Metabolically healthy obesity

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Metabolically healthy obesity
Synonyms MHO, Metabolically-healthy obesity
Pronounce N/A
Specialty N/A
Symptoms Obesity without metabolic abnormalities
Complications Potential long-term cardiovascular risks
Onset Variable, typically adulthood
Duration Chronic, variable
Types
Causes Genetic, environmental, lifestyle factors
Risks Family history, diet, physical activity levels
Diagnosis Clinical assessment, absence of metabolic syndrome components
Differential diagnosis Metabolic syndrome, standard obesity
Prevention Healthy lifestyle, balanced diet, regular exercise
Treatment Lifestyle modifications (diet and physical activity)
Medication Generally not required, supportive if metabolic health deteriorates
Prognosis Controversial; some studies suggest potential long-term risks
Frequency Estimates vary widely, 6–75%
Deaths Usually related to eventual metabolic complications


Metabolically healthy obesity (MHO), also known as metabolically-healthy obesity, is a disputed medical condition characterized by obesity that does not result in metabolic complications commonly associated with excess weight. These complications include dyslipidemia, impaired glucose tolerance, and metabolic syndrome.

Characteristics[edit | edit source]

There is no universally accepted definition for MHO. However, diagnostic criteria generally include:

  • Obesity as defined by a body mass index (BMI) of ≥30 kg/m²
  • Absence of significant metabolic abnormalities such as:

Individuals with MHO typically demonstrate:

Due to these characteristics, it has been proposed that cardiometabolic risk might not significantly improve following weight loss interventions in MHO individuals.

Epidemiology[edit | edit source]

Estimates of the prevalence of MHO vary widely, ranging from 6% to 75%. It is generally believed that approximately 10–25% of obese individuals may be metabolically healthy. Reported findings include:

  • One study identifying 47.9% of obese individuals as having MHO
  • Another reporting just 11%

MHO is more commonly observed in women than in men and tends to decline with increasing age.

Clinical Significance[edit | edit source]

The clinical importance of MHO remains controversial. While MHO individuals appear to have a more favorable metabolic profile in the short term, long-term studies suggest they may still be at elevated risk for:

Therefore, continued monitoring and lifestyle optimization are recommended.

Management[edit | edit source]

Even in the absence of metabolic dysfunction, management for individuals with MHO typically includes:

  • Balanced, nutrient-rich diet
  • Regular physical activity
  • Weight monitoring and regular check-ups to detect any metabolic changes early

Current guidelines emphasize the importance of preventive care and individualized risk assessment for patients with MHO.

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Contributors: Prab R. Tumpati, MD