Effects of Weight Loss Among Metabolically Healthy Obese Men and Women

OBJECTIVE

Weight loss among metabolically healthy obese (MHO) individuals may be unnecessary or result in elevated cardio-metabolic risk. We studied the effects of exercise- or diet-induced weight loss on cardio-metabolic risk among MHO and metabolically abnormal obese (MAO) adults.

RESEARCH DESIGN AND METHODS

Participants were 63 MHO and 43 MAO adults who took part in 3 to 6 months of exercise- or diet-induced weight loss intervention. Changes in anthropometry, adipose tissue distribution, and cardio-metabolic risk factors were assessed.

RESULTS

Body weight, waist circumference, and total abdominal and visceral adipose tissue were reduced in all subjects (P < 0.05). Improvements in insulin sensitivity were observed in MHO and MAO men and women (P < 0.05), but were greater in the MAO individuals (P < 0.05). Fasting insulin was the only other cardio-metabolic improvement among MHO individuals (P < 0.05).

CONCLUSIONS

Lifestyle-induced weight loss among MHO subjects is associated with a reduction in total and abdominal obesity and improvement in selected cardio-metabolic risk factors.Weight loss among metabolically healthy obese (MHO) individuals characterized by low cardio-metabolic risk and low prospective risk of type 2 diabetes and cardiovascular disease may be unnecessary and paradoxically may actually increase health risk (1,2). That weight reduction may be contraindicated for MHO individuals is at odds with the standing recommendation from leading health authorities that weight loss be the primary treatment strategy for all obese patients, regardless of cardio-metabolic status (3). We sought to investigate the effects of exercise- and diet-induced weight reduction on cardio-metabolic risk factors among MHO and metabolically abnormal obese (MAO) adults.