Normal weight obesity

Normal weight obesity is the condition of having normal body weight, but with a high body fat percentage, leading to some of the same health risks as obesity.

Normal Weight Obesity
Other namesSkinny fat
A man with a mass of 175 lbs/79.3 Kg and a height of 5ft 11 in/181 cm with a Body mass index of 24.4. the noticeable part of the obesity is that there is a bit of fat around my buttocks, upper arms, hips, and legs so this is more of peripheral obesity than central obesity
SpecialtyEndocrinology
Risk factorsRapid weight loss, Sedentary lifestyle, Air pollution, Genetics, Diet high in refined carbohydrates and low protein, Age, Sleep deprivation, Stress, Alcohol consumption
PreventionGradual weight loss when overweight, Proper diet, Exercise,
TreatmentDiet, Exercise, Intermittent Fasting

Definition
Main article: Classification of obesity

The term "metabolically obese normal weight" (MONW) refers to people with normal weight and body mass index (BMI), who display some metabolic characteristics which increase the risk of developing metabolic syndrome in the same way as obesity. People with MONW have excess visceral fat, and are predisposed to hyperinsulinemia, insulin-resistance and thus predisposition to type 2 diabetes, hypertriglyceridemia, hypertension and premature coronary heart disease or cardiovascular disease.[1] The BMI does not capture information about percentage body fat (PBF), which is a better predictor of risk due to obesity.[2][3][4][5] Some studies have suggested that the main factor which explains the metabolic abnormalities in MONW individuals is fat distribution. On the basis of these studies, a scoring method has been proposed to identify MONW individuals, based on the presence of associated diseases or biochemical abnormalities related to insulin resistance.[6]

Prevalence

In 2008, the first prevalence of US adults above 20 years was published, based on the National Health and Nutrition Examination Surveys from 1999-2004, finding that 24% of normal-weight adults were metabolically abnormal; on the other hand 51% of overweight adults and 32% of obese adults were metabolically healthy.[7] An analysis from an earlier NHANES from 1988 to 1994 found people with NWO had a four-fold higher frequency of metabolic syndrome compared with the low body fat group.[8]

Treatment

As of 2018, optimal treatment is unknown.[9] A 1998 study suggested that energy restriction and weight loss, for example a 4- to 12-week period of diet and exercise was beneficial.[1] A small study of 11 Asians with MONW published June 2018 found that moderate weight loss through dieting reduced their cardiometabolic risk per improved body composition, lipid profile, and insulin sensitivity.[9]

References
  1. Ruderman, N; Chisholm, D; Pi-Sunyer, X; Schneider, S (May 1998). "The metabolically obese, normal-weight individual revisited". Diabetes. 47 (5): 699–713. doi:10.2337/diabetes.47.5.699. PMID 9588440.
  2. Gómez-Ambrosi, J; Silva, C; Galofré, JC; Escalada, J; et al. (2012). "Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity". Int J Obes (Lond). 36 (2): 286–94. doi:10.1038/ijo.2011.100.
  3. Flegal, KM (2010). "Commentary: the quest for weight standards". Int J Epidemiol. 39 (4): 963–7. doi:10.1093/ije/dyq124.
  4. Sun, Q; van Dam, RM; Spiegelman, D; et al. (2010). "Comparison of Dual-Energy X-Ray Absorptiometric and Anthropometric Measures of Adiposity in Relation to Adiposity-Related Biologic Factors". Am J Epidemiol. 172 (12): 1442–54. doi:10.1093/aje/kwq306. PMC 2998203.
  5. World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995; 854: 1–452. Okorodudu DO, Jumean MF, Montori VM, et al. Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and metaanalysis. Int J Obes 2010 34(5): 791-9
  6. Karelis, AD; St-Pierre, DH; Conus, F; Rabasa-Lhoret, R; Poehlman, ET (2004). "Metabolic and body composition factors in subgroups of obesity:what do we know?". J Clin Endocrinol Metab. 89: 2569–2575. doi:10.1210/jc.2004-0165.
  7. Wildman RP, Muntner P, Reynolds K, et al. The Obese Without Cardiometabolic Risk Factor Clustering and the Normal Weight With Cardiometabolic Risk Factor Clustering. Prevalence and Correlates of 2 Phenotypes Among the US Population (NHANES 1999-2004). Arch Intern Med. 2008;168(15):1617–1624. doi:10.1001/archinte.168.15.1617
  8. Abel Romero-Corral, Virend K. Somers, Justo Sierra-Johnson, Yoel Korenfeld, Simona Boarin, Josef Korinek Michael, D. Jensen Gianfranco Parati, Francisco Lopez-Jimenez Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality European Heart Journal, Volume 31, Issue 6, 1 March 2010, Pages 737–746.
  9. Rubin R. What’s the Best Way to Treat Normal-Weight People With Metabolic Abnormalities? JAMA. 2018;320(3):223–225. doi:10.1001/jama.2018.8188
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