Metabolically healthy obesity: the low-hanging fruit in obesity treatment?

被引:229
作者
Stefan, Norbert [1 ,2 ,3 ]
Haering, Hans-Ulrich [1 ,2 ,3 ]
Schulze, Matthias B. [3 ,4 ]
机构
[1] Univ Hosp Tubingen, Dept Internal Med 4, Otfried Muller Str 10, D-72076 Tubingen, Germany
[2] Helmholtz Ctr Munich, Inst Diabet Res & Metab Dis, Tubingen, Germany
[3] German Ctr Diabet Res, Neuherberg, Germany
[4] German Inst Human Nutr Potsdam Rehbrucke, Dept Mol Epidemiol, Nuthetal, Germany
关键词
LIFE-STYLE INTERVENTION; BODY-MASS INDEX; CARDIOVASCULAR-DISEASE OUTCOMES; TYPE-2; DIABETES-MELLITUS; UNHEALTHY NORMAL-WEIGHT; LOW-FAT DIETS; MEDITERRANEAN DIET; RISK-FACTORS; BARIATRIC SURGERY; OVERWEIGHT;
D O I
10.1016/S2213-8587(17)30292-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Obesity increases the risk of several other chronic diseases and, because of its epidemic proportions, has become a major public health problem worldwide. Alarmingly, a lower proportion of adults have tried to lose weight during the past decade than during the mid-1980s to 1990s. The first-line treatment option for obesity is lifestyle intervention. Although this approach can decrease fat mass in the short term, these beneficial effects typically do not persist. If a large amount of weight loss is not an easily achievable goal, other goals that might motivate people with obesity to adopt a healthy lifestyle should be considered. In this setting, the concept of metabolically healthy obesity is useful. Accumulating evidence suggests that, although the risk of all-cause mortality and cardiovascular events might be higher in people with metabolically healthy obesity compared with metabolically healthy people of a normal weight, the risk is substantially lower than in individuals with metabolically unhealthy obesity. Therefore, every person with obesity should be motivated to achieve a normal weight in the long term, but more moderate weight loss sufficient for the transition from metabolically unhealthy obesity to metabolically healthy obesity might also lower the risk of adverse outcomes. However, how much weight needs to be lost for this transition to occur is under debate. This transition might be supported by lifestyle factors-such as the Mediterranean diet-that affect cardiovascular risk, independent of body fat. In this Series paper, we summarise available information about the concept of metabolically healthy obesity, highlight gaps in research, and discuss how this concept can be implemented in clinical care.
引用
收藏
页码:249 / 258
页数:10
相关论文
共 69 条
[41]   Definitions of Metabolic Health and Risk of Future Type 2 Diabetes in BMI Categories: A Systematic Review and Network Meta-analysis [J].
Lotta, Luca A. ;
Abbasi, Ali ;
Sharp, Stephen J. ;
Sahlqvist, Anna-Stina ;
Waterworth, Dawn ;
Brosnan, Julia M. ;
Scott, Robert A. ;
Langenberg, Claudia ;
Wareham, Nicholas J. .
DIABETES CARE, 2015, 38 (11) :2177-2187
[42]   Effects of Moderate and Subsequent Progressive Weight Loss on Metabolic Function and Adipose Tissue Biology in Humans with Obesity [J].
Magkos, Faidon ;
Fraterrigo, Gemma ;
Yoshino, Jun ;
Luecking, Courtney ;
Kirbach, Kyleigh ;
Kelly, Shannon C. ;
de las Fuentes, Lisa ;
He, Songbing ;
Okunade, Adewole L. ;
Patterson, Bruce W. ;
Klein, Samuel .
CELL METABOLISM, 2016, 23 (04) :591-601
[43]   Metabolic health and weight: Understanding metabolically unhealthy normal weight or metabolically healthy obese patients [J].
Mathew, Hannah ;
Farr, Olivia M. ;
Mantzoros, Christos S. .
METABOLISM-CLINICAL AND EXPERIMENTAL, 2016, 65 (01) :73-80
[44]   Heterogeneity in the prevalence of risk factors for cardiovascular disease and type 2 diabetes mellitus in obese individuals - Effect of differences in insulin sensitivity [J].
McLaughlin, Tracey ;
Abbasi, Fahim ;
Lamendola, Cindy ;
Reaven, Gerald .
ARCHIVES OF INTERNAL MEDICINE, 2007, 167 (07) :642-648
[45]   Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease [J].
Meigs, James B. ;
Wilson, Peter W. F. ;
Fox, Caroline S. ;
Vasan, Ramachandran S. ;
Nathan, David M. ;
Sullivan, Lisa M. ;
D'Agostino, Ralph B. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2006, 91 (08) :2906-2912
[46]   Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States [J].
Micha, Renata ;
Penalvo, Jose L. ;
Cudhea, Frederick ;
Imamura, Fumiaki ;
Rehm, Colin D. ;
Mozaffarian, Dariush .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2017, 317 (09) :912-924
[47]  
National Center for Health Statistics, 2016, HLTH US 2015 SPEC FE
[48]   Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors - A meta-analysis of randomized controlled trials [J].
Nordmann, AJ ;
Nordmann, A ;
Briel, M ;
Keller, U ;
Yancy, WS ;
Brehm, BJ ;
Bucher, HC .
ARCHIVES OF INTERNAL MEDICINE, 2006, 166 (03) :285-293
[49]   Metabolically healthy obesity across the life course: epidemiology, determinants, and implications [J].
Phillips, Catherine M. .
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 2017, 1391 (01) :85-100
[50]   Lifestyle Change and Mobility in Obese Adults with Type 2 Diabetes [J].
Rejeski, W. Jack ;
Ip, Edward H. ;
Bertoni, Alain G. ;
Bray, George A. ;
Evans, Gina ;
Gregg, Edward W. ;
Zhang, Qiang .
NEW ENGLAND JOURNAL OF MEDICINE, 2012, 366 (13) :1209-1217