Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

OBESITY

Metabolically healthy obesity: time for a change of heart?

Nature Reviews Endocrinology volume 17, pages 519–520 (2021)Cite this article

Subjects

Metabolically healthy obesity (MHO) describes the presence of obesity with limited or no features of poor metabolic health. MHO might be a transient state associated with long-term health complications. A recent study highlights that MHO is associated with an increased risk of heart failure. Obesity, in all forms, requires intervention.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Obesity phenotypes.

References

  1. Stefan, N. et al. Identification and characterization of metabolically benign obesity in humans. Arch. Intern. Med. 168, 1609–1616 (2008).

    Article  Google Scholar 

  2. Smith, G. I., Mittendorfer, B. & Klein, S. Metabolically healthy obesity: facts and fantasies. J. Clin. Invest. 129, 3978–3989 (2019).

    Article  Google Scholar 

  3. Zembic, A., Eckel, N., Stefan, N., Baudry, J. & Schulze, M. B. An empirically derived definition of metabolically healthy obesity based on risk of cardiovascular and total mortality. JAMA Netw. Open 4, e218505 (2021).

    Article  Google Scholar 

  4. Caleyachetty, R. et al. Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women. J. Am. Coll. Cardiol. 70, 1429–1437 (2017).

    Article  Google Scholar 

  5. Kramer, C. K., Zinman, B. & Retnakaran, R. Are metabolically healthy overweight and obesity benign conditions?: A systematic review and meta-analysis. Ann. Intern. Med. 159, 758–769 (2013).

    Article  Google Scholar 

  6. Dobson, R. et al. Metabolically healthy and unhealthy obesity: differential effects on myocardial function according to metabolic syndrome, rather than obesity. Int. J. Obes. 40, 153–161 (2016).

    Article  CAS  Google Scholar 

  7. Commodore-Mensah, Y. et al. High burden of subclinical and cardiovascular disease risk in adults with metabolically healthy obesity: The Atherosclerosis Risk in Communities (ARIC) Study. Diabetes Care https://doi.org/10.2337/dc20-2227 (2021).

    Article  PubMed  Google Scholar 

  8. Morkedal, B., Vatten, L. J., Romundstad, P. R., Laugsand, L. E. & Janszky, I. Risk of myocardial infarction and heart failure among metabolically healthy but obese individuals. The HUNT Study, Norway. J. Am. Coll. Cardiol. 63, 1071–1078 (2013).

    Article  Google Scholar 

  9. Zhou, Z. et al. Are people with metabolically healthy obesity really healthy? A prospective cohort study of 381,363 UK Biobank participants. Diabetologia https://doi.org/10.1007/s00125-021-05484-6 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mongraw-Chaffin, M. et al. Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk. J. Am. Coll. Cardiol. 71, 1857–1865 (2018).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK

    Daniel J. Cuthbertson & John P. H. Wilding

  2. University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK

    Daniel J. Cuthbertson & John P. H. Wilding

Authors
  1. Daniel J. Cuthbertson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John P. H. Wilding
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel J. Cuthbertson.

Ethics declarations

Competing interests

D.J.C. has received funding for investigator-initiated studies from AstraZeneca, Novo Nordisk, Pfizer, Ipsen and Boehringer Ingelheim and educational grants from Janssen Pharmaceuticals, Lilly and Sanofi. J.P.H.W. has acted as a consultant, received institutional grants, and given lectures on behalf of pharmaceutical companies developing or marketing medicines used for the treatment of diabetes and obesity, specifically Astellas, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen Pharmaceuticals, Mundipharma, Napp, Novo Nordisk, Orexigen, Rhythm Pharmaceuticals, Sanofi and Takeda, and Wilmington Healthcare.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cuthbertson, D.J., Wilding, J.P.H. Metabolically healthy obesity: time for a change of heart?. Nat Rev Endocrinol 17, 519–520 (2021). https://doi.org/10.1038/s41574-021-00537-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41574-021-00537-7

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing