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Healthy obesity

Wildman, Rachel P

Current Opinion in Clinical Nutrition and Metabolic Care: July 2009 - Volume 12 - Issue 4 - p 438–443
doi: 10.1097/MCO.0b013e32832c6db7
Carbohydrates: Edited by David D'Alessio and Luc Tappy

Purpose of review To introduce the healthy obese phenotype, characterized by favorable cardiometabolic risk factors despite excess adipose tissue. The epidemiology of the healthy obese phenotype is presented, including associated risk of cardiovascular disease (CVD), and potential biologic mechanisms which may give rise to the phenotype are discussed.

Recent findings Although it appears that approximately 30% of obese individuals maintain healthy cardiometabolic profiles, little published data exist examining the healthy obese phenotype. The healthy obese do not appear to be at increased risk of incident CVD events compared with at-risk obese, and the location of adipose tissue and the metabolic characteristics of the fat in a given location, including the presence of ectopic fat and associated adipocytokine response, may give rise to the phenotype. Recent data also suggest that weight loss among healthy obese may adversely impact their favorable cardiometabolic profile.

Summary A high prevalence of the healthy obese phenotype has been reported, and these individuals appear to be at no increased risk of CVD. Further research is needed into the mechanisms that allow these individuals to maintain low risk of CVD despite excess adiposity and appropriate weight loss recommendations for this group.

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA

Correspondence to Rachel P. Wildman, PhD, MPH, FAHA, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Room 1309, Bronx, NY 10461, USA Tel: +1 718 430 2316; fax: +1 718 430 8780; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.