Highlights
- •Metabolically healthy obesity (MHO) is a unique phenotype of obesity which deserves further attention.
- •Although having a relatively favorable metabolic profile compared to metabolically unhealthy obesity (MUO), MHO is not a benign condition and is associated with a number of chronic diseases including cardiovascular disease, hypertension, type 2 diabetes, chronic kidney disease as well as certain types of cancer. In addition, MHO has the risk of progression into MUO.
- •The potential therapeutic alternatives to be used in MHO include dietary modifications, exercise, bariatric surgery and certain medications including glucagon-like peptide-1 (GLP-1) analogs, sodium-glucose cotransporter-2 (SGLT-2) inhibitors and tirzepatide.
- •Pre-clinical and large-scale clinical studies with long term follow-up are needed for improving our understanding of the pathophysiology, associations and the management approaches of MHO.
Abstract
Obesity is a heterogenous condition with multiple different phenotypes. Among these
a particular subtype exists named as metabolically healthy obesity (MHO). MHO has
multiple definitions and its prevalence varies according to study. The potential mechanisms
underlying the pathophysiology of MHO include the different types of adipose tissue
and their distribution, the role of hormones, inflammation, diet, the intestinal microbiota
and genetic factors. In contrast to the negative metabolic profile associated with
metabolically unhealthy obesity (MUO), MHO has relatively favorable metabolic characteristics.
Nevertheless, MHO is still associated with many important chronic diseases including
cardiovascular disease, hypertension, type 2 diabetes, chronic kidney disease as well
as certain types of cancer and has the risk of progression into the unhealthy phenotype.
Therefore, it should not be considered as a benign condition. The major therapeutic
alternatives include dietary modifications, exercise, bariatric surgery and certain
medications including glucagon-like peptide-1 (GLP-1) analogs, sodium-glucose cotransporter-2
(SGLT-2) inhibitors and tirzepatide. In this review, we discuss the significance of
MHO while comparing this phenotype with MUO.
Keywords
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Article info
Publication history
Published online: March 06, 2023
Accepted:
February 27,
2023
Received in revised form:
February 16,
2023
Received:
December 19,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
