Metabolically healthy versus unhealthy obesity and risk for diabetes mellitus and cardiovascular diseases

Obesity presents one of the biggest issues of modern-day life for a wide variety of medical specialties, starting with the cardiologist and ending with the diabetologist or the bariatric surgeon. However, in the last few years a new entity has emerged, the metabolically healthy obese (MHO) individual. This category encompasses obese individuals without the presence of metabolic diseases such as type 2 diabetes mellitus, dyslipidemia, or hypertension. Several studies have thus been undertaken to determine the risk of these MHO individuals for diabetes mellitus or cardiovascular diseases compared with the ‘unhealthy’ obese. Data are still controversial on this matter, but one trend seems to be emerging: MHO is but a transient phase in the path toward insulin resistance and metabolic syndrome.