Healthy obesity

What is Healthy Obesity?

Although obesity is a major risk factor for cardiovascular disease and type 2 diabetes mellitus, about a third of obese individuals maintain healthy cardiometabolic profiles; this phenotype of healthy obesity may be linked to the location of adipose tissue and the metabolic characteristics of the fat. Some data also suggest that weight loss by healthy obese subjects may have an adverse impact on their favorable cardiometabolic profile.

Why is Healthy Obesity Worthwhile investigating?

Investigating why H.O can't be regarded as simply obesity e.g. treatment problems, some weight losing methods actually detrimental to H.O individual

Waste of money to treat all H.O individuals as simply obese?

The Cause of Healthy Obesity?

Adiponectin and Healthy Obesity

Adiponectin is a protein hormone which is secreted into the bloodstream from adipose tissue and modulates several metabolic processes, including fatty acid catabolism and glucose regulation. The level of adiponectin in the bloodstream is inversely correlated to the percentage of body fat in adults. It is associated with the suppression of metabolic processes that can lead to obesity, type 2 diabetes mellitus and NAFLD. Diabetics tend to have reduced levels of the hormone and levels of adiponectin are significantly increased with weight loss. Other metabolic effects of adiponectin action are: decreased gluconeogenesis and increased glucose uptake; lipid catabolism; protection from endothelial dysfunction; insulin sensitivity, and control of energy metabolism. Hypoadiponectinaemia, therefore, is an independent risk factor for metabolic syndrome and type 2 diabetes mellitus– two conditions associated with an unhealthy metabolic profile of obese individuals.

It has been found that there is an inverse relationship between body mass index (BMI) and concentrations of adiponectin in both humans and animals. However, recent studies have shown that in ob/ob mice - mutant mice that eat excessively and become obese - overexpression of the adiponectin gene in its adipose tissue increased plasma adiponectin concentrations, keeping them in a physiological range. This increase in adiponectin concentrations resulted in significant weight gain and reduced hyperglycaemia and amended metabolic abnormalities. These findings suggest a role of variable plasma adiponectin concentrations in the pathophysiology of the healthy obese phenotype. Data from one recent study shows that lack of suppression of adiponectin concentrations is independently associated with the metabolically healthy profile of certain obese individuals (Aguillar-Salinas et al, 2008). Victoria Catherine Pickard 19:57, 31 October 2011 (UTC)

Criticism of Current Data - Does the Healthy Obesity Phenotype Actually Exist?

Investigating whether or not H.O is a genuine phenotype or has this subgroup emerged as a result of methodological/ measurement issues? Are these people healthy and truely obese/ are they obese yet truely healthy?

Conflicting findings of meta-analyses from NEJM and American heart journal etc. the impact of adjusting for physical activity and the role of other parameters. eg. lack of any the metabolic syndrome criteria & no insulin resistance counts as healthy. non metabolic morbidity.

or if that overlaps too much with someone else's section I could cover:

the role of ethnicity: A higher proportion of black healthy obese? Possible underlying mechanism?

Losing weight can be harmful for the healthy obese: (Gaesser 1999)Tijmen van Slageren 18:38, 24 October 2011 (UTC)