Metabolically healthy obesity across the life course: epidemiology, determinants, and implications

Ann N Y Acad Sci. 2017 Mar;1391(1):85-100. doi: 10.1111/nyas.13230. Epub 2016 Oct 10.

Abstract

In recent years, different subphenotypes of obesity have been described, including metabolically healthy obesity (MHO), in which a proportion of obese individuals, despite excess body fat, remain free of metabolic abnormalities and increased cardiometabolic risk. In the absence of a universally accepted set of criteria to classify MHO, the reported prevalence estimates vary widely. Our understanding of the determinants and stability of MHO over time and the associated cardiometabolic and mortality risks is improving, but many questions remain. For example, whether MHO is truly benign is debatable, and whether risk stratification of obese individuals on the basis of their metabolic health status may offer new opportunities for more personalized approaches in diagnosis, intervention, and treatment of diabetes remains speculative. Furthermore, as most of the research to date has focused on MHO in adults, little is known about childhood MHO. In this review, we focus on the epidemiology, determinants, stability, and health implications of MHO across the life course.

Keywords: definitions; determinants; life course; metabolically healthy obesity; personalized medicine; stability.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / physiopathology
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / physiopathology
  • Health Status
  • Humans
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / physiopathology
  • Obesity, Metabolically Benign / epidemiology*
  • Obesity, Metabolically Benign / physiopathology
  • Risk Factors