Obesity Research Analysis

Q: What are the factors that differentiate people with MHO from people with MUO?

Metabolically healthy obesity (MHO) is most common in women, younger adults, people with a BMI <35, and people of European ancestry.[6] Compared to people with metabolically unhealthy obesity (MUO), people with MHO have greater insulin sensitivity and insulin secretion, as well as less inflammation.[4][21] People with MHO also seem to have greater levels of physical activity and cardiorespiratory fitness.[22] Evidence suggests that differences in body fat distribution — which is controlled by genetics, age, sex, and total body fat content — explain a large part of the difference in cardiometabolic risk between people with MHO and MUO.[23] Specifically, people with MHO have more subcutaneous fat and less visceral and skeletal muscle fat.[24][25] People with MHO that consume excess calories display a much greater capacity for subcutaneous fat expansion via the formation of new fat cells than people with MUO who primarily accommodate excess calories by increasing the size of existing fat cells.[23][26] Subcutaneous fat expansion via new fat cell formation prevents fat deposition into visceral fat and results in smaller fat cells, attenuating the negative metabolic effects of obesity.

Q: How valid is BMI as a measure of health and obesity?

BMI is not a highly accurate measure of obesity. That being said, it can be useful as a complementary datum. BMI has a high rate of false negatives, particularly among females, with nearly half of obese people being classified as normal or overweight in some studies. The amount of false positives, on the other hand, is surprisingly small: less than 5% in men and 1% in women, according to one study.

Q: Do 95% of diets fail?

In most cases, someone undertaking a diet with the goal of losing weight — regardless of what diet it is — will experience initial weight loss, followed by a significant amount of weight regain.[36][37] But do “95% of diets fail”, as is sometimes claimed? This, of course, requires defining what is a “diet success”, and there is no universally accepted definition for what this means (and it likely varies according to each person’s needs and preferences). Nevertheless, some researchers have proposed a weight loss of ≥10% of one’s initial body weight after ≥1 year as successful weight loss.[38] Using that definition, the percentage of people achieving successful weight loss has been variable in studies, with rates of 10%,[39] 20%,[38] 26%,[40] and 33%[41] reported over periods of 1–8 years. An important note about these studies is that they usually included people who were exercising (or were recommended to do so), and physical activity seems to enhance the effect of dietary interventions on weight loss.[37]

Marina Shkayeva

Obesity

•Last Updated: August 19 2022

Obesity is a condition of excessive body fat that increases the risk for other conditions such as diabetes and heart disease. Fat is how the body stores extra calories that were eaten but not used. Obesity treatment usually involves restricting the calories eaten or creating negative calorie balance.

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Obesity falls under theFat Losscategory.

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Marina Shkayeva, PharmD

:

Nick Milazzo, MSc, MPH

Last Updated: August 19 2022

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Frequently asked questions

What is obesity?

Obesity means having more body fat than what's calculated to be healthy. Obesity increases the risk of diabetes, heart disease, stroke, arthritis, and some cancers. In people with obesity, losing even 5–10% of the total weight can delay or prevent some of these other conditions.^[1]

What is metabolically healthy obesity?

What are the factors that differentiate people with MHO from people with MUO?

How is obesity diagnosed?

Obesity is defined as having a body mass index (BMI) of greater than or equal to 30 kilograms per meters squared (kg/m²; “meters” meaning a person’s height). More specifically, a person with:^[2]

A BMI of 25 to 29.9 is “overweight”
A BMI of 30 to 34.9 has “class I obesity”
A BMI of 35 to 39.9 has “class II obesity”
And a BMI of 40 or higher has “class III obesity”

How valid is BMI as a measure of health and obesity?

What are some of the main medical treatments for obesity?

The primary treatment for obesity in patients without other health conditions is lifestyle modifications (i.e., changes to diet and exercise); sometimes, weight loss medications are also used. If lifestyle modifications do not work after trying for a long time, or if the person has class II or III obesity with additional chronic conditions like heart disease or diabetes, then bariatric surgery may be considered.^[2]

Have any supplements been studied for obesity?

Many dietary supplements and dietary ingredients have been studied for weight loss. In a recent meta-analysis of 67 randomized trials, the dietary ingredients chitosan, glucomannan, and conjugated linoleic acid were shown to help reduce weight by 1–1.9 kilograms. Other ingredients commonly studied for weight loss include green-tea-extract, green-coffee-extract, bitter orange, and Garcinia cambogia. Evidence about their effects is limited.^[3]

How could diet affect obesity?

Diet is central to both the development and the management of obesity and the mainstay of dietary interventions for treating obesity involves calorie restriction. A commonly used approach includes limiting daily calorie intake to 1200–1500 kilocalories (calories adjusted to a person’s weight) for women and 1500–1800 kilocalories for men. Another approach is eating a diet with a 500–750 kilocalorie deficit. Many different types of diets have been used for weight loss; the diet that will be most beneficial over time will vary from person to person, and adherence to the diet is crucial.^[2]

Do 95% of diets fail?

Are there any other treatments for obesity?

Physical activity and behavioral therapies are important in the treatment of obesity. Increasing physical activity increases calories burned and works in tandem with calorie-restricting diets for obesity. Engaging in 200–300 minutes of physical activity per week is recommended for those with obesity. Behavioral therapy usually involves regular self-monitoring of food intake, physical activity, and changes to weight.^[2]

What causes obesity?

Obesity happens after a prolonged time of eating more calories than what is needed and used by the body. Extra calories are stored as fat. The factors that determine caloric need differ for each person. Factors that affect weight include genetic makeup, overeating, eating high-fat foods, and not being physically active.^[1]

Does the microbiome influence body weight and obesity?

Examine Database: Obesity

Conjugated Linoleic Acid

Obesity

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