OBESITY – BETWEEN NORMALITY AND PATHOLOGY

Abstract

There are large amounts of evidence that obesity has many metabolic complications, notably dyslipidemia and metabolic syndrome, which increase the risk of developing type 2 diabetes mellitus and cardiovascular diseases. A unique subgroup of obese individuals, that seems to be protected against obesity related complications, has been identified so that obesity may be not paradigmatically associated with comorbidities. The purpose of this review was to investigate the roles of some metabolic factors, body composition, cardiovascular disease risk in metabolically healthy obese (MHO) individuals, and to emphasize metabolic and clinical characteristics of this subset of obese subjects. MHO individuals, despite their high fat mass, compared with at risk obese subjects, show a normal metabolic profile with remarkably normal to high levels of insulin sensitivity. Compared to “at risk” obese, this subgroup has lower visceral fat mass, that could explain insulin sensitivity, and early onset of obesity. Recent study suggest that MHO subject, also, have a favorable inflammatory profile with less C-reactive protein and IL-6 concentrations. We also analyzed the conclusions of different studies which had as a purpose to determine the role of diet in treatment of MHO subjects. A better understanding of metabolic healthy obesity individuals has important implications for medical education and research.