation to dietary and lifestyle behaviours. In light of the current obesity epidemic it is clear that current “one size fits all” approaches to tackle obesity are largely unsuccessful. Whether dietary, lifestyle and/or therapeutic interventions based on stratification of obese individuals according to their metabolic health phenotype are more effective remains to be seen, with limited and conflicting data available so far. This review will present the current state of the art including the epidemiology of MHO and its definitions, what factors may be important in determining metabolic health status and finally, some potential implications of the MHO phenotype in the context of obesity diagnosis, interventions and treatment.


Metabolically healthy obesity Definitions Determinants: Diet Physical activity Inflammation, Mortality Treatment 



This work was supported by a research grant from the Irish Health Research Board (reference HRC/2007/13).

Disclosure summary

The author has nothing to disclose.


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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.HRB Centre for Diet and Health Research, Department of Epidemiology and Public HealthRoom 4.033, Western Gateway Building, University College CorkCorkIreland

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