“Metabolically Healthy” Obesity: Fact or Threat?

Introduction: Obesity is a serious, worldwide and growing problem, with associated complications ranging from cardiovascular disease to cancer. It has been suggested that a subgroup of obese patients- the “metabolically healthy” (MH)- would constitute a phenotype whose cardiovascular risk would be closer to that of normal weight individuals and lower than that of obese patients with other risk factors. The definitions of MH obesity are heterogeneous, what makes the estimation of its prevalence quite difficult. Besides that, data are still controversial about the risk of incident cardiovascular disease in these patients and therefore this remains an unresolved matter. In parallel, the possibly lower risk of MH obesity may raise questions about the need for weight loss in MH obese patients. Conclusion: This issue should be carefully addressed, and evidence for a “benign” profile of MH obesity critically evaluated, as obesity is a risk factor for numerous health outcomes, and weight loss in obese people additionally offers protection against these nonmetabolic diseases.