title: Metabolically healthy obese individuals: Key protective factors.
abstract: OBJECTIVE
  Obesity is a significant quality of life-impairing health problem affecting industrialized nations. However, despite carrying a large fat mass, some very obese individuals exhibit normal metabolic profiles (metabolically healthy obesity). The physiological factors underlying their protective and favorable metabolic profiles remain poorly defined.
  
  
  METHODS
  A search of the National Library of Medicine PubMed database was performed using the following keywords: Metabolically healthy obese, metabolically normal obese, insulin resistance, metabolically unhealthy normal weight, and uncomplicated obesity.
  
  
  RESULTS
  This article reviewed factors associated with severe obesity that lacks complications, and suggests putative activities by which these obese individuals avoid developing the clinical features of metabolic syndrome, or the metabolic complications associated with severe obesity.
  
  
  CONCLUSIONS
  Despite the knowledge that visceral fat deposition is the seminal factor that ultimately causes insulin resistance (IR) and the detrimental inflammatory and hormonal profile that contributes to increase risk for cardiovascular disease, it remains unknown whether metabolically healthy obesity (MHO) has genetic predisposing factors, and whether MHO ultimately succumbs to IR and the metabolic syndrome, indicating a need for prophylatic bariatric surgery.
authors.affiliation: Department of Surgery, Positivo University, Curitiba, PR, Brazil 81280 to 330. Surgical Metabolism Laboratory, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil.
authors.forename: Carolina G
authors.initials: CG
authors.lastname: Gonçalves
authors.affiliation: The Nutrition Doctor, Kailua Kona, HI, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Glade
authors.affiliation: Surgical Metabolism and Nutrition Laboratory, Department of Surgery, University Hospital, SUNY Upstate Medical University, Syracuse, NY, USA. Electronic address: meguidm@upstate.edu.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Meguid
mesh_terms: D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D024821:Metabolic Syndrome / Q000209:etiology* / Q000378:metabolism; D009765:Obesity; D000067329:Obesity, Metabolically Benign / Q000150:complications*
keywords: Insulin resistance; Metabolic syndrome; Metabolically healthy obesity; Morbid obesity; Visceral obesity