MHO individuals display less visceral adipose tissue, smaller adipocytes, and a reduced inflammatory profile relative to metabolically unhealthy obese individuals.[3][4][5] As a result, it has been argued that cardiometabolic risk might not improve significantly as a result of weight loss interventions.[6]
Prevalence estimates of MHO have varied from 6 to 75 percent,[7] and it has been argued that between 10 and 25 percent of obese individuals are metabolically healthy.[8] One study found that 47.9% of obese people had MHO, while another found that 11% did.[3] It seems to be more prevalent in women than men, and its prevalence decreases with age.[9][10]
Some research suggests that metabolically healthy obese individuals are at an increased risk of several adverse outcomes when compared to individuals of a normal weight, including type 2 diabetes,[11]depressive symptoms,[12] and cardiovascular events.[13][14] Other research also suggests that although MHO individuals display a favorable metabolic profile, this does not necessarily translate into a decrease in mortality.[15] Research to date has produced conflicting results with respect to cardiovascular disease and mortality.[16] MHO individuals are at a higher risk of cardiovascular disease compared to metabolically healthy non-obese individuals, but they are also at a lower risk thereof than individuals who are both unhealthy and obese.[17][18] A 2016 meta-analysis found that MHO individuals were not at an increased risk of all-cause mortality (but were at an increased risk of cardiovascular events).[19] The relatively low risk of cardiovascular disease among people with MHO relative to metabolically unhealthy obese people has been attributed to differences in white adipose tissue function between the two groups.[20]
^Rey-López, JP; de Rezende, LF; Pastor-Valero, M; Tess, BH (October 2014). "The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used". Obesity Reviews. 15 (10): 781–90. doi:10.1111/obr.12198. PMID25040597. S2CID825441.
^Blüher, Susann; Schwarz, Peter (September 2014). "Metabolically healthy obesity from childhood to adulthood — Does weight status alone matter?". Metabolism. 63 (9): 1084–1092. doi:10.1016/j.metabol.2014.06.009. PMID25038727.
^van Vliet-Ostaptchouk, Jana V; Nuotio, Marja-Liisa; Slagter, Sandra N; Doiron, Dany; Fischer, Krista; Foco, Luisa; Gaye, Amadou; Gögele, Martin; Heier, Margit; Hiekkalinna, Tero; Joensuu, Anni; Newby, Christopher; Pang, Chao; Partinen, Eemil; Reischl, Eva; Schwienbacher, Christine; Tammesoo, Mari-Liis; Swertz, Morris A; Burton, Paul; Ferretti, Vincent; Fortier, Isabel; Giepmans, Lisette; Harris, Jennifer R; Hillege, Hans L; Holmen, Jostein; Jula, Antti; Kootstra-Ros, Jenny E; Kvaløy, Kirsti; Holmen, Turid; Männistö, Satu; Metspalu, Andres; Midthjell, Kristian; Murtagh, Madeleine J; Peters, Annette; Pramstaller, Peter P; Saaristo, Timo; Salomaa, Veikko; Stolk, Ronald P; Uusitupa, Matti; van der Harst, Pim; van der Klauw, Melanie M; Waldenberger, Melanie; Perola, Markus; Wolffenbuttel, Bruce HR (2014). "The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies". BMC Endocrine Disorders. 14 (1): 9. doi:10.1186/1472-6823-14-9. PMC3923238. PMID24484869.
^Eckel, Nathalie; Meidtner, Karina; Kalle-Uhlmann, Tamara; Stefan, Norbert; Schulze, Matthias B (2016). "Metabolically healthy obesity and cardiovascular events: A systematic review and meta-analysis". European Journal of Preventive Cardiology. 23 (9): 956–966. doi:10.1177/2047487315623884. PMID26701871. S2CID6085134.
^Primeau, V; Coderre, L; Karelis, A D; Brochu, M; Lavoie, M-E; Messier, V; Sladek, R; Rabasa-Lhoret, R (26 October 2010). "Characterizing the profile of obese patients who are metabolically healthy". International Journal of Obesity. 35 (7): 971–981. doi:10.1038/ijo.2010.216. PMID20975726.
^Phillips, Catherine M. (9 August 2013). "Metabolically healthy obesity: Definitions, determinants and clinical implications". Reviews in Endocrine and Metabolic Disorders. 14 (3): 219–227. doi:10.1007/s11154-013-9252-x. PMID23928851. S2CID489228.
^Fan, Jingyao; Song, Yiqing; Chen, Yu; Hui, Rutai; Zhang, Weili (October 2013). "Combined effect of obesity and cardio-metabolic abnormality on the risk of cardiovascular disease: A meta-analysis of prospective cohort studies". International Journal of Cardiology. 168 (5): 4761–4768. doi:10.1016/j.ijcard.2013.07.230. PMID23972953.
^Zheng, R; Zhou, D; Zhu, Y (28 April 2016). "The long-term prognosis of cardiovascular disease and all-cause mortality for metabolically healthy obesity: a systematic review and meta-analysis". Journal of Epidemiology and Community Health. 70 (10): 1024–1031. doi:10.1136/jech-2015-206948. PMID27126492. S2CID21145367.