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Metabolically healthy obesity and metabolically obese normal weight: a review

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Abstract

Despite the general relationship between obesity and its co-morbidities, there are both obese individuals who scarcely present the associated pathologies (metabolically healthy obese; MHO) and individuals who present obesity alterations despite having normal weight (metabolically obese normal weight; MONW). It is still difficult to define metabolically MHO and MONW individuals because different classifications have been used in the studies reported. Indeed, different inclusion criteria have been used to discriminate between metabolically healthy and metabolically unhealthy subjects. Due to this and other reasons, such as differences in ethnicity, genetics, and lifestyle of the populations, data concerning the prevalence of MHO and MONW are very variable. The main determinants of MHO are type of growth (hypertrophy or hyperplasia), anatomical location, inflammation of adipose tissue, ectopic fat accumulation, genetic factors, and lifestyles factors. In the case of MONW, the main determinants are genetic background and lifestyle factors. With regard to treatment, it is not clear whether MHO subjects would benefit from traditional lifestyle interventions, based on diet energy restriction and increased physical activity. For MONW subjects, there is still no specialized treatment, and the therapies are the same as those used in obese subjects.

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Funding

This work was supported by grants from the University of the Basque Country under Grant GIU18-173 and Instituto de Salud Carlos III (CIBERobn).

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Author notes

  1. Saioa Gómez-Zorita and Maite Queralt contributed equally to this work.

Authors and Affiliations

  1. Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain

    Saioa Gómez-Zorita, Maite Queralt & María P. Portillo

  2. BIOARABA Health Research Institute, Vitoria, Spain

    Saioa Gómez-Zorita, Maria Angeles Vicente & María P. Portillo

  3. CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Vitoria, Spain

    Saioa Gómez-Zorita & María P. Portillo

  4. Alava University Hospital (Osakidetza), Vitoria, Spain

    Maria Angeles Vicente

  5. Nutrition and Food Science Department, Faculty of Biochemistry and Biological Sciences, National University of Litoral and National Scientific and Technical Research Council (CONICET), 3000, Santa Fe, Argentina

    Marcela González

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  1. Saioa Gómez-Zorita
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Key Points

• MONW and MHO phenotypes are not well defined

• MONW and MHO need to be more studied

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Gómez-Zorita, S., Queralt, M., Vicente, M.A. et al. Metabolically healthy obesity and metabolically obese normal weight: a review. J Physiol Biochem 77, 175–189 (2021). https://doi.org/10.1007/s13105-020-00781-x

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