Obesity vs. Metabolically Healthy Obesity in East Asia

With over one-third of East Asia’s 1.7 billion people overweight or obese, mounting demographic pressure and burgeoning healthcare costs are forcing public health officials to grapple with the rising morbidity and mortality associated with obesity. However, the presence of metabolically healthy obesity, in which the short-term disease risks of diabetes and heart disease are low, represents a possible buffer for healthcare planning in East Asia. This narrative review analyzes the health risks from obesity through representative Japan- and China-specific analyses that take into account unique cultural, genetic, and other factors that drive obesity; the potential impact of metabolically healthy obesity on public health; and suggested non-surgical/non-pharmacological interventions to relieve pressure on the nationalized healthcare systems prevalent in the region. Such an emphasis on interventions to both delay obesity as well as potentially reverse metabolic syndrome could save millions of lives and billions of USD equivalents in healthcare throughout East Asia.